Interdisciplinary Care Team Performs First-Ever Infant Domino Partial Heart Transplant – Advances in Cardiology, Pediatrics, and Transplantation

Recovery and future impacts

Mia's heart transplant and Brooklyn's partial heart transplant went smoothly. Both patients have been discharged from the hospital and are doing well since their surgery. “Babies usually recover very well after a transplant,” says Dr. Richmond. [Mia] “She will reach all of the developmental milestones of a baby and then shortly thereafter be able to do all the toddler and preschool things we want her to do, with very few limitations on her future life. Brooklyn's heart function is already better than it was before her surgery; both valves are functioning normally with no issues. We are hopeful that she will recover, thrive, and do all the normal things we want her to do.”

For the doctors, it's a case they'll never forget. “Any time you do something for the first time, you understand the risks before you embark on this new endeavor and understand the impact it will have on the families and the children you care for,” says Dr. Richmond. “Seeing how quickly these two infants recovered and how grateful their families were motivates us to keep pushing the boundaries and offering these new technologies.”

“It's really exciting to be involved in this work,” Dr. Goldstone says, “and while the day-to-day work can be stressful, experiences like this are completely restorative and remind me why I became a doctor.”

Domino partial heart transplant success at NewYork-Presbyterian HospitalColumbia holds a lot of implications for the future, including the potential to save many more lives. “In transplant medicine, we're always looking for ways to increase the donor pool and find donors in new ways. We call it the gift of life,” Dr. Richmond says. “One of the things we've really thought about when doing this procedure is that one donor, one gift of life from one donor, can help two children. We're already talking about how best to make these serendipitous moments happen more often.”

New York Presbyterian/The Columbia Pediatric Heart Failure team is working to identify and strategize among patients on the hospital's heart transplant waiting list who could become living heart donors for other patients, like Mia, who need valve replacements. The goal is to create a system to match available bioprosthetic valves with recipients so that when donor hearts become available, surgical teams can be quickly mobilized to perform additional domino partial heart transplants.

To help expand the use of living donor partial heart transplants, Dr. Kalfa says he's in touch with other physicians who have performed these procedures to discuss cases and learn from each other. “We're looking at creating a consortium and registry to collect all the data from patients who have undergone this new procedure across the country,” he says. “Locally, we're working to systematically organize our partial heart transplant program to streamline donor and recipient identification so that this new procedure can benefit the greatest number of children and make the greatest impact on their lives.”

Dr. Kalfa is a member of the NewYork-Presbyterian/Columbia's procedure is one of a kind. “At NewYork-Presbyterian, we were able to perform this groundbreaking, disruptive procedure because we bring together all of the expertise necessary for this type of surgery,” he said. “Working at a world-class institution with a team that has complementary expertise and is willing to innovate to achieve the best possible outcomes for patients made this historic procedure possible. It was an honor and a privilege for me to be a part of this procedure.”