RIYADH: King Faisal Specialist Hospital and Research Centre has successfully treated two children using a single donor heart in what it described as the first pediatric domino heart transplant of its kind in the Middle East and Europe, SPA reported. The donor heart was transplanted into a 12-year-old boy 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, maximizing the therapeutic value of each donated organ. The first patient, who had dilated cardiomyopathy and end-stage heart failure, had spent about six weeks in the 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. He had 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. The vacated pulmonary position was then reconstructed using the pulmonary valve and root taken from the first child’s explanted heart. The first child therefore became both a heart transplant 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. This 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 the procedure was one of the rarest forms of partial heart transplantation in children and placed the hospital among a select group of centers worldwide capable of performing it. Alsergani said the achievement builds on KFSH’s expertise in heart transplantation and complex congenital cardiac surgery. SPA reported that the procedure required simultaneous coordination of two complex operations and close collaboration among specialists in heart transplantation, pediatric and congenital cardiac surgery, pediatric cardiology, heart failure, cardiac imaging, anesthesia and critical care. The operation was also supported by perfusion, nursing and transplant coordination teams and relied on the hospital’s ability to assess, preserve and prepare viable cardiac tissue for transplantation. KFSH was 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 by Brand Finance as the most valuable health care brand in Saudi Arabia and the Middle East for 2026. The hospital was also listed by Newsweek among the World’s Best Hospitals, World’s Best Smart Hospitals and World’s Best Specialized Hospitals for 2026.