Partial Heart Transplantation Promotes Organ Stewardship: Domino Hearts and Split Roots

BACKGROUND Partial heart transplantation (PHT) has emerged as a pioneering approach for treating infants with irreparable heart valve dysfunction. However, the scarcity of suitable donors presents a significant bottleneck to its widespread application. This study introduces and evaluates the novel use of domino and split root procedures within PHT. METHODS We describe six pediatric cardiac patients who underwent either domino or split root PHT at our institution. RESULTS From May to August of 2023, our team successfully executed three domino and three split root PHTs, including one procedure that involved interinstitutional collaboration. These cases highlight the procedural feasibility and the potential for broader application. CONCLUSIONS The implementation of PHT represents a significant advance in pediatric heart care. Domino and split root techniques within the PHT framework have the potential to substantially increase both donor availability and recipient capacity. These strategies usher in a new era of organ stewardship through addressing the challenge of donor organ shortage.