Risks
A heart-lung transplant is a major operation that carries a high risk of complications, some of which can be fatal.
This is why it's usually only considered when all other treatment options have been exhausted and it's thought the potential benefits outweigh the risks.
As well as the risk of rejection and infection, there's also a chance your new heart and lungs won't work properly.
Bronchiolitis obliterans syndrome
Bronchiolitis obliterans syndrome (BOS) is a fairly common form of lung rejection that can occur in the years after a heart-lung transplant.
In BOS, the immune system causes the airways inside the lungs to become inflamed, blocking the flow of air through the lungs.
Symptoms of BOS include shortness of breath, a dry cough and wheezing. In some people, this can be treated with additional immunosuppressants. However, not all cases of BOS respond to treatment.
Infections
As immunosuppressants weaken your immune system, you'll be more vulnerable to infections, including bacterial, fungal and cytomegalovirus (CMV) infections.
Signs of a possible infection include:
- a high temperature (fever) of 38C or above
- breathing problems, such as shortness of breath and wheezing
- generally feeling unwell
- sweating and shivering
- loss of appetite
- diarrhoea
- chest pain
- coughing up thick mucus that may be yellow, green, brown or bloodstained
- a rapid heartbeat
- dizziness
- a change in mental behaviour, such as confusion or disorientation
Contact your GP or transplant team if you think you have an infection. Depending on the type of infection you have, you may need treatment with antibiotics, antifungals or antivirals.
As a precaution, you may be given these medications for a few months after your transplant to protect you from serious infections.
Try to reduce your risk of picking up an infection, particularly in the early stages of recovery. For example, avoid crowds and close contact with anyone you know who has an infection. You should also avoid substances that can irritate your lungs, such as smoke or chemical sprays.
Narrowing of the heart arteries
Sometimes, the blood vessels connected to the donor heart can become narrowed and hardened. This is known as cardiac allograft vasculopathy or coronary artery vasculopathy (CAV).
It's a common long-term complication after a heart transplant, but it tends to be less common following a heart-lung transplant.
CAV can be serious because it can restrict the blood supply to the heart, which can sometimes trigger a heart attack or lead to heart failure.
Because of this risk, your new heart will be regularly checked to make sure it's receiving enough blood.
Treatment options for CAV are limited but may include statins and calcium channel blockers (medication to help widen blood vessels).
Introduction 