Combined heart-lung transplantation: Options for increasing the donor pool

Area of Science:

• Cardiothoracic Surgery
• Transplantation Medicine
• Organ Preservation

Background:

• Combined heart-lung transplantation (HLT) numbers declined globally after 1990 but have steadily increased in the US since 2014.
• A recent International Society for Heart and Lung Transplantation session addressed the resurgence of interest in HLT.

Discussion:

• Ex vivo normothermic perfusion presents a novel method to overcome geographical limitations for donor organs.
• This technique, however, may reintroduce historical complications related to en bloc double lung transplantation and tracheal anastomosis.

Key Insights:

• Addressing logistical and distance barriers is crucial for improving donor organ access for HLT candidates.
• Developing best practices for machine perfusion and temperature-controlled preservation strategies is essential.

Outlook:

• Continued research and collaboration are needed to refine organ preservation techniques and mitigate risks associated with HLT.
• Advancing HLT care requires a comprehensive approach to donor organ procurement and recipient management.