Domenico, who had been on life support for nearly two months, died shortly before 09:30 local time on Saturday, February 21 at Monaldi Hospital in Naples, according to the family’s lawyer, Francesco Petruzzi. The hospital said the toddler suffered a “sudden and irreversible worsening of his clinical condition.”

The heart transplanted into Domenico in late December was reportedly transported in direct contact with dry ice, causing extensive tissue damage.

Prosecutors have opened an investigation into the case, and six medical professionals are under formal investigation.

Petruzzi said the organ arrived “burned by frostbite” after being transported more than 800 kilometres from Bolzano to Naples in an unsuitable container, without a thermometer to monitor the temperature.

He said the circumstances amounted to a serious failure in the handling and transport of the donor organ.

Domenico had been kept alive using advanced life support systems while doctors assessed whether a second transplant was possible.

Earlier this week, a panel of paediatric specialists concluded that his condition was “not compatible” with another transplant, warning that prolonged life support may have compromised his lungs, liver and kidneys.

His mother, Patrizia Mercolino, had previously appealed to Pope Francis to help save her son.

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Speaking after his death, she said: “It’s over. Domenico is gone.” She added that a foundation would be created in his name to support children unable to receive transplants and victims of alleged medical negligence.

Petruzzi said the family wanted full access to medical records and accountability. “If the time for hope has ended, then the time for responsibility has begun,” he said.

Italian Prime Minister Giorgia Meloni offered condolences, writing on X: “The whole of Italy mourns the loss of little Domenico, a warrior who will never be forgotten.

“I offer my sincerest condolences and deepest sympathy to his mother, his father and all his loved ones. I am certain that the competent authorities will shed full light on this terrible incident.”

Italy’s Health Minister Orazio Schillaci also called for clarity. He said: “We must absolutely clarify what happened. We owe it to the child, to the family, but also to all Italians.”

He added that the case should not undermine confidence in the country’s healthcare system, which he described as “excellent” despite the tragedy.