Definition A heart and lung transplant is a surgical procedure in which a person's poorly functioning heart and lungs are replaced with those a person who has died and donated their organs.
Who is a candidate for the procedure? A heart and lung transplant is a serious operation. It is reserved for those who will die without it. The procedure is expensive and risky, demanding that an individual undergo intense treatment for many years. Candidates for the operation are people who have serious diseases that involving both lungs and the heart.
severe high blood pressure in the lung arteries, known as pulmonary hypertension
To be considered for the operation, a person must be under age 45. Overall health must also be good. Finally, a person must be able to adhere to the schedule of complex medication treatments and frequent visits to the doctor that will be needed after the transplant. The procedure cannot be done until a suitable organ donor is found.
How is the procedure performed? The transplant is done with general anaesthesia. This means that the person is put to sleep with medications and feels no pain. The person is put on a ventilator, or artificial breathing machine, during the surgery.
The chest area is first cleaned with antibacterial chemicals. Next, an incision is made into the chest. The heart and lungs are exposed. The person is then put on a heart-lung bypass machine. This involves special tubes to move blood around the heart and lungs. The blood is sent into a special machine to keep the blood circulating and full of oxygen.
The surgeon can then take out the person's heart and lungs. The replacement heart and lungs are put into the chest and sewn into place.
After the new heart and lungs are connected, the person is taken off the heart-lung bypass machine. Once the person's heart is working again and pumping the blood, the surgeon checks for any bleeding. If everything is working properly, the chest incision is closed. The person is taken off anaesthesia and sent to the surgery recovery room or surgical intensive care unit.
What happens right after the procedure? The person will spend at least an hour in the surgery recovery room until the anaesthesia has worn off. The patient is then transferred to an Intensive Care Unit (ICU). Once the person is breathing well, the ventilator is turned off and the person can breathe normally. The person must stay in the hospital several days or even weeks to recover. Analgesics are given as needed for pain. Medications to suppress the immune system are given to prevent the body from rejecting the new organs.
What happens later at home? Individuals who have had this surgery must stay on medications for the rest of their lives to prevent rejection of the new organs. Frequent visits to the doctor, blood tests and x-ray tests are required for monitoring. Activity is gradually increased as tolerated.
What are the potential complications after the procedure? The most important complication is death, which can occur during surgery or afterwards. Only about 50% of people are still alive 3 years after a heart-lung transplant. There are complications with any surgery or anaesthesia. These include bleeding, infection, and reactions to the anaesthesia medications.
The medications that must be taken to prevent rejection have many side effects. These include allergic reactions, stomach upset, and kidney damage. Other side effects depend on the medications used. Because these medications suppress the immune system, there is also an increased risk of infection.
Author: Adam Brochert, MD Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
