Surgeons at Baylor St. Luke’s Medical Center have completed what they report as the first fully robotic heart transplant in an adult patient in the United States.

The team, led by Dr. Kenneth Liao, used a robotic-assisted approach to remove and implant a donor heart without opening the chest or cutting the breastbone. Instead, the transplant was performed through the preperitoneal space using small incisions.

“Opening the chest and spreading the breastbone can affect wound healing and delay rehabilitation and prolong the patient’s recovery, especially in heart transplant patients who take immunosuppressants,” said Liao, who also serves as professor and chief of cardiothoracic transplantation and circulatory support at Baylor College of Medicine. “With the robotic approach, we preserve the integrity of the chest wall, which reduces the risk of infection and helps with early mobility, respiratory function and overall recovery.”
In addition to avoiding the risks associated with traditional sternotomy, the approach may reduce bleeding and lessen the need for blood transfusions. This can help limit the development of antibodies that could complicate transplant outcomes.

The 45-year-old patient had been hospitalized with end-stage heart failure since November 2024 and was reliant on mechanical circulatory support before receiving a transplant in March 2025. According to the hospital, the patient was discharged about a month after surgery without complications.

Dr. Todd Rosengart, chair of the Michael E. DeBakey Department of Surgery at Baylor, called the procedure a “remarkable, giant step forward.” Hospital president Dr. Bradley T. Lembcke said the achievement enhances the institution’s standing in advanced cardiovascular care.

Baylor St. Luke’s Medical Center and Baylor College of Medicine are both based in Houston, Texas.

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