Combined Heart and Lung Transplantation
This is a very complex operation where both the lungs and heart of a donor are transplanted to a patient. This is done in situations such as Primary Pulmonary Hypertension, Bilateral End-Stage lung disease with severe RV Disfunction.
Heart Transplantation is a procedure where a patient’s failing heart is removed and replaced with a donor’s heart so that the patient can live a normal life once again. The donor’s heart is obtained from a Brain Dead Patient whose brain has ceased
to function but his heart is still working. This condition can be maintained for 1 to 2 days during which time the relatives of the donor brain dead patient would be requested for the donation of organs. If they agree then necessary tests would be done to do tissue matching of the donor with the patient. Transplantation is done in situations like Dilated Cardiomyopathy, Ischaemic Cardiomyopathy, Restrictive Cardiomyopathy. Generally, once the diagnosis, necessary tests, and immunization to prevent any community-acquired infections are all done then the patient is wait-listed. Once a suitable donor heart is offered then the process of transplantation is initiated. We have a donor team who go and harvest the heart, put it in the preservative solution and then transfer to our hospital. Usually, the time limit for the transplantation to happen is 4 to 6 hrs. Within this time the diseased heart of the patient is removed and the new heart is put in. Most of the time, within 24 hrs of the transplant surgery the patient is off the ventilator and kept in a transplant ward for observation and medications. He is usually ready to go home in two weeks’ time.
This is also another section of Thoracic Organ Transplantation where either one or two lungs are transplanted for patients whose lungs are damaged due to various diseases and they are dependent on external Oxygen sources. The usual condition is Idiopathic Pulmonary Fibrosis, or else Emphysematous Disease, etc. Patients who have been very sick for a period varying from 6 to 9 months is the initial stage and during this initial stage, the results of transplantation are good. Beyond one year of diagnosis of the disease, the progression of fibrosis or loss of lung tissue is fast and the oxygen requirement is also more. Beyond this stage, patients develop Right-Sided Heart Failure and therefore are not suitable for Lung Transplantation.