Historic Medical Milestone: World’s Youngest Domino Liver Transplant Performed by Children’s Healthcare of Atlanta

On October 6, 2025, surgeons at Children’s Healthcare of Atlanta achieved a historic medical milestone by performing what is believed to be the world’s youngest domino liver transplant. This groundbreaking procedure, involving two pediatric patients aged 2 and 1, spanned a complex 24-hour operation that could revolutionize pediatric transplant medicine.

In this innovative procedure, Patient A, a 2-year-old, received a donor liver to correct a rare metabolic genetic disorder that prevents proper protein processing. The child’s original liver was then transplanted into Patient B, a 1-year-old, who suffered from a potentially fatal liver disease. Because Patient B doesn’t have the genetic defect, the transplanted liver functions normally.

The operation was led by Dr. Bhargava Mullapudi, surgical director of abdominal transplant, and Dr. Richard Hendrickson, pediatric surgeon. Both physicians are among the few in the country dually-trained in pediatric surgery and transplant surgery with specialization in complex procedures.

Domino liver transplants are extremely rare. Between 1996 and 2020, only approximately 185 were performed in the U.S. This procedure expands the liver donor pool for patients awaiting transplantation, potentially shortening wait times and saving more lives.

Both patients are expected to live healthy lives free of liver disease, though they will require anti-rejection medications.

Source: Children’s Healthcare of Atlanta Newsroom