Sissy Keasling Needed a New Heart at 9, and Vanderbilt Made Her the First U.S. Child to Get a Donor Heart Recovered With a Method That Keeps It Going 10 Hours

A donor heart recovered the traditional way stays usable for only about four to five hours before its function starts to slip. That narrow window shaped the odds for Aleah “Sissy” Keasling, a 9-year-old from Newport, Tennessee, whose heart was failing. On Jan. 3, surgeons at Vanderbilt’s Monroe Carell Jr. Children’s Hospital gave her a heart recovered with a newer method that has kept donor hearts working normally after 10 hours, making her the first child in the country to receive a heart procured that way, Vanderbilt Health announced on Oct. 7.

A Weak Heart Since Infancy

Sissy was diagnosed as a baby with dilated cardiomyopathy, a genetic disease that weakens the heart muscle over time, according to Vanderbilt. In dilated cardiomyopathy, the heart’s lower chambers become enlarged and weakened and do not pump well, so the heart has to work harder to move blood through the body, the National Heart, Lung, and Blood Institute explains.

She also has autism and chromosome 1p36 deletion syndrome, a rare genetic disorder that Vanderbilt says is linked to heart disease and developmental delays. The condition is caused by a missing segment of genetic material on chromosome 1 and is estimated to affect about 1 in 5,000 newborns a year in the United States, according to MedlinePlus Genetics.

Her heart got worse as she grew. By early 2025, episodes in which her skin turned blue showed that her heart was failing. Her mother, Tiffany Keasling, at first thought Sissy had the flu or a cold because she stopped eating. The family later learned that was an early sign of heart failure.

Doctors at Vanderbilt said her medical and developmental needs made the usual road to transplant especially hard. That road often involves months in the hospital on mechanical support while a child waits for a match.

The Call to Newport on Jan. 3

In January 2026, the family agreed to a second repair of a heart valve, knowing it might not work. Then, on Jan. 3, while they were at home in Newport, the phone rang with the offer of a donor heart.

Tiffany Keasling has described breaking down in tears when she was told a heart was available. The family left for Nashville immediately. Around 10 p.m. that night, Sissy went into the operating room. The transplant went well, and her parents saw her the next morning.

She spent three weeks recovering in the hospital, then stayed in local housing near Vanderbilt for follow-up care. About two weeks after the transplant, she turned 10.

Asked what the new heart meant to the family, her father, Michael Keasling, answered with one word: “Everything.”

How Vanderbilt’s REUP Method Works

The heart Sissy received came from a donor after circulatory death, meaning the donor’s heart had stopped before recovery. Those hearts have traditionally been harder to use.

Vanderbilt’s adult heart transplant team developed a technique called rapid recovery with extended ultraoxygenated preservation, or REUP. Instead of restarting the donor heart inside or outside the body, the team flushes the newly recovered heart with oxygenated blood and a del Nido cardioplegia solution for 18 to 20 minutes, Vanderbilt said. Surgeon Dr. Ziv Beckerman, the hospital’s surgical director of pediatric heart transplantation, said hearts preserved with the approach have shown normal function after 10 hours.

The adult team began using REUP in November 2024 and had used it in 20 transplants by July 2025, Vanderbilt reported at the time, with first results published in The New England Journal of Medicine. A follow-up study of 24 adult recipients, published in JAMA, found that only one developed severe primary graft dysfunction requiring temporary life support, according to Vanderbilt. The authors said more study is needed to compare REUP with other recovery methods.

Dr. Aaron Williams, the adult transplant surgeon who recovered Sissy’s donor heart with cardiothoracic surgery fellow Dr. Kevin McGann, said the adult team has now performed more than 130 REUP recoveries.

Why More Usable Hearts Matter for Children

Dr. Carlos Mery, chief of pediatric cardiac surgery, and Dr. Larry Markham, chief of pediatric cardiology, called Sissy’s transplant a milestone that could enlarge the pool of donor organs and shorten waits. Beckerman put the problem plainly, saying the main obstacle is donor availability and that there are not enough hearts for children.

More than 2,000 children are on the transplant waitlist each year, according to Vanderbilt. Nationally, about 109,817 people of all ages were on the organ transplant waiting list as of July 30, 2026, someone is added every 7 minutes, and 12 people die each day while waiting, federal data show.

Monroe Carell surgeons have done 10 pediatric heart transplants using REUP this year, out of 12 heart transplants overall. Dr. Ashish Shah, chair of cardiac surgery, said the Vanderbilt method solves a problem once thought impossible: using hearts from donors after circulatory death in the smallest and sickest patients.

Sissy at 10, Laughing and Riding a Pink Golf Cart

Dr. Caroline West, the pediatric cardiologist who treated Sissy before and after the transplant, said her prognosis is excellent and that she is thriving.

Her parents say the change is easy to see. Sissy now sits upright, is alert, laughs often and has more energy, and her appetite has come back. They said she recovered faster from the transplant than she did from her earlier valve repair.

Once she was cleared from her post-transplant restrictions, the family took her to an aquarium. She also rides a pink golf cart from Make-A-Wish that plays country music. Her parents told Vanderbilt their biggest worry now is keeping up with her.

Families following other children with rare conditions may remember Eliza O’Neill, whose parents raised $2 million to fund a gene therapy for her rare disease. For the Keaslings, the breakthrough came in the form of a few extra hours on a donor heart’s clock.

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This article was produced with AI assistance and edited for accuracy against the sources linked above.

Image: SenatorDF – CC BY-SA 3.0/Wikimedia Commons