Heart Transplantation Information | Lung Transplantation Information
Facts on Heart Transplantation
Heart transplantation is a wonderful life-saving surgery, but this complicated procedure can raise a lot of questions for someone learning about it for the first time. The information provided does not constitute medical advice and it should not be relied upon as such. The New York Cardiothoracic Transplant Consortium (NYCTC) does not engage in the practice of medicine. The NYCTC, under no circumstances, recommends particular treatments for individuals and, in all cases, recommends that you consult your physician before pursuing any course of treatment.
What does the heart do? The heart is located behind the breastbone between the lungs, a little to the left of center. In adults, the heart is about the size of a fist. The heart is a muscle that pumps blood throughout the body. Deoxygenated blood flows from the heart to the lungs where it gives up carbon dioxide and is freshly oxygentated. From there, the blood returns to the heart and is pumped to the rest of the body. 
What is a heart transplant and how are hearts matched? A heart transplant is the replacement of the recipient's heart with one that has been donated by someone else. The donated heart can be obtained when a person or their family decides to donate their organs when they die. The main things considered to make a match when a donor heart becomes available are blood type, weight, age, and urgency of need. Geography can also be a factor as a donor heart generally only stays usable if it is outside the body for less than 6 hours.
When is a heart transplant considered?Your doctors take many factors into consideration before listing a patient for transplant as a wide variety of treatments are available and not all patients would benefit from a transplant. Although there are many diseases that have been treated with heart transplant, several common ones treated that may lead to transplant are:
- Coronary heart disease Coronary heart disease, also commonly referred to as coronary artery diease, is a narrowing or blockage of the coronary arteries due to plaque build-up. These arteries provide the heart with blood, and as this flow becomes restricted due to narrowing the risk of heart attack or stroke increases.
- Cardiomyopathy Cardiomyopathy is a disease of the heart muscle that affects the hearts ability to pump blood to the rest of the body. Causes of cardiomyopathy include coronary heart disease and heart valve disease.
- Congenital heart disease Congenital heart disease is an abnormality that develops before birth. It may be related to improper valve size, malformed leaflets, or an irregularity in the way the leaflets are attached. This most often affects the aortic or pulmonic valve.
- Hypertensive heart disease Hypertensive heart disease is also known as high blood pressure.
Who can get a heart transplant?Each transplant center develops their own criteria as to what patients they will add to the national waiting list for a heart transplant. Heart transplant is major surgery and not everyone can survive it. In some cases, the doctor might decide that a transplant won't work. Some things that might prevent a patient from getting a heart transplant are:
- Having any form of cancer
- Morbid Obesity
- Having any current active infection
- Serious organ damage from diabetes
- Having severe impairment of any other organ that is irreversible
- Having advanced HIV disease (AIDS)
- Continuing use of alcohol, tobacco or illegal drugs
- Being at high risk of using drugs or alcohol again after the surgery
- Being unable to follow doctor's instructions, like taking medicine when needed
- Having too little support from people at home to care for the patient after the operation
What is a VAD and when are they used? A Ventricular Assist Device (VAD) is a mechanical pump used to support heart function and blood flow in people with weakened hearts. VADs are surgically implanted to provide either partial or total circulatory assistance to the natural heart to help sustain a patient’s life and maintain their other organ function while awaiting a heart transplant. Some VADs are now available that allow patients the opportunity to go home while awaiting a transplant. VADs are not right for all patients and come with their own possible complications such as infection, device dysfunction, bleeding, and stroke.
What can I do to keep healthy before and after a heart transplant?
- Make sure you follow your doctor's advice
- Eat well-balanced, healthy meals
- Lose weight, if your doctor tells you to
- Do not use tobacco or illegal drugs
- Get treatment for any mental illness or behavioral problems
- Get treated for any other health problems (diabetes, blood pressure, cholesterol)
- Talk to your doctor before you use any other prescription or over the counter medicine
- Talk to your doctor before using any vitamins, supplements or natural or herbal remedies
Additional resources on heart transplantation can be found on our links page.
Facts on Lung Transplantation
Although a lung transplant can be a life-saving surgery, it is also a complex procedure which brings many questions to mind. The information provided does not constitute medical advice and it should not be relied upon as such. The New York Cardiothoracic Transplant Consortium (NYCTC) does not engage in the practice of medicine. The NYCTC, under no circumstances, recommends particular treatments for individuals and, in all cases, recommends that you consult your physician before pursuing any course of treatment.
What do the lungs do? The lungs are a paired organ located in the chest, although the left lung is slightly smaller than the right to allow room for the heart. The lungs are a vital part of the respiratory system, separating the gases in the air we breathe. The fresh oxygen is carried from the lungs, into our cells, by the bloodstream. The lungs also separate out the carbon dioxide and release it back into the air when we breathe out. While there are physical limitations to doing so, it is possible to live with only one lung. 
What is a lung transplant and how are lungs matched?Lungs can be transplanted either singly or as a pair, replacing the recipients lungs with one(s) that have been donated by someone else. The donated lungs can be obtained:
- Through deceased donation when a person or their family decides to donate their organs when they die,
- Through a living donor procedure where one person donates the right lower lobe from one donor and the left lower lobe from a second donor. This procedure is much more complex as it requires major surgery for three people.
Lungs are matched to potential recipients on the national waitlist using the lung Composite Allocation Score (CAS). The lung CAS, which is individual for each recipient and each organ offer, assigns point values for multiple factors based on objective medical information. For more information on the lung allocation process click here.
When is a lung transplant considered?Lung transplantation is a complicated procedure that is usually reserved for those with no other treatment options. A comprehensive evaluation of the patient, conducted by the transplant team will determine if a transplant is appropriate. Although there are many diseases that have been treated with lung transplants, several common ones that may lead to transplant are:
- COPD Chronic Obstructive Pulmonary Disease (COPD) is a disease that progressively limits lung function by obstructing the flow of air through the airways both in and out of the lungs. COPD is used to describe chronic bronchitis and emphysema. Chronic Bronchitis is an inflammation of the airway tubes which eventually leads to scarring. Emphysema is the enlargement and destruction of the air sacs within the lungs. People with COPD can have one or both of these conditions.
- Idiopathic pulmonary fibrosis Idiopathic pulmonary fibrosis is a disease that worsens over time, and is characterized by scarring and thickening of tissues deep in the lungs which limits the ability to breathe.
- Primary pulmonary hypertension Primary pulmonary hypertension is a rare disease where the blood pressure in the lungs is elevated for no apparent reason and causes the right side of the heart to work harder than normal.
- Cystic fibrosis Cystic fibrosis is a life-threatening, genetic disorder that causes a thick mucus to build up in the lungs and other parts of the body.
Who can get a lung transplant?Every transplant center develops their own criteria for adding patients to the national lung transplant waiting list. Lung transplant is a major surgery and not appropriate for everyone. Some things that might prevent a patient from being considered for a lung transplant are:
- Having current or recent cancer
- Having advanced HIV disease (AIDS)
- Current use of alcohol, tobacco or illegal drugs
- Concurrent chronic illness
- Some psychiatric conditions
- Being unable to follow doctor's instructions, like taking medicine when needed
- Having too little support from people at home to care for the patient after the operation
What can I do to keep healthy after a lung transplant?
- Follow your doctor's advice and consult your transplant team with any questions or concerns
- Follow the prescribed rehabilitative exercise program
- Pay close attention to food preparation and personal hygiene
- Do not use tobacco or illegal drugs
- Seek treatment for any mental illness or behavioral problems
- Seek treatment for any other health problems (diabetes, blood pressure, cholesterol)
- Do not drive until you have passed an assessment clearing your capacity to drive (includes eyesight, and physical ability to wear a seatbelt and turn to check blindspots)
- Talk to your doctor before you use any other prescription or over the counter medicine
- Talk to your doctor before using any vitamins, supplements or natural or herbal remedies
- Eat well-balanced, healthy meals
Additional resources on lung transplantation can be found on the links page.