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School of Medicine
Describe the heart-lung transplant program.
Heart-lung transplantation actually has a very long history here at Johns Hopkins. The first one was done in the mid-80s and it’s a very unique procedure. Although there was great interest in this for many years in the 80s and the early 90s, that has decreased considerably. The indications are really limited to the select patients whose heart and lungs are so bad that just replacing one of those organs is not enough. So, for example, patients who have bad abnormalities of their hearts from childhood that have also rendered their lungs non-functional, they are very commonly referred for both heart and lung transplant, because, simply removing or replacing their lungs won’t fix their heart; simply removing their heart is not going to fix their lungs. We do this procedure maybe once or twice a year and there’s probably about 20-50 done in the country in a year to year. The indications is probably decreasing for heart-lung transplants, and that’s because we are able to provide lung transplant to many of these patients and manage their heart problems pretty well and vice versa. Many patients with some lung disease who need a heart transplant, we can manage their lung disease pretty well medically. The difficulty with heart-lung transplant is that the organs are very difficult to come by. As you can imagine, that a heart and two lungs could provide a life-saving gift for three people, and so we are very careful about allocating a block like that to one individual.
Describe the heart-lung transplant surgery.
The procedure is very similar to lung transplant with respect to the incisions that we use, we always use the heart-lung machine, and essentially, as one can imagine, we remove both the heart and the lungs. Then we reconnect. In this case, we reconnect the airways, the connection tube to the rest of the body – that is the aorta - and the blood that comes back to the heart. And that’s it. There’s actually four connections and it’s really straightforward. Sometimes removing heart and lungs as a block can be very difficult because of previous surgery, but the goals are very straightforward.