Overview
The Duke Congenital Heart Surgery Research and Training Laboratory (CHSRTL) explores basic, translational, clinical, and global projects related to challenges in congenital heart disease. Much of the basic and translational work in the laboratory focuses on transplant immunology pertaining to pediatric and congenital heart diseases. Specifically, investigative efforts include: thymus-heart co-transplant for tolerance development, partial heart transplantation, early heart valve degradation with alpha gal sensitization, ex vivo and normothermic regional perfusion cardiac reanimation in donation after circulatory death heart transplantation, partial and full heart xenotransplantation.
The CHSRTL exists in a dynamic interplay with clinical surgical advancement, wherein benchtop investigations have led to transformative clinical innovations that then inform future benchtop studies. Most notably, work from this laboratory led to our team performing the world’s first co-transplant of a heart and cultured thymus tissue, in an operation that could usher in an era in which solid organ transplant recipients can develop tolerance to their newly transplanted organ, recognizing them as “self”. In another highly innovative operation, our center performed the world’s first partial heart transplant for a newborn without functioning aortic or pulmonary valves, maintaining growth capacity of the newly implanted valves. Additionally, our Duke team completed the nation’s first pediatric donation after circulatory death heart transplant with ex vivo reanimation and then did the same with in situ reanimation, as a means to expand the already limited donor pool of available organs.
The laboratory also supports a growing program in global pediatric cardiac surgery, focused on developing sustainable, locally led systems of care for children with congenital heart disease in resource-constrained settings. Thorugh long-term partnerships in Guyana, Honduras, and Ghana, our team combines clinical collaboration, education, workforce development, quality improvement, and outcomes research to strengthen pediatric cardiac programs beyond individual surgical missions. This work is conducted in partnership with Gift of Life International (GOLI), whose model emphasizes empowering local healthcare teams to care for children within their own countries.
Contact Us
Interested in collaborating with us or learning more about our lab?
E-mail: chsrtl@duke.edu
Twitter: @Duke_CHSRTL
Lab Members
Resident Alumni
Current and Former Students
Current Students
- Gunjan Agarwal
- William Boone
- Natasha Anders
- Samuel Bohlen
- Lauren Parker
- Haoran Jiang
- Sydney Jeffs
- Lindsey Reynolds
- Danielle Pitchon
- Akosua Odei
Former Students
- Vivan Brennan
- Michael Mensah-Mamfo
- John Kyle Cook
- Cathlyn Medina
Collaborators
Translational Research Projects
Our heart-thymus research program investigates whether transplantation of donor thymic tissue alongside a heart can promote donor-specific immune tolerance and fundamentally change the way pediatric organ transplantation is approached. Building on the laboratory's work that contributed to the world's first heart and cultured-thymus co-transplant, our studies examine the development and durability of immune tolerance, thymic function, donor-specific immune responses, and the potential to reduce dependence on lifelong immunosuppression. This work spans mechanistic studies of immune reconstruction through translational large-animal models, with the ultimate goal of making organ transplantation safer and more durable for children.
Bioprosthetic heart valves are widely used in congenital and adult cardiac surgery, but their durability is limited, particularly in younger patients. Our laboratory investigates whether immune sensitization to the carbohydrate antigen alpha-gal contributes to inflammation, calcification, and premature degeneration of porcine-derived bioprosthetic valve tissue. Using translational models of alpha-gal sensitization, we study antibody responses, immune-cell infiltration, tissue injury, and structural valve changes over time. By defining the immunologic mechanisms that drive bioprosthetic valve failure, this work seeks to identify strategies for improving valve durability and informing the development of next-generation biologic valve materials.
Xenotransplantation offers the possibility of overcoming one of the central limitations of transplantation: the scarcity of suitable human donor tissue. Our laboratory is developing large-animal models of partial heart xenotransplantation. These studies examine surgical feasibility, graft function and growth, immunologic compatibility, rejection, and the immunosuppressive strategies required to support durable xenograft survival. The program brings together advances in genetic engineering, transplant immunology, and partial heart transplantation to explore whether living porcine cardiac tissue could someday provide an expandable source of growing valve-containing grafts for children with congenital heart disease.
Partial heart transplantation introduces a new paradigm in valve replacement by transplanting living donor heart tissue that retains the capacity for growth, repair, and biologic adaptation. Following the clinical development of the world's first partial heart transplant, our laboratory studies what happens to these grafts after implantation at the cellular, tissue, and immunologic levels. Areas of investigation include graft cellularization and repopulation, endothelial and interstitial cell biology, extracellular matrix remodeling, immune-cell infiltration, growth and structural adaptation, and the mechanisms underlying graft dysfunction or failure. By defining how partial heart transplant tissue changes over time, we aim to understand what makes living grafts durable, and how their performance can be further improved.
Global Research
The Duke Congenital Heart Surgery Research and Training Laboratory’s global pediatric cardiac surgery program works alongside partner institutions and non-profit organizations to build sustainable systems capable of diagnosing, treating, and caring for children with congenital heart disease within their own communities. Our work centers on long-term institutional partnerships, bidirectional education, workforce development, clinical mentorship, quality improvement, research, and progressive transfer of responsibility to local teams.
Our global work complements the laboratory’s broader mission of translating innovation into meaningful improvements in the care of children with congenital heart disease.
Successful pediatric cardiac surgery requires far more than an operating room. It requires an interconnected system of pediatric cardiologists, surgeons, anesthesiologists, intensivists, perfusionists, nurses, imaging specialists, administrators, and many others working together.
For that reason, our global program emphasizes:
- longitudinal partnerships rather than isolated visits;
- multidisciplinary education and mentorship;
- development of local clinical and surgical leadership;
- standardized clinical pathways and quality improvement;
- collaborative research and outcomes measurement;
- bidirectional exchange between Duke and partner institutions; and
- progressive development of independent, locally led pediatric cardiac programs.
Ghana
Our work in Ghana supports efforts to expand sustainable pediatric cardiac surgical capacity through clinical partnership, education, mentorship, and multidisciplinary team development. Visiting teams work side-by-side with Gift of Life International and local clinicians while emphasizing the systems required to safely care for children before, during, and after cardiac surgery.
Guyana
Our partnership in Guyana focuses on the development of sustainable pediatric cardiac care in Georgetown. Duke clinicians work alongside Gift of Life International and Guyanese physicians, nurses, perfusionists, and other healthcare professionals through recurring clinical visits, education, mentorship, and collaborative program development.
The partnership is designed to expand local capacity across the entire continuum of congenital heart care, from diagnosis and preoperative evaluation through cardiac surgery, catheter-based intervention, intensive care, and long-term follow-up.
Honduras
In Honduras, our team works with local clinicians to strengthen pediatric cardiac services through longitudinal clinical collaboration and intensive training. The partnership extends beyond operative care to include pediatric cardiology, cardiac intensive care, perfusion, nursing, surgical education, and systems development.
An important component of this work is bidirectional training: Duke teams travel to Honduras to work alongside local clinicians, while members of the Honduran pediatric cardiac team also participate in educational and observational experiences at Duke. GOLI continues to support pediatric cardiac training activities in Honduras as part of its international network.
Get Involved
Our global pediatric cardiac partnerships depend on participation from physicians, nurses, perfusionists, trainees, researchers, educators, and other professionals who are committed to building sustainable systems of care.
Opportunities may include participation in multidisciplinary training visits, educational initiatives, collaborative research, curriculum development, visiting-team support, and mentorship of partner clinicians.
Support the Program
Philanthropic support allows us to extend the reach and sustainability of these partnerships. Donations can help support clinical training visits, travel for partner clinicians to train at Duke, educational programming, equipment and supplies, research and quality-improvement initiatives, and the development of the local infrastructure necessary for durable pediatric cardiac programs.
In the News
Duke Surgery Hosts Pediatric Cardiac Team From Honduras (9/16/2026)
Joseph Turek, MD, Named to Time's 2026 TIME100 Health (2/13/2026)
Duke Today: More Kids Could Receive a Heart Procedure Pioneered at Duke Health (8/29/25)
Duke Health: Duke Health Performs the World’s First Living Mitral Valve Replacement (2/27/25)
Duke Med School: Saving More Babies Through Innovation in Pediatric Heart Surgery (2/13/24)
Duke Health: Duke Performs Pediatric Domino Partial Heart Transplant (2/6/24)
CNN: Groundbreaking procedure allows heart repairs to grow with children, new study shows (1/9/24)
ABC News: Baby boy thriving 1 year after ‘world’s first partial heart transplant’ (1/3/24)
Good Morning America: Baby boy thriving 1 year after ‘world’s first partial heart transplant’ (1/3/24)
Duke Health: World's First Partial Heart Transplant Proves Successful in First Year (1/2/24)
Today Show: 1st ever partial heart transplant saves 5-month-old: ‘Revolutionary’ for other kids (8/2/22)
CBS News Features Pioneering Duke Heart-Thymus Transplant in Infant (4/27/22)
ABC News: Baby gets first-of-its kind heart transplant to help fight rejection (3/11/22)
Good Morning America: Baby gets first-of-its kind heart transplant to help fight rejection (3/11/22)
Duke Today: Baby Receives World's First Combination Heart Transplant-Thymus Procedure (3/7/22)