Allogeneic Mitral Valve Transplant: Historical Precedent, Current Considerations, and Future Implementation

Living allogeneic heart valve transplant (HVT) first emerged in 2022, featuring the unique advantage of being a valve capable of growth and self-repair over time, thus reducing the number of reoperations required in children undergoing valve intervention. This article summarizes the historical precedent for the use of growth-capable HVT, strategies for success, including the importance of preserving and implanting donor papillary musculature, and the reasons for long-term failure. Future research will focus on investigating the relationship between HVTs and donor-recipient size matching; acceptable warm and cold ischemic times, especially when papillary musculature is preserved; immunosuppression requirements; and the validation of current implantation protocols.