An extracorporeal artificial heart could have saved Domenico, a two-and-a-half-year-old boy from Italy, who passed away at the Monaldi Hospital in Naples. The death occurred following a heart transplant operation, which was found to be 'damaged' last December. According to the report, he could have qualified for a new procedure with over 70% chance of success.
The data is contained in a six-hundred-page report presented on Thursday by three experts appointed by the Prosecutor's Office: Biagio Solarino, Ugolino Livi, and Ferdinando Luca Lorini. This document will be discussed in the coming days, November 12 and 13, as part of the investigation into the death of Domenico Caliendo, which happened on February 21.
The report established that if the boy had been connected to an extracorporeal artificial heart and undergone a new transplant, his survival rate in the medium and long term would have exceeded 70%.
The child's family representative, Francesco Petruzzi, quoted by the Ansa agency, requested that the Prosecutor's Office consider charging intentional homicide instead of manslaughter. He stated that according to the investigative judge's experts in their five-hundred-and-fifty-page report, if Domenico had been connected to the Berlin Heart EXCOR, an extracorporeal artificial heart, for 72 hours, he would have been a candidate for a new transplant with a success probability greater than 70%.
The lawyer explained that the experts noted that 'VAD (Berlin Heart Excor), as long-term circulatory support, would allow for the preservation and/or restoration of organ function, making the patient potentially suitable for a new transplant for a longer period than membrane extracorporeal oxygenation (ECMO) guarantees.'
In the technical assessment, specialists answered questions posed by the investigating judge, particularly regarding decisions made after the transplant on December 23, 2025. This operation was performed despite the heart being unsuitable and 'damaged' because it was transported and prepared incorrectly.
The judge also demanded an examination of the doctors' actions while the child was on ECMO in the Monaldi intensive care unit, as well as an assessment of the reasons why the option of using an extracorporeal artificial heart was excluded.
When a compatible heart became available on February 17, the boy no longer met the criteria for a new transplant due to the condition of his organs. Domenico died on February 21. It should be noted that the Naples Prosecutor's Office is investigating the child's death concerning seven doctors.