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Updated: Jan 14, 2026
07:28
Donor Posterior Atrial Flap Rotation for Left Atrial Cuff Reconstruction in Lung Transplantation
Published on: October 11, 2024
698
Specific risk factors for heart-lung transplantation
Justin Issard1,2, Jérôme Le Pavec3, Gaelle Dauriat3
1Inserm UMR_S 999 (Pulmonary Arterial Hypertension: Pathophysiology and Therapeutic Innovations), Paris-Saclay University, Le Plessis-Robinson, France.
JHLT Open
|October 17, 2025
Summary
Heart-lung transplantation (HLTx) is rare but remains crucial for complex cardiopulmonary disease, especially Eisenmenger syndrome (ES) with congenital heart disease (CHD). Expert centers show improved survival, exceeding 85% at 1 year.
Area of Science:
- Cardiology
- Thoracic Surgery
- Transplantation Medicine
Background:
- Heart-lung transplantation (HLTx) is increasingly rare, with <50 annual procedures globally.
- Evolving indications are dominated by Eisenmenger syndrome (ES) in congenital heart disease (CHD).
- HLTx is complex, carrying significant perioperative and long-term risks, especially in ES/CHD patients.
Purpose of the Study:
- Identify HLTx risk factors in modern indications.
- Examine patient selection, listing timing, perioperative challenges, and outcomes.
- Focus on ES and CHD-related HLTx cases.
Main Methods:
- Synthesized current literature.
- Analyzed registry data.
- Focused on ES and CHD patient populations.
Main Results:
- HLTx candidates present with comorbidities like prior surgeries, polycythemia, and multi-organ dysfunction, increasing complexity.
- Long waitlists and donor shortages complicate management.
- Expert centers report improved 1-year survival >85% and potential protective effects against graft dysfunction.
Conclusions:
- HLTx is the treatment of choice for select complex cardiopulmonary disease, particularly ES with CHD.
- Optimizing outcomes requires early referral, risk stratification, and expert center management.
- Advances improve survival, but HLTx demands multidisciplinary expertise and individualized care.
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