Heart-Lung Transplant
Definition
A heart-lung transplant is surgery to remove a severely diseased and damaged heart and lungs. They are replaced with a healthy heart and lungs from a donor.
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Reasons for Procedure
A heart-lung transplant is done if:
- A life-threatening lung disease affects the heart—such as pulmonary hypertension
- Surgery and medicines have not helped the disease
Possible Complications
Problems are rare but all procedures have some risk. The doctor will go over some problems that could happen, such as:
- Excess bleeding
- Infection
- Problems from anesthesia
- Rejection of the donor heart or lungs
- Damage to other organs and nearby structures
- Irregular heart rate
Things that may raise the risk of problems are:
- Chronic diseases, such as diabetes, immune system problems, or kidney or liver disease
- Smoking
- Drug abuse or alcohol use disorder
What to Expect
Prior to Procedure
The care team may meet with you to talk about:
- Anesthesia options
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to stop them before the surgery
- Fasting before the surgery, such as avoiding food and drink after midnight the night before
- Whether you need a ride to or from the surgery
- Identifying your blood group and tissue type
Anesthesia
The doctor will give general anesthesia. You will be asleep.
Description of the Procedure
An incision will be made in the skin and breastbone. The chest will be opened. A heart-lung machine will take over the functions of the heart and lungs during surgery. The lungs and heart will be removed. The donor lungs will be attached. Then, the new heart will be sewn into place. Next, the blood vessels will be connected. The blood will start to flow and warm the heart.
The new heart may begin beating on its own. If not, the doctor may give an electrical shock to get the heart started. The heart and lungs will be checked to make sure they are working. The heart-lung machine will then be disconnected. Next, temporary tubes may be placed in the chest cavity. The tubes will drain any blood that has collected. The breastbone will be wired together. The chest will be closed with stitches or staples. A bandage will be placed over the site.
How Long Will It Take?
Several hours
Will It Hurt?
There is some pain during recovery. Medicine and home care will help.
Average Hospital Stay
The usual length of stay is 2 weeks. If you have any problems, you may need to stay longer.
Post-procedure Care
At the Hospital
After surgery, the staff will give medicine:
- To control pain or nausea
- To prevent rejection of the new heart and lungs—these are taken for life
During your stay, the hospital staff will take steps to lower your risk of infection, such as:
- Washing their hands
- Wearing gloves or masks
- Not letting others touch your incisions
There are also steps you can take to lower your risk of infection, such as:
- Washing your hands often and reminding visitors and staff to do the same
- Reminding staff to wear gloves or masks
- Not letting others touch your incisions
At Home
Recovery may take 3 to 6 months. Physical activity will be limited during this time.
Call Your Doctor
Call your doctor if you are not getting better or you have:
- Signs of infection, such as fever and chills
- Redness, swelling, excess bleeding, or discharge from the incision site
- Problems coughing, breathing, chest pain, or uneven heartbeats
- Severe nausea or vomiting
- Sudden headache or feeling faint
- Changes in weight or blood pressure
- Problems passing urine
- Excessive tiredness or swelling of feet
If you think you have an emergency, call for medical help right away.
RESOURCES:
Scientific Registry of Transplant Recipients
https://www.srtr.org
Transplant Living
https://transplantliving.org
CANADIAN RESOURCES:
Health Canada
https://www.canada.ca
Heart and Stroke Foundation of Canada
http://www.heartandstroke.ca
REFERENCES:
Cardiac transplantation procedure and immediate postoperative care. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/cardiac-transplantation-procedure-and-immediate-postoperative-care. Accessed July 22, 2021.
Devices and surgical procedures to treat heart failure. American Heart Association website. Available at: https://www.heart.org/en/health-topics/heart-failure/treatment-options-for-heart-failure/devices-and-surgical-procedures-to-treat-heart-failure#.WiBiEFWnFQI. Accessed July 22, 2021.
Explore lung transplant. National Heart, Lung, and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health-topics/lung-transplant. Accessed July 22, 2021.
Lung transplant - procedure and perioperative management. EBSCO DynaMed website. Available at: https://www.dynamed.com/procedure/lung-transplant-procedure-and-perioperative-management. Accessed July 22, 2021.
McCurry KR. Brief overview of lung, heart, and heart-lung transplantation. Crit Care Clin. 2019;35(1):1-9.
Last reviewed July 2021 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC Last Updated: 7/22/2021