KFSH Treats Two Children Using One Donor Heart in First-of-Its-Kind Procedure in the Middle East and Europe

King Faisal Specialist Hospital and Research Centre (KFSH) has successfully treated two children using a single donor heart in the first paediatric domino heart transplant of its kind in the Middle East and Europe. The donor heart was transplanted into a child with end-stage heart failure, while the healthy pulmonary valve and root from his explanted heart were used to treat a second child, extending the benefit of a single donated heart to two patients.

Known as domino heart transplantation, the procedure uses healthy tissue from the explanted heart of a transplant recipient to treat another patient, maximising the therapeutic value of each donated organ.The first patient, a 12-year-old boy with dilated cardiomyopathy and end-stage heart failure, had spent approximately six weeks in hospital receiving continuous medication to support his heart while awaiting transplantation. Although he required a complete heart transplant, his pulmonary valve and root remained healthy and suitable for transplantation.

At the same time, a nine-year-old boy with severe aortic stenosis and regurgitation underwent a complex Ross procedure, having previously undergone two procedures to repair the affected valve. During the operation, the second child’s healthy pulmonary valve was moved to the aortic position to replace the damaged valve, while the vacated pulmonary position was reconstructed using the pulmonary valve and root taken from the first child’s explanted heart.

The first child therefore became both a heart recipient and a source of viable cardiac tissue for the second patient, enabling one donor heart to benefit two children through a carefully coordinated sequence of procedures. Because the transplanted valve is living tissue, it has the potential to grow with the child, which may reduce the need for repeated valve replacement surgery as the patient develops, unlike conventional prosthetic valves, which remain fixed in size. Dr Hani Alsergani, Executive Director of the Heart Centre of Excellence at KFSH, said: “This is one of the rarest forms of partial heart transplantation in children and places KFSH among a select group of centres worldwide capable of performing it, building on the hospital’s expertise in heart transplantation and complex congenital cardiac surgery.”

The achievement required the simultaneous coordination of two complex operations and close collaboration among specialists in heart transplantation, paediatric and congenital cardiac surgery, paediatric cardiology, heart failure, cardiac imaging, anaesthesia and critical care, supported by perfusion, nursing and transplant coordination teams. It also relied on the hospital’s ability to assess, preserve and prepare viable cardiac tissue for transplantation.

King Faisal Specialist Hospital and Research Centre has been ranked first in the Middle East and Africa and 12th globally among the world’s top 250 academic medical centers for 2026. It was also recognized as the most valuable healthcare brand in the Kingdom and the Middle East for 2026, according to Brand Finance, and listed by Newsweek among the World’s Best Hospitals, World’s Best Smart Hospitals, and World’s Best Specialized Hospitals for 2026.