World’s First “On-Table Heart Reanimation” Saves Infant’s Life
World’s First “On-Table Heart Reanimation” Saves Infant’s Life
The Duke Study:
Published: July 16, 2025
The New England Journal of Medicine (NEJM)
1. What’s the Traditional Way to Transplant a Heart?
Normally, donor hearts come from brain-dead patients, and doctors quickly transplant them while the heart is still beating.
In some cases, hearts are donated after the heart has stopped beating — this is called Donation after Circulatory Death (DCD). In adults, doctors may restart the heart inside the donor’s body using a method called NRP (normothermic regional perfusion).
But for infants and children, this method often raises ethical concerns and isn’t allowed in many places.
2. What’s the New Method by Duke?
Surgeons at Duke Health created a new, life-saving method for babies:
• They removed a heart from a baby donor after it stopped beating.
• Instead of restarting it inside the donor, they placed it on a surgical table.
• Using a life-support machine called ECMO, they restarted the heart outside the body — this is called on-table heart reanimation.
• They checked if the heart was working well.
• Then they transplanted it into a 3-month-old infant.
Result: After 3 months, the baby was doing well with no signs of rejection.
3. Why It Matters
• This method offers a new option for babies who need a heart transplant, especially where NRP is not allowed.
• It could increase the number of infants who can receive a donated heart.
4. A Second Innovation from Vanderbilt
At Vanderbilt University Medical Center, doctors developed another method to preserve donor hearts:
• They used cold oxygenated fluid to keep the heart healthy for up to 8 hours after removal.
• This may make heart transplants more accessible around the world — especially for DCD donors.
Final Takeaway
These two breakthroughs — from Duke and Vanderbilt — could change the future of heart transplantation, giving hope to more babies and patients in need.
DOI: 10.1056/NEJMoa2500456
