Heart Lung Transplant
A heart-lung transplant is a major and rarely performed surgical procedure.
During a heart-lung transplant, a person's diseased heart and lungs are replaced with the heart and lungs of a recently deceased donor. As with any transplant there are risks, but the procedure aims to extend or improve quality of life in suitable candidates.[1]
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Description
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Heart transplantation[edit | edit source]
A pioneering heart surgeon, Dr Christiaan Barnard, performed the first successful human-to-human heart transplant operation in 1967 in Cape Town, South Africa. Unfortunately, early operations resulted in problems such as infection and rejection, and heart recipients did not survive very long.
With advances in technique and development of new drugs to suppress the immune system, a majority of transplant recipients currently survive more than 3 years.
- A "bridge" device (assisted device) has been developed that lets certain people live longer while they wait for transplantation. A balloon pump inserted into the aorta, along with battery generator device, that can help the heart to provide blood flow to the body. This “bridge” cannot be used for long and used only in people who are critically ill and very close to getting a new heart.
- A newer procedure involves implanting a mechanical pump into your body to help pump the blood. This pump, called a left ventricular assist device (LVAD), can be used for months or even years. Some devices can be utilized indefinitely.
Total artificial hearts are now available and have been implanted in a few patients. Besides costs, complications are still present.[2]
Lung transplantation:[edit | edit source]
Successful lung transplantation has been performed since the early 1980s. The first surgeries involved transplanting both lungs and the heart together. Since then, operations have been developed to transplant both lungs, a single lung, and even partial lung (lobes).[2]
Indication
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A heart-lung transplant is the only treatment available for people who have combined heart and lung failure. It is a treatment that carries high risks but can offer benefits. For this reason it is only recommended when all other treatment options have failed. If the damage is severe in both organs, replacing the heart or lungs alone may not be possible.
The conditions that most often require a heart-lung transplant are:
- adult congenital heart disease (ACHD) – where an adult has one or more birth defects that affect their heart
- Ischemia, or lack of oxygenated blood to the heart (coronary heart disease), leading to heart attack and permanently damaged heart muscle
- Heart valve disease, such as with damage from rheumatic fever
- Infections of heart tissue, especially heart valves
- Untreated, uncontrolled high blood pressure
- Heart muscle disease, secondary to multiple causes
- Congenital heart defects (certain heart defects that an individual is born with)
- Certain drugs
- Cystic fibrosis
- Eisenmenger syndrome, which is due to unoperated congenital heart defects
- Idiopathic pulmonary fibrosis
- pulmonary hypertension – where high blood pressure develops inside the blood vessels of the lungs, which can damage both the lungs and the heart.[1]
Organ rejection:[edit | edit source]
The purpose of your immune system is to protect your health. It recognizes and attacks anything different from the substances normally present in your body, even those only slightly different, like your newly transplanted lung and heart. The immune system does not discriminate between harmful substances, like bacteria, fungi and viruses, and transplanted organs — so to your immune system your new lung and heart appears as a foreign substance that needs to be eliminated.Even with the use of immunosuppressants, your body can at times recognize your transplanted organ as a foreign object and attempt to protect you by attacking it. Rejection is the term used when your body's immune system is attacking your transplanted organ. Nearly all patients will experience at least one episode of rejection. If and when you suffer an episode rejection, remember:
- it does not mean that you will lose your new lung or heart,
- it does not mean your new lung or heart is failing.
Rejection may occur early or late after transplantation. Early rejection occurs most often in the first six months after transplant, and late rejection typically occurs after six months.[3]
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- ↑ 1.0 1.1 http://www.nhs.uk/conditions/Heart-lung-transplant/Pages/Introduction.aspxGo to NHS Choices homepageYour health, your choices
- ↑ 2.0 2.1 http://www.emedicinehealth.com/heart_and_lung_transplant/article_em.htm expert for everyday emergancy Cite error: Invalid
<ref>tag; name "em" defined multiple times with different content - ↑ http://www.columbiasurgery.org/pat/lungtx/guide_immunosuppression.html
