Symptom: Heart and Lung Transplant

    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.
  • 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). Combined heart and lung transplants are rare.
  • With improved surgical techniques and powerful medicines to prevent rejection, life expectancy after transplantation has increased over the last 2 decades.
  • In the United States, people may wait 18 months or longer for a donor lung.
  • Because of such demand, systems have been developed to make sure that the sickest people are first to receive donor organs. Donors are carefully screened to make sure that only healthy lungs are transplanted. Because of the severe shortage, bilateral lung transplants are rare. Most patients receive a single lung.


    The most common indication for heart transplantation is severe end-stage heart failure, which means the heart cannot pump blood well enough to reach all tissues in the body. People who receive heart transplants get them only when their failing hearts do not respond to medicines or other surgical treatments. Several conditions lead to heart failure, including the following:
    • 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
    The most common reason people get lung transplants is for chronic obstructive lung diseases such as emphysema. Other people are born with conditions that cause their lungs to fail, such as the following:
    • Cystic fibrosis
    • Eisenmenger syndrome, which is due to unoperated congenital heart defects
    • Idiopathic pulmonary fibrosis
    • Primary pulmonary hypertension - High pressure in the arteries (of unknown cause) that supply blood to the lungs
    • Alpha1 antitrypsin deficiency


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    June 26, 2015
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