What Is a Heart-Lung Transplant?

A heart-lung transplant is a surgical procedure during which the heart and lungs are replaced at one time. This helps to avoid multiple surgeries, which can be dangerous for patients who are already weak. A heart-lung transplant typically is done only when the patient's life is in danger.

The purpose of a heart-lung transplant is to perform multiple transplants all at one time. Transplants are major surgical procedures. A single transplantation takes time to recover from before another surgical procedure — even a minimally invasive one — can be done. For patients who need a new heart and a lung, a combined transplant is often recommended.

Candidates of a heart-lung transplant must have significant damage of the heart and one or both lungs. The damage must pose life-threatening dangers to the patient. After eligibility is determined, the patient is placed on a donor list, and has to wait for a match. Patients must be younger than age 55, have no other major medical conditions, be mentally healthy and be capable of undergoing therapies to aid in recovery.

Preparing for a heart-lung transplant involves many steps. The patient is given anesthesia to induce unconsciousness. Donor organs are thoroughly examined to make sure that they are healthy. A surgeon opens the area with an incision that starts above the sternum and stretches down below the sternum, exposing the bone. The bone is cut and spread to expose the heart and lungs.

During the beginning of the procedure, a heart-lung machine is used. This machine keeps oxygen in the blood and the blood circulating through the body. After the bad organs are replaced with the new ones and then connected to the body, the machine is removed. Internal defibrillator paddles might be used to start the new heart, and the lungs inflate as they warm up and match body temperature. The surgeon then closes the chest and the incision.

Complications of a heart-lung transplant are rare but possible. During surgery, new organs can fail to start functioning despite the surgeon’s best efforts, resulting in the death of the patient. After a successful surgery, complications that might occur include infection and a rejection of the new organs. To avoid these possibilities, medications are given to suppress the immune system and fight off infection.

Typically, a patient remains in the intensive care unit at the hospital for a few days after a heart-lung transplant. If complications do not occur, the patient is moved to a non-intensive wing for about two weeks. Follow-up visits after discharge will ensure that the patient remains healthy and that healing is progressing as it should. Activity should be minimal and should increase only as the patient's doctor recommends.