Overview
A heart and lung transplant might be performed if serious disease has affect a patient’s lungs as well as the heart. It is similar in procedure and risks to a heart transplant.
Sixty percent of heart/lung transplant recipients live more than one year after their surgery, and 50% live at least five years. In comparison, 80% live one year after transplanting only the heart.
Detailed Description
What warrants a heart/lung transplant?
As in the heart transplant, successful heart/lung transplant candidates have severe disease but are otherwise healthy, and thus have a good chance of surviving the surgery. Usually the patient will die without the surgery. Candidates under 45 are almost always accepted; candidates under 60 have a better chance than those over. If the patient has kidney or liver problems, or diabetes, a transplant is probably too risky. Most transplant recipients have a lung disease called pulmonary hypertension, which is increased pressure in the lungs. The increased pressure provides resistance that makes the heart work harder, eventually damaging it. Conversely, heart failure can over time damage the lungs, necessitating this double transplant. Disorders such as emphysema, cystic fibrosis and pulmonary fibrosis, accompanied by heart failure, may also warrant this costly procedure.
The Procedure
This procedure may take 6-8 hours.
While waiting for a transplant, the recipient may use an artificial heart, which can keep patients alive for two years. Then, when an organ becomes available, the recipient is contacted via pager, and comes immediately to the hospital for the operation.
The heart and lung transplant operation must occur immediately after the donor has died; usually, though the donor has been declared brain dead, his or her body is kept on life support to keep the organs working until the last possible minute. This is even more important with the heart and lung transplant than it is for the heart transplant, because infections and abnormalities invade the lungs soon after death. The donor’s tissues must also match the recipient’s as closely as possible to minimize the possibility of rejection.
The patient’s chest is shaved, if necessary, and antiseptic is applied. The patient is under general anesthetic during the procedure, and a heart lung machine keeps oxygen flowing through the body’s organs while the patient is without a heart and lungs. The diseased heart and lungs are removed separately, but the new heart and lungs are removed from the donor together and placed together in the recipient’s body.
Recovery
Recovery can take up to six months. There is a high risk that the body will reject the organs, particularly the lungs. Because of this, the patient must remain on immunosuppresent drugs indefinitely. The physician will also want to take regular lung biopsies to assess the progress of the operation and test for rejection.
Last updated: 31-May-04
