I
HEART RATE
HEART-LUNG TRANSPLANT
In this procedure, both the heart and
the lungs of a patient have to be removed
and are replaced with organs taken from
a brain-dead donor. The donor organs
are then inserted into the patient. The
removed heart can sometimes be given
to another patient. A heart-lung
transplant is more straightforward than
a
h e a r t t r a n s p l a n t
because blood vessels
to the lungs need not be disturbed.
I
The donor heart and
lungs must be healthy.
The lungs must also match
the size ofthe patient’s
chest, as measured by
means of chest X-rays.
2
In both donor and
patient, the heart and
lungs are reached via an
incision in the sternum
(breastbone), and the
Chest X-ray
chest is opened up.
Site of incision
I n t r a v e n o u s
fl u i d
T u b e r e t u r n in g
b l o o d t o
c ir c u la t i o n
’■ JrXkkkKk
H e a r t - l u n g
m a c h i n e
WHY IT IS DONE
Subject to the availability of a donor, a heart-lung
transplant can offer hope to someone who is dying of a
terminally chronic lung disease, whether or not he or she
is also suffering from heart disease. The range of diseases
that can be treated with this operation include
e m p h y s e m a , c y s t i c f i b r o s i s , s a r c o i d o s i s ,
and
i n t e r s t i t i a l
p u l m o n a r y f i b r o s i s .
The record of success for the
heart-lung transplant operation is better than that
for lungtransplant alone.
Healthy and diseased lung
These images are of a healthy lung (left) and a lung damaged by
emphysema (right), in which the alveoli (tiny air sacs) have become
greatly enlarged and the walls surrounding them are damaged.
T r a c h e a
A o r t a
R i g h t a t r i u m / V e n a c a v a
4
In both patient and donor, the
heart and lungs are removed
through cuts in the aorta, trachea
(windpipe), and the area where the
venae cavae join the heart. The
blood vessels linking the donor
heart and lungs are left intact.
T r a c h e a l r e c o n n e c t i o n
A o r t ic r e c o n n e c t i o n
R i g h t a t r i u m / V e n a c a v a
r e c o n n e c t i o n
5
The donor heart and lungs are
inserted into the patient. The
trachea and aorta are joined to
those ofthe patient, and the right
atrium ofthe donor heart is joined
to the patient’svenae cavae. (This
procedure is simpler than attaching
a donor heart in a heart transplant,
because fewer connections have
to be made.)
T e c h n ic ia n
A n a e s t h e t i c
m a c h i n e
3
The patient is
connected to a
heart-lung machine.
During the operation,
this machine takes over
the function of heart
and lungs, oxygenating
blood taken from the
venae cavae and
pumping it back to the
body via the aorta.
T u b e s c a r r y i n g b l o o d
f r o m h e a r t t o m a c h i n e
H
371
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