Naples. - In the dramatic case of the two-year-old boy who underwent a heart transplant in Naples with an organ that was later found to be damaged, "it is very difficult to judge the surgeons' choices," says cardiac surgeon Luigi Chiariello, a former professor at the University of Rome Tor Vergata and known for having operated on Benedict XVI in 2012.
According to the specialist, based on the available information, "the fundamental error appears to have occurred earlier", when a heart "poorly preserved with dry ice instead of normal ice" was sent for transplant.
“The procedure had already begun when the organ arrived.”
Chiariello recalls standard heart transplant protocols: once a heart is removed and sent to the transplant center, the team that will implant it begins the intervention on the recipient to minimize ischemic times.
"It's likely that the baby's chest had already been opened and prepared when the organ arrived," he explains. "If the child had already been operated on, what should we do now? Go back due to concerns about its preservation? Abort the procedure when no alternatives were available?"
The “bridge heart” hypothesis
In an extreme emergency scenario, the decision to implant the organ anyway may have been dictated by the lack of immediate options. "The new heart could have served as a 'bridge' while waiting for another transplant," the cardiac surgeon hypothesizes.
“Given the rapid decision-making process, colleagues may have considered it less dangerous to implant that organ rather than closing the child's chest with no alternative.”
The crux of communication with the family
Chiariello emphasizes, however, that such a choice "had to be explained to the family," clarifying that it was considered the least risky solution under the circumstances. Finding a compatible heart for a pediatric patient is particularly complex: "The donor must be a child who died of other causes, and these cases are extremely rare."
“The surgeons did everything they could”
According to the specialist, the operating team "most likely tried to do the best they could at the time." And it cannot be ruled out that there was even no certainty, in the operating room, that the organ had been preserved incorrectly.
An assessment, Chiariello concludes, which makes it even more complex to attribute immediate responsibility to the surgeons involved in the procedure.
Changes and revisions to this article
- Article updated on 13/02/2026 at 06:37 PM - Title typo corrected
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Comments (1)
It's difficult to understand the child's situation and the doctors' decisions. It's a matter of life and death, and a transplant is always a risk. We hope there will be improvements in transplant protocols in the future.