Though his valves worked perfectly, Asher Hobby needed a whole new heart. Duke surgeons realized his case was an opportunity to save two lives. The world’s first partial heart transplant performed at Duke Health in 2022 now inspired a new procedure. Asher would be both a recipient and donor in North Carolina’s first domino heart transplant.

A new heart for Asher would mean healthy valves for another baby.

Duke Health pioneered the world’s first partial heart transplant and has built upon that innovation through the domino heart transplant. The partial heart transplant allows providers to save and use functional valves from a deceased donor heart with poor muscle tissue. Previously, a heart with poor muscle tissue would’ve been seen as unusable. This innovation allows providers to save the lives of more people in need of a heart transplant by making more efficient use of the precious gift of organ donation.

The domino heart transplant builds upon this innovation using those lessons. It happens when a person receives a full heart transplant due to a weak heart muscle, despite having strong valves. The patient’s original valves can then be used to help a second person in need. Duke Health performed the first such surgical chain in NC on a child whose family decided to pay that life-saving gift forward when they donated his original valves to another, allowing one heart to save two lives.