Combined heart-lung transplantation: a perspective on the past and the future

Area of Science:

• Cardiology
• Thoracic Surgery
• Transplantation Medicine

Background:

• A significant shift from combined heart-lung transplantation (HLT) to bilateral lung transplantation has occurred over the past two decades.
• This shift aimed to optimize donor heart utilization for other patients.
• However, HLT remains a crucial intervention for specific complex conditions.

Purpose of the Study:

• To provide a historical perspective on combined heart-lung transplantation.
• To discuss the ongoing necessity and future of HLT.
• To highlight the role of HLT in managing specific congenital heart diseases and Eisenmenger's syndrome.

Main Methods:

• This article presents a perspective based on clinical experience and literature review.
• It analyzes trends in transplantation practices over the last 20 years.
• The focus is on the indications and outcomes of HLT.

Main Results:

• Combined heart-lung transplantation (HLT) is the definitive treatment for certain congenital heart disorders and Eisenmenger's syndrome.
• The number of adult patients with congenital heart disease is increasing, underscoring the continued need for HLT.
• HLT allows for the management of complex cardiopulmonary conditions where isolated lung transplantation is insufficient.

Conclusions:

• Combined heart-lung transplantation (HLT) remains a vital procedure despite the rise of bilateral lung transplantation.
• The growing population of adults with congenital heart disease necessitates the continued availability and development of HLT strategies.
• Future perspectives should consider optimizing HLT for specific patient groups requiring combined cardiopulmonary support.