What happens before and during a heart-lung transplant

What happens before and during a heart-lung transplant

If a heart-lung transplant is thought to be a potential treatment for you, you'll be asked to have an assessment before potentially being placed on the transplant waiting list.

The purpose of the assessment is to check whether you're a suitable candidate for a heart-lung transplant.

Assessment

An in-depth assessment will be carried out at your nearest transplant centre to build up a detailed picture of your current state of health. This will also check whether there are any underlying problems that could affect your suitability for having a transplant.

You'll also have the chance to hear details about the transplant. Before visiting the transplant centre, you may find it useful to write a list of questions you would like to ask the transplant team.

Tests

As part of your assessment, you may have some of the tests described below:

• Blood tests and urine tests to check for infections and assess the health of your organs, such as your liver
• chest X-rays
• blood pressure tests
• tests to find out how well your heart and lungs work, such as measuring how much air you can exhale and the level of oxygen in your blood
• computerised tomography (CT) scans and magnetic resonance imaging (MRI) scans , which can be used to check the health of certain organs, such as your lungs

The whole assessment process usually takes a few days to complete. If your child is being assessed, the transplant centre will normally be able to arrange accommodation for you if you need it.

Making the decision

The final decision about whether you or your childare suitable for a heart-lung transplant is not made by one person. An agreementis reached on a case-by-case basis by anumber of membersof the transplant team during a formal meeting.

After your assessment is complete, the team may:

• think you will benefit from a transplant and offer you the opportunity to go on the transplant list
• request further investigations or certain targets to be met before you are offered a place on the transplant list
• not offer you a place on the transplant list if they feel there would be little benefit from a transplant

Once the decision has been made, you will have the opportunity to speak in person with a member of the transplant team.

If it's decided that you or your child are not suitable for a heart-lung transplant, you will have the opportunity to discuss the other treatment options suitable for you.

Waiting for a suitable donor

It's impossible to say how long it will take for a suitable donor to be found. It may be several months, or even years, before a donated heart and lungs of the right size and blood group become available. The waiting times for a heart-lung transplant are often very long and your condition could deteriorate while you wait.

While you're on the waiting list, you'll be seen regularly to monitor your condition. Your transplant centre will be able to offer any support, guidance and information you need while you're waiting for a suitable donor to be found. They're fully aware that for many people this can be both a frustrating and frightening experience.

In some cases, a planned transplant might not go ahead. This may be because your health deteriorates to such an extent that a transplant is no longer considered to be a safe or effective treatment. Unfortunately, dying before a donated heart and lungs becomes available is also a possibility.

You should discuss both possibilities with the staff at your transplant centre and, if necessary, with your friends, family and loved ones.

The transplant operation

When a donated set of heart and lungs becomes available, your transplant team will contact you to arrange for transport to take you to the transplant centre as quickly as possible.

You will be taken to the operating theatre and given a general anaesthetic so you're asleep while the procedure is carried out.

A piece of equipment known as a heart-lung bypass machine will be attached to your body using tubes that are inserted into your blood vessels. The machine pumps oxygen-rich blood around your body until the operation is complete.

A cut (incision) will be made in your chest to enable the surgeon to remove your heart and lungs. The donated set of heart and lungs will be put in place and reconnected to the surrounding blood vessels.

The incision in your chest will then be stitched up and you will be transferred to an intensive care unit (ICU) , where your recovery will be closely monitored.

Because ofthe complexity of the procedure, a heart-lung transplant procedure usually takes several hours to complete.

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