Living Heart Valves Show Promise Across Multiple Pediatric Conditions
New study reveals expanding applications for partial heart transplant
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DURHAM, N.C. – A procedure which uses living heart valves may have expanded application as a treatment for various types of pediatric heart valve conditions.
The research was led by pediatric heart specialists at Duke Health. It looked at 19 children with various heart conditions who received a partial heart transplant, a procedure which uses living valves from donor hearts.
The study published in Journal of the American Medical Association on August 27. It found the partial heart transplant series resulted in valves that worked across different diagnoses and grew over time, matching the child’s development.
“This study shows that partial heart transplantation is not just a one-time success – it’s a versatile option that can be used across a range of heart conditions,” said Joseph Turek, M.D., Ph.D., corresponding author of the study and chief of pediatric cardiac surgery at Duke Health.
“We’re seeing valves that grow, function well, and require less immunosuppressant medication than a full heart transplant,” Turek said, “That’s a huge win for these kids and their families.”
The research builds on Duke Health’s pioneering work in partial heart transplantation. Duke performed the world’s first partial heart transplant in 2022 and later achieved another milestone with the world’s first living mitral valve replacement.
For this study, researchers followed 19 patients who received partial heart transplants at Duke between April 2022 and December 2024. The children ranged in age from newborns to teens and had a variety of heart conditions, including truncus arteriosus, Tetralogy of Fallot, and other diagnoses.
The team measured valve growth using ultrasound and found the valves in all 19 cases maintained healthy function with no patients needing a reoperation due to valve failure.
In one remarkable case, a child had to stop taking anti-rejection medication altogether (due to an unrelated infection) and the valve continued to grow and function normally.
“This case gives us hope that some children may not need lifelong immunosuppression,” said Douglas Overbey, M.D., study author and assistant professor in the Department of Surgery at the Duke University School of Medicine.
“That’s important because these medications can cause serious side effects over time,” Overbey said. “If we can reduce or even eliminate the need for them, it’s a major step forward.”
Partial heart transplant is still a new approach. Researchers say more studies are needed to understand its long-term effects, but the early results are encouraging.
In addition to Turek and Overbey, study authors include Berk Aykut, John Kucera, Cathlyn Medina, Neeta Sethi, Piers Barker, and Erin Shea.
Preclinical research was funded by the Brett Boyer Foundation and the Graeme McDaniel Foundation.