Partial heart transplant valves demonstrate growth in piglets despite prolonged cold storage.
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2025-10
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Abstract
Background
Traditional heart valve replacement options lack growth potential, limiting their long-term effectiveness in pediatric patients. Partial heart transplantation is an emerging approach that offers growth-capable valves by transplanting only the valve-containing segment of the heart. We report on the effects of extended cold storage on the viability and growth potential of partial heart transplantation grafts.Methods
Pulmonary and aortic conduits were harvested from piglets and human donors and stored at 4°C in cold-storage solution, with some samples supplemented with apoptosis inhibitors, membrane stabilizers, and antibiotics to optimize cellular viability. Viability was assessed in vitro over 7 days using the MTS assay. A piglet model of pulmonary valve replacement was used to assess in vivo growth potential after 1 week of cold storage.Results
In vitro analysis showed a gradual decline in metabolic activity over 7 days, with approximately 50% viability retained in both porcine and human valves. Supplementation with apoptosis inhibitors and membrane stabilizers did not significantly enhance viability. In vivo, transplanted conduits demonstrated robust leaflet and annular growth without significant stenosis or regurgitation, confirming the maintenance of growth potential despite reduced viability.Conclusions
Partial heart transplantation grafts can be preserved in cold storage for up to 1 week without significantly compromising in vivo growth potential. These findings support the feasibility of partial heart transplantation as a viable growth-capable valve replacement option for children and suggest that optimized cold storage protocols could facilitate broader access to this technique.Type
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Publication Info
Aykut, Berk, Hiba Ghandour, Michael Mensah-Mamfo, Smith M Ngeve, Tatum Baldwin, Cathlyn K Medina, John A Kucera, Seth E Wolf, et al. (2025). Partial heart transplant valves demonstrate growth in piglets despite prolonged cold storage. The Journal of thoracic and cardiovascular surgery, 170(4). pp. 1119–1124.e1. 10.1016/j.jtcvs.2025.03.018 Retrieved from https://hdl.handle.net/10161/33801.
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Scholars@Duke
Berk Aykut
College/University: Ruprecht Karl University of Heidelberg
Medical School: Ruprecht Karl University of Heidelberg
Stephen Gary Miller
Fetal echocardiography, fetal cardiac imaging, prenatal diagnosis.
Echocardiography and other imaging modalities in the diagnosis, assessment and treatment of congenital heart disease.
Intracardiac echocardiography.
Joseph W Turek
Joseph W. Turek, MD, PhD, MBA is an academic pediatric cardiac surgeon at Duke University in Durham, North Carolina. Since 2017, Dr. Turek has served as chief of pediatric cardiac surgery. Prior to Duke, he served in a similar leadership role at the University of Iowa Stead Family Children’s Hospital from 2012-2017.
Dr. Turek attended the Illinois Mathematics and Science Academy for secondary education. He then graduated from Northwestern University with a degree in biochemistry and received his MD/PhD (pharmacology) from the University of Illinois in Chicago with Alpha Omega Alpha distinction. He completed his general surgery education at Duke University, where he also finished a cardiothoracic surgery residency. During this time, he served as a visiting congenital heart surgery fellow at Texas Children’s Hospital. Dr. Turek completed a congenital cardiac surgery fellowship at the Children’s Hospital of Philadelphia in 2011. He received his MBA with a concentration in Health Sector Management from Duke’s Fuqua School of Business in 2020.
Board certified in general surgery, thoracic surgery and congenital cardiac surgery, Dr. Turek has been one of the foremost innovators of the last decade in congenital heart surgery, developing novel operations, modifying techniques and introducing new products and procedures to children and adults with congenital cardiac disease. Most notably, he performed the world’s first co-transplant of a heart and cultured thymus tissue, in an operation that could usher in an era in which solid organ transplant recipients can develop tolerance to their newly transplanted organ, recognizing them as “self”. In another highly innovative operation, he performed the world’s first partial heart transplant for a newborn without functioning aortic or pulmonary valves, maintaining growth capacity of the newly implanted valves. Additionally, he led the team at Duke in completing the nation’s first pediatric donation after circulatory death heart transplant with ex vivo reanimation and with normothermic regional perfusion, as a means to expand the already limited donor pool of available organs. His clinical passion and expertise lies in high complexity neonatal heart surgery.
Academically, Dr. Turek has published over 200 peer-reviewed manuscripts and numerous book chapters. He maintains an active and well-funded research laboratory with projects spanning from basic science to translational to clinical research, in areas such as heart transplant tolerance with thymus-heart co-transplant, partial heart transplantation, xenotransplantation, Marfan syndrome, and the role of alpha-gal sensitization in biologic valve degradation. He maintains active leadership roles in national and international cardiothoracic surgery societies.
Douglas Overbey
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