This is a surgery to remove a severely diseased and damaged heart and lungs. They are replaced with a healthy heart and lungs from a deceased donor.
The Heart and Lungs
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A heart-lung transplant is done if you have:
An irreversible, life-threatening lung disease that affects the heart (but are in otherwise good health)—An example of this is severe
(an increase in blood pressure in the lung's blood vessels).
Have undergone other treatments (such as, surgery, medicine) without success
If you are planning to have a heart-lung transplant, your doctor will review a list of possible complications, which may include: InfectionRejection of the donor heart or lungsCoronary artery diseasePneumoniaBlood clotsBleedingDecreased brain functioningDamage to other organs, like the kidneysIrregular heart rateAnesthesia-related problems
related to taking immunosuppressive medicines
Some factors that may increase the risk of complications include: Preexisting heart or lung conditionsAge: 60 or olderKidney or liver disease
alcohol abusePoor circulationAutoimmune disease
Be sure to discuss these risks with your doctor before the procedure.
There is a shortage of donors, so you may be on a transplant list for some time. You may need to carry a cell phone with you at all times. This is to allow the transplant team to reach you if organs become available.
Your doctor will monitor your health to make sure that you are ready for the transplant. Before the surgery, your doctor will likely do the following: Physical examBlood tests—to make sure your liver and kidneys are functioning normallyIdentify your blood groupTissue typing
Leading up to the surgery:
Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
Anti-inflammatory drugs (such as,
Blood thinners, like
Do not take over-the-counter medicine without checking with your doctor.Arrange for a ride to and from the hospital.Arrange for help at home after the surgery.Eat a light meal the night before the surgery. Do not eat or drink anything after midnight.
will be used. It will block any pain and keep you asleep through the surgery. It is given through an IV in your hand or arm.
After you are asleep, the doctor will cut through the skin and breastbone. She will open the chest and connect you to a heart-lung machine. This machine takes over the functions of the heart and lungs during the surgery. The doctors will then remove the lungs and the heart. The donor lungs will be attached. Then, the doctor will sew the new heart 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, or the doctor may give you an electrical shock to get the heart started. The doctor will make sure that there are no leaks and that the heart and lungs are working fine. After this, the heart-lung machine will be disconnected. Next, temporary tubes may be placed in the chest cavity to drain any blood that has collected. The breastbone will be wired together, and the chest will be closed.
You will be closely monitored in the intensive care unit (ICU) with the help of the following devices: Heart monitorPacing wires used to help control heart rateTubes connected to a machine that helps drain excess blood and air from the chest cavityBreathing tube, until you can breathe on your own
You will have pain during the recovery process. Your doctor will give you pain medicine.
This surgery is done in a hospital setting. The usual length of stay is two weeks. Your doctor may choose to keep you longer if you shows signs of rejecting the new organs or have other problems.
While you are recovering at the hospital, you will need to: Breathe deeply and cough 10-20 times every hour to help keep your lungs working well.Take immunosuppressive drugs—You will likely need to take these for the rest of your life. These drugs reduce the chance that your body will reject the new heart.
Your doctor may need to take a
of your heart or lungs if you:
Have persistent feverHave poor heart functionDo not feel well
When you return home, do the following to help ensure a smooth recovery: Take medicines as directed.Work with a physical therapist. Keep in mind that your new heart will respond slowly to increases in physical activity.Ask your doctor about when it is safe to shower, bathe, or soak in water.Be sure to follow your doctor's
The surgical site in your breastbone heals in 4-6 weeks.
After you leave the hospital, contact your doctor if any of the following occurs: Signs of infection, including fever and chills—You are at increased risk for infection because of the immunosuppressive drugs.Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision siteCough, shortness of breath, chest pain, or severe nausea or vomitingIncreased sputum (phlegm) productionCoughing up bloodWaking up at night due to being short of breathSudden headache or feeling faintChanges in weight or blood pressureChest pain or sensation of your heart fluttering, missing beats, or beating erraticallyPain, burning, urgency, frequency of urination, or persistent bleeding in the urineExcessive tiredness or swelling of feet
In case of an emergency, call for medical help right away.
Last reviewed December 2013 by Michael J. Fucci, DO
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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