science

Heart–lung transplant

Heart–lung transplant is a science topic covered in the lgStudy science library. This page brings together a partial reference excerpt, illustrations, worked examples, real-world applications and a short study plan, so you can understand Heart–lung transplant rather than just read about it. In short: A heart–lung transplant is a procedure carried out to replace both failing heart and lungs in a single operation. Due to a shortage of suitable donors and because both heart and lung have to be transplanted together, it is a rare procedure; with about 94 to 108 performed annually worldwide.

Key takeaways

Heart–lung transplant belongs to science; place it in that map before memorising details.
Learn the definition first, then one example that makes the definition concrete.
Connect Heart–lung transplant to a quantity you can measure, compute or draw — that is where exam questions come from.
Reproduce the core statement of Heart–lung transplant from memory before moving on to harder problems.

Reference excerpt

A heart–lung transplant is a procedure carried out to replace both failing heart and lungs in a single operation. Due to a shortage of suitable donors and because both heart and lung have to be transplanted together, it is a rare procedure; with about 94 to 108 performed annually worldwide.

Procedure The patient is anesthetised. When the donor organs arrive, they are checked for fitness; if any organs show signs of damage, they are discarded and the operation cancelled. Once suitable donor organs are present, the surgeon makes an incision starting above and finishing below the sternum, cutting all the way to the bone. The skin edges are retracted to expose the sternum. Using a bone saw, the sternum is cut down the middle. Rib spreaders are inserted in the cut, and spread the ribs to give access to the heart and lungs of the patient. The patient is connected to a heart–lung machine, which circulates and oxygenates blood. The surgeon removes the failing heart and lungs. Most surgeons endeavour to cut blood vessels as close as possible to the heart to leave room for trimming, especially if the donor heart is of a different size than the original organ. The donor heart and lungs are positioned and sewn into place. As the donor organs warm up to body temperature, the lungs begin to inflate. The heart may fibrillate at first – this occurs because the cardiac muscle fibres are not contracting synchronously. Internal paddles can be used to apply a small electric shock to the heart to restore proper rhythm. Once the donor organs are functioning normally, the heart–lung machine is withdrawn, and the chest is closed.

Qualifying conditions Most candidates for heart–lung transplants have life-threatening damage to both their heart and lungs. In the US, most prospective candidates have between twelve and twenty-four months to live. At any one time, there are about 250 people registered for heart–lung transplantation at the United Network for Organ Sharing (UNOS) in the US, of which around forty will die before a suitable donor is found. Conditions which may necessitate a heart–lung transplant include:

Congenital problems (defects present at birth) affecting the heart and lungs (48%); Pulmonary hypertension (20%); Cystic fibrosis (2%); A second transplant after the first transplant was rejected or failed to operate satisfactorily (4%). Candidates for a heart–lung transplant are usually required to be:

Under 55 years old; Have no other medical conditions (e.g. AIDS, Diabetes, Hepatitis); Mentally sound; Capable of following a post-operative regimen of exercise and immunosuppressant drugs.

Post-operation Most patients spend several days in the intensive care unit after the operation. If there are no complications (e.g., infection, rejection), some are able to return home after just two weeks in hospital. Patients will be given anti-rejection drugs and antibiotics to prevent infection as the anti-rejection drugs weaken the immune system. A schedule of frequent follow up visits is necessary.

Statistics The success rate of heart–lung transplants has improved significantly in recent years. The British National Health Service states that the survival rate is now around 85%, one year after the transplant was performed. In 2004, there were only 39 heart–lung transplants performed in the entire United States and only 75 worldwide. By comparison, in that same year there were 2,016 heart and 1,173 lung transplants.

History Norman Shumway laid the groundwork for heart lung transplant with his experiments into heart transplant at Stanford in the mid-1960s. Shumway conducted the first adult heart transplant in the US in 1968. The first successful heart transplant was performed in South Africa in 1967. The first successful heart–lung transplant was performed at Stanford in the United States, by Bruce Reitz on Mary Gohlke in 1981. Magdi Yacoub performed the first heart-lung transplant in the United Kingdom in 1983. Australia's first heart-lung transplant was conducted by Victor Chang at St Vincent's Hospital, Sydney in 1986. Iran's first heart-lung transplant was performed in Tehran in 2002.

See also Organ transplant Heart transplantation Lung transplantation

References

External links National Heart, Lung and Blood Institute (NHLBI) Photograph of first successful heart–lung transplant

Worked examples

Example 1 — a first encounter with Heart–lung transplant

Start with the simplest possible case. Write down what Heart–lung transplant claims or describes in one sentence, then invent the smallest concrete situation in which that sentence is true. In science, the smallest case is usually a single object, a single equation or a single measurement. Check that every symbol or term in your sentence has a meaning in that case.

Example 2 — changing one variable

Take the situation from Example 1 and change exactly one quantity: double it, halve it, or set it to zero. Predict what should happen to Heart–lung transplant before you calculate. Comparing your prediction with the result is the fastest way to find out whether you understand the idea or only the words.

Example 3 — an exam-style question

Typical questions about Heart–lung transplant ask you to (a) state it precisely, (b) apply it to given data, and (c) explain a limitation. Practise writing all three answers in under five minutes; the third part is what separates a full-mark answer from an average one.

Applications of Heart–lung transplant

In research: Heart–lung transplant appears in science research whenever the underlying quantities have to be modelled precisely. Papers usually cite it as a starting assumption and then explore where it breaks down.
In technology and industry: Engineering practice reuses Heart–lung transplant in design rules, simulations and safety margins. Knowing the idea lets you read a specification sheet and understand why the numbers look the way they do.
In the classroom: Heart–lung transplant is common in secondary-school and first-year university syllabi. It links to neighbouring topics Cardiac surgery, Heart, Lung, so understanding it makes those chapters shorter.
In everyday life: Look for Heart–lung transplant outside the textbook — in sport, cooking, traffic, electronics or the sky above you. An example you found yourself is remembered far longer than one you were given.

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How to study Heart–lung transplant in 20 minutes

Read the reference excerpt below once, without taking notes.
Close the page and write down what Heart–lung transplant means in your own words.
Compare your version with the excerpt and mark what you missed.
Work through the three examples above with pen and paper.
Explain Heart–lung transplant out loud to somebody else — or to Teacher Smith in the lgStudy chat.

Frequently asked questions

What is Heart–lung transplant in simple terms?

Why does Heart–lung transplant matter?

Because it connects several science ideas at once: it gives you a definition you can apply, a quantity you can calculate, and a way to check whether a result is plausible.

How should I study Heart–lung transplant?

Read the excerpt, restate it from memory, then work through the examples and applications listed on this page. The five-step study plan above takes about twenty minutes.

What does this page cover?

It gives you a compact reference excerpt plus original lgStudy explanations, examples, applications and study material on Heart–lung transplant.