Transplantation

 

Please note this information is general in nature. Full details on all aspects of pre and post-transplant care should be sort from your treating medical team.

 

Heart transplantation

Cardiac transplant surgery is a proven treatment for patients with end-stage heart disease, characterized by cardiac failure that does not respond to standard, optimal medical or surgical treatments. When heart failure is no longer responsive to medical therapy, heart transplantation is considered an alternative.

The world’s first human heart transplant was performed by South African cardiac surgeon Christiaan Barnard in 1967. Since that time significant advances in surgical technique, medication and patient management have improved the success significantly. Worldwide about 3500 heart transplants are performed, with just over 100 of those being performed in Australia.

 

Common indications for heart transplantation include;

  • Cardiomyopathy – Dilated, restrictive or hypertrophic

  • Inoperable coronary artery disease

  • Inoperable valvular disease

  • Congenital heart disease

  • Life-threatening arrhythmias refractory to other treatments

  • Secondary myocardial involvement such as:

    • Myocarditis

    • Connective tissue disorders

    • Infiltrations and granulomas (e.g. sarcoid and amyloid)

    • Neuromuscular (eg. Becker’s muscular dystrophy)

    • Peripartum heart disease

 

Lung transplantation

Lung transplant surgery is a proven therapeutic option for patients with end-stage lung disease characterised by respiratory failure that does not respond to optimal medical or surgical treatments.

It has increasingly been shown to improve survival and should be considered for patients with advanced lung disease whose clinical status has progressively declined despite maximal medical or surgical therapy.

Indications for lung transplantation include the following conditions (although not exclusively limited to):

•          Chronic Obstructive Pulmonary Disease (COPD)

•          Cystic Fibrosis

•          Interstitial Lung Disease

•          Bronchiectasis

•          Idiopathic Pulmonary Arterial Hypertension

•          Bronchiolitis Obliterans

•          Sarcoidosis

•          Lymphoangioleiomyomatosis

•          Alpha 1 Antitrypsin Deficiency

 

Heart / Lung Transplantation

Heart/lung transplant surgery is a proven therapeutic treatment for patients with end-stage heart and lung disease. Heart-Lung transplantation is a rarely performed procedure accounting for less than 2% of thoracic organ transplants.

All patients listed for heart and lung transplantation have;

•          End-stage disease involving both the heart and lungs despite maximal medical therapy

•          A poor probability of survival without transplantation

 

This surgery is possible for the following conditions (although not exclusively limited to):

•          Eisenmengers syndrome

•          Complex congenital heart disease

•          Pulmonary hypertension with associated left heart failure

 

Suitability for transplantation

Patients referred for transplantation must undergo complete medical and psychosocial evaluation. They are only placed on the active transplant list once they have successfully completed a full workup evaluation and are deemed an acceptable candidate.

 

Unfortunately, not all individuals with a severe respiratory or cardiac condition are suitable to receive a transplant. Exclusion criteria may include;

  • Active malignancy

  • Complicated diabetes

  • Morbid obesity

  • Uncontrolled infection

  • Inability to comply with complex medical therapy

  • Active substance use – cigarettes, alcohol and drugs

  • Irreversible damage of other organ systems that prevent rehabilitation after transplant

  • Acute medical conditions – may be reconsidered at a later stage when resolved.

 

 

Australian Heart / Lung Transplant Units

There are four heart and/or lung transplant units in Australia;

 

Advanced Lung Disease and Lung Transplant Unit

Fiona Stanley Hospital, Perth, WA

 

Transplant & General Respiratory Medicine

The Alfred Hospital, Melbourne, VIC

 

Qld Lung Transplant Service

The Prince Charles Hospital, Brisbane, QLD

 

Heart & Lung Transplant Unit

St Vincent's Hospital, Sydney, NSW

 

Transplant Resources

 

Statistics on heart and/or lung transplantation in Australia are available on the Australian and New Zealand Cardiothoracic Organ Transplant Registry (ANZCOTR) website

www.anzcotr.org.au

 

Worldwide statistics on heart and/or lung transplantation can be found on the International Society of Heart and Lung Transplantation (ISHLT) website

www.ishlt.org

 

Transplant Information Manual - a step by step guide for patients having a heart transplant at St Vincent's Hospital

Dealing with a Transplant Book - a manual to help patients and families cope with a transplant

Heart Transplant Patient Treatment Record - understand your medications and keep track of any changes to your plan

https://www.svhhearthealth.com.au/procedures/resources

 

Lung transplant recipient stories

https://www.cfwa.org.au/wp-content/uploads/2018/03/Positive-Profiles-Low.pdf

 

CF facts – Lung Transplant

https://www.cfwa.org.au/wp-content/uploads/2018/02/CF-Fact-Lung-transplant.pdf

 

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