Cardiology in the young
October 19, 2026 · via Europe PMC
Partial heart transplantation in resource-limited settings: challenges and feasibility.
Lee DS, Rajab TK.
AI summary — for doctors, generated from the abstract only
Partial heart transplantation for children could be feasible in resource-limited settings, starting at established middle-income cardiac surgery centres.
What was studied
Narrative literature review and feasibility mapping of partial heart transplantation requirements against cardiac surgical capacity in low- and middle-income countries.
Key findings
- Favorable features include longer tolerated graft ischaemia, tacrolimus monotherapy and use of valves from hearts unsuitable for whole-heart transplant
- Barriers include limited organ procurement infrastructure, no equitable allocation frameworks, restricted drug monitoring and high loss to follow-up
- A phased approach using international partnerships and generic immunosuppression is proposed
Clinical relevance
Offers a possible growth-capable valve option for children with rheumatic and other valve disease where current replacements are poor.
Who should care
Limitations
Conceptual feasibility analysis, not a clinical study; it rests on limited published partial-transplant outcomes.
Treat this as a planning roadmap; consider partnership-based pilot programmes at capable centres.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Introduction
Partial heart transplantation provides living, growth-capable valve implants for paediatric recipients. The feasibility and challenges of implementing partial heart transplantation in resource-limited settings are evaluated, where the burden of valvular heart disease is greatest and paediatric valve replacement options remain severely limited.
Methods
A comprehensive search was conducted examining partial heart transplantation clinical outcomes, organ procurement logistics, immunosuppression requirements, and the infrastructure landscape for cardiac surgery in low-and middle-income countries. A feasibility framework was developed by mapping partial heart transplantation-specific requirements against existing low-and middle-income country cardiac surgical capacity.
Results
Compared to orthotopic heart transplantation, several features of partial heart transplantation are inherently favourable for low-and middle-income country adaptation: it allows for longer graft ischaemia times, requires only tacrolimus monotherapy, and can source valves from hearts unsuitable for orthotopic heart transplantation. However, significant barriers persist, including limited organ procurement infrastructure, absence of regulatory frameworks for equitable donor-recipient matching, restricted access to therapeutic drug monitoring, and high rates of loss to follow-up.
Conclusions
Implementation of partial heart transplantation in resource-limited settings is feasible at established middle-income country cardiac surgery centres with transplant capability. A phased strategy leveraging international partnerships, existing infrastructure, and generic immunosuppression offers a realistic pathway to bringing this innovation to the children who need it most.
DOI
10.1017/s1047951126124573
PMID
42894974
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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