The Midwest’s first pediatric domino partial heart transplant
Through the ultimate gift of life — and thanks to groundbreaking science and compassionate care — one donor heart saved two children. A team of experts at St. Louis Children’s Hospital and WashU Medicine Heart Center successfully performed the Midwest’s first living pediatric “domino” partial heart transplant, joining an elite group of only eight programs nationwide to perform this rare, lifesaving procedure.
A domino transplant occurs when one donor’s organ is transplanted into a patient, who then becomes a donor for another patient. In this case, the first pediatric patient needed a new heart. Despite damage to the patient’s heart, the heart valves were healthy, which offered an opportunity for another child to benefit. When a donor heart became available, the first patient received a total heart transplant. Surgeons then removed that patient’s fully functioning aortic heart valve and transplanted it into another young patient whose aortic valve was failing.
The highly complex surgery required the skill of more than 20 specialists working in two operating rooms — including WashU Medicine pediatric heart transplant surgeons, cardiologists, cardiac intensivists and anesthesiologists — along with inpatient and operating room nurses, perfusionists, transplant coordinators, child life specialists and other practitioners at St. Louis Children’s.
This isn’t just a surgical triumph — it’s a game-changer for pediatric medicine. Traditional valve replacements do not grow with a patient, meaning children face a lifetime of repeated, high-risk open-heart surgeries. A partial heart transplant — also known as a heart valve transplant — offers a promising alternative, with the expectation that the transplanted valve will grow along with the child, paving the way for a healthier, more active childhood free from constant surgical interventions.
This historic milestone reinforces WashU Medicine and St. Louis Children’s Hospital’s long-standing position at the forefront of pediatric organ transplantation — where together we continue to push the boundaries of what is possible.