Heart-Lung Transplant

A heart-lung transplant is a dual-organ procedure that replaces your diseased lungs and heart with healthy organs from a deceased donor. Usually, both organs come from the same donor to reduce the risk of rejection and are transplanted during the same operation.

At UPMC, our experts work as a multidisciplinary team to perform heart-lung transplants using some of the most advanced surgical techniques.

Start Your Transplant Journey

What is a Heart-Lung Transplant?

A heart-lung transplant is a dual-organ procedure that replaces your diseased lungs and heart with healthy organs from a deceased donor. Usually, both organs come from the same donor to reduce the risk of rejection and are transplanted during the same operation.

Conditions we treat with heart-lung transplant

• Advanced heart failure — When your heart can’t pump enough blood to support your body's needs.
• Cardiomyopathy — When your heart muscle becomes diseased, enlarged, or rigid, and can’t pump blood effectively.
• Congenital heart disease — A heart defect that is present at birth.
• Coronary artery disease — A narrowing of the blood vessels that supply blood and nutrients to the heart.
• Cystic fibrosis — An inherited disease that causes glands throughout the body to make abnormally thick, sticky mucus that can build up and lead to blockages, infections, and organ damage.
• Heart valve disease — An illness characterized by one or more of your four heart valves not working properly.
• Pulmonary hypertension — High blood pressure in the lungs that can cause heart failure.
• Severe lung disease — Caused by conditions such as chronic obstructive pulmonary disease (COPD), emphysema, pulmonary fibrosis, sarcoidosis, or scleroderma.

Why Would I Need a Heart-Lung Transplant?

You may need a heart-lung transplant if:

• A single-organ transplant won’t effectively treat your condition.
• A single-organ transplant can’t be performed without transplanting other organs at the same time.
• You have several organs that fail — either one after the other, or independently.
• You have a disease that affects multiple organs, such as cystic fibrosis.

Who’s a candidate for heart-lung transplant?

You may be a candidate for heart-lung transplant if you:

• Are in good overall health.
• Are willing and able to follow your doctor’s pre- and post-transplant treatment plan.
• Are younger than age 65.
• Do not have a serious physical health condition, such as cancer, blood poisoning, HIV, or hepatitis.
• Do not have chronic health conditions such as severe diabetes, obesity, or osteoporosis.
• Do not have a mental health condition that would prevent you from following your post-transplant treatment plan.
• Do not smoke or misuse alcohol or drugs.
• Have life-threatening heart and lung disease that is no longer responding to medical treatment.

What Are the Risks and Complications of Heart-Lung Transplant?

Risks and complications after heart-lung transplant include:

• Abnormal heart rhythms.
• Bleeding.
• Blood clots.
• Diabetes.
• Heart attack.
• Infection.
• Kidney disease.
• Narrowing of your airway.
• Osteoporosis.
• Problems with your new organs.
• Rejection of your new organs.
• Side effects from post-surgical anti-rejection medications.

What Should I Expect From Heart-Lung Transplant Surgery?

The first step in the transplant process is for your doctor to refer you for heart transplant services. We also accept self-referrals.

After you are referred to our program, our heart-lung transplant team will:

• Look at your medical records.
• Check your insurance benefits. A credit analyst will contact you to discuss your coverage and the costs of transplant surgery.
• Decide if you're a good candidate for a heart-lung transplant evaluation.
• Get you started with testing as part of your pre-transplant journey.

We work closely with your referring doctor to learn about your heart and lung problems and how a transplant might help you.

Your heart-lung transplant journey

Our heart-lung transplant team assesses every person referred to our program. Our transplant cardiologists, pulmonologists, surgeons, and other team members work together to decide if you would benefit from a transplant.

Factors that help decide if a heart-lung transplant is right for you include:

• Ability to stick to the treatment plan before and after transplant.
• Age.
• Height and weight, which can affect the waiting period and likelihood of receiving a transplant.
• Medical options to manage heart and lung disease.
• Other diseases that may affect the outcome of the transplant or increase the risks of surgery.
• Severity of your heart and lung disease.

After your heart-lung transplant, you'll need to take medication that suppresses your immune system for the rest of your life.

If the care team finds you might be a good fit for a heart-lung transplant, your journey will begin.

The four stages of the heart-lung transplant journey are:

Pre-heart-lung transplant exams and tests

This stage of the process begins after insurance approval. You'll have several outpatient tests and consultations to see if a heart-lung transplant is right for you. These tests and consults take about a week to complete.

You must bring a care partner to all of your visits. The heart-lung transplant exams and tests are physically demanding. It can be hard for someone with heart and lung disease to get from one appointment, test, or location without help.

If we decide you're a candidate for transplant, we'll work with your insurance plan to approve the surgery.

How much does a heart-lung transplant cost?

The cost of a heart-lung transplant can vary from person to person, depending on many factors. Our team is here to make sure you can handle the burden, understand your insurance coverage, and help you find financial aid if you need it. Your UPMC heart-lung transplant credit analyst and social worker will help you find out what parts of your care your insurance will cover.

Waitlist

Next, we'll add you to the heart-lung transplant waiting list. Your cardiologist and pulmonologist will manage your heart failure and lung disease as you wait for your transplant.

You need to be able to get to UPMC within four hours after you're on the heart-lung transplant waiting list. Many people drive, but some arrange private flights to Pittsburgh. Your social worker can give you details about flights.

How long will I need to wait for a transplant?

Heart-lung transplant waiting list times are hard to predict and highly variable — from one day to over a year.

Some factors that affect your wait time for a heart-lung transplant include your:

• Blood type.
• Health status.
• Size and weight.

Before your heart-lung transplant surgery

When a donor heart and lung(s) are ready, your transplant coordinator will call you to come to the hospital for your transplant.

You must get to the hospital right away. We ask people on the heart-lung transplant waiting list to be within four hours of UPMC.

Before coming to the hospital

Before coming to the hospital for your heart-lung transplant:

• Do not eat or drink anything.
• Pack your phone and charger.
• Bring your medicines.
• If you have a ventricular assist device (VAD), bring your equipment.

When you arrive at the hospital

When you arrive at UPMC, we will prepare you for your heart-lung transplant surgery.

The donor team will examine the heart and lung(s) to ensure they are suitable for transplant and match your needs.

In the meantime — to confirm you're in good health with no active illnesses — you'll:

• Complete a medical history and physical examination.
• Have blood work.
• Get x-rays.

Before moving you to the OR, your anesthesiologist will speak with you about what to expect. You'll receive general anesthesia and sleep through the procedure.

You will also speak to one of the surgical team members to get consent for the transplant to take place.

How long does heart-lung transplant surgery take?

The amount of time for a heart-lung transplant depends on the complexity of your case and whether you need other procedures. You can expect the surgery to take several hours.

During your heart-lung transplant

During your heart-lung transplant, your surgeon and care team will:

• Connect you to a heart-lung bypass machine. It does the work of your heart and takes the strain off your lungs. It pumps filtered, oxygen-rich blood into your body so your heart is still during the operation.
• Remove your diseased heart and lung(s).
• Replace them with the healthy donor heart and lung(s).

After the donor heart and lung(s) are placed into your open chest, your surgeon will attach them to the surrounding major blood vessels. Your new heart should start beating after blood flow is restored, but an electric shock can be used to get it started, if necessary. Your lungs should begin working as soon as the heart-lung bypass machine is disconnected.

Recovery after heart-lung transplant surgery

Your hospital stay

Our team is here for you when you need us for the rest of your life.

After your heart-lung transplant, you will:

• Start taking antirejection drugs right away. When your body detects something new, your immune system begins working to fight what it views as a threat. Antirejection drugs suppress your immune system's natural response, so your body will accept the new organs.
• Be in the cardiothoracic ICU for about three days before moving to a room on the transplant floor.
• Stay in the hospital for about 10 to 14 days, but this varies based on how sick you are before your transplant.

During this time, the heart-lung transplant team will:

• Adjust your medications.
• Create an eating plan for you to follow at home. A registered dietitian will develop and review your plan with you.
• Teach you coughing and breathing exercises that you'll need to do often. These help keep your lungs clear and prevent pneumonia.
• Watch for rejection, infection, or other problems.
• Work with you and your care partner to get ready for taking care of yourself at home.

Before you leave the hospital, make sure you and your care partner clearly understand:

• Any other instructions for at-home care.
• The meal plan and nutrition guidelines.
• Your follow-up care schedule (blood work, clinic visits, and testing).
• Your medication schedule.

Please feel free to ask members of your UPMC heart-lung transplant team to explain anything you're unsure of and answer any questions you may have. We're here for you through each stage of your transplant journey.

Follow-up care after discharge from the hospital

After heart-lung transplant surgery, you begin the journey of healing and enjoying the gift of your new heart and lung(s).

As you heal after heart-lung transplant surgery, you'll need to:

• Have follow-up tests and attend all appointments.
• Move around — Focus on regaining the strength and muscle mass that you lost while being sick before your transplant.
• Take care of your incision site.
• Take your medication twice a day.

You need to stay close to UPMC for at least a month after your heart-lung transplant. If you don't live nearby, you and your care partner can arrange for a room at Family House until you can go home. Family House offers patients and their loved ones an affordable home away from home. It is not a medical facility.

Learn more about traveling to Pittsburgh for transplant services.

For the first four weeks, you'll come back once a week for biopsies. During the biopsies, we take a tiny piece of your heart and lung and look for signs of inflammation or rejection. This is the only way doctors can tell early on if your body is rejecting your donor organs.

Then, if your recovery is going well, your appointments will follow this schedule:

• Month two post-transplant — Every other week.
• Months three through six post-transplant — Once a month.
• Months seven through 12 post-transplant — Every other month.

Along with tests and follow-up visits, the transplant team will ask you to keep track of and report any changes in your:

• Blood pressure.
• Temperature.
• Pulse.
• Weight.

Call us right away if you have any major changes. They can be signs of an infection or problem. You can reach us at 412-648-6202 or toll-free 844-548-4591.

Cardiac and pulmonary rehabilitation after heart-lung transplant

For people who need more help after heart-lung transplant surgery, we may suggest spending time in inpatient rehab before going home. The cardiac and pulmonary rehab programs at UPMC can help you recover and get stronger after your heart-lung transplant.

Rehab lasts anywhere from six to 12 weeks and will help you:

• Keep up with the breathing exercises you started while in the hospital.
• Strengthen your whole body.

Recovering at home after heart-lung transplant

When you return home, you will not be able to drive for about six weeks after a heart-lung transplant.

You'll need a care partner with you 24 hours a day for the first few months post-transplant.

This can be one person or a team of people who are willing to help you with daily tasks such as:

• Keeping track of changes to your health or any strange behaviors. Call the heart transplant team right away if you notice any major changes or problems.
• Taking your meds on time.
• Driving you to and from appointments.
• Refilling prescriptions, shopping, and running other errands.

Life after heart-lung transplant

Recovery after transplant can be a challenge. Getting the most from your new heart and lung(s) while ensuring quality of life requires a strong commitment.

You'll need to follow the medication and lifestyle guidelines you received before and after your heart-lung transplant surgery.

Medications

There is a risk that your body could reject your new heart or lung(s) after heart-lung transplant surgery. To help avoid rejection, you'll need to take antirejection medicine every day for the rest of your life. It's vital to your recovery that you don't forget to take these medications.

After a heart-lung transplant:

• You'll take some medicines for the rest of your life. You must always take these on time and at the correct dose.
• Do not stop taking your medications or try to adjust them on your own.
• Contact your transplant coordinator if other doctors or care teams prescribe medications for you. They will review them for potential interactions with your antirejection drugs.

You'll also need blood work so that we can keep an eye on your antirejection medicine levels.

Your care team may prescribe other medications to manage or prevent:

• High blood pressure or diabetes.
• High cholesterol or lipid levels.
• Infection.
• Pain.

Call your transplant coordinator or pharmacist if you have any questions.

Infection prevention

Antirejection drugs help prevent your immune system from rejecting your new heart. However, they can also weaken your body's ability to fight infections.

To prevent infection, make sure to practice good hygiene and ask any visitors to do so as well.

Tips to prevent infection include:

• Ask loved ones and friends to avoid visiting when they are sick.
• Avoid crowds during peak times for illness, like flu season.
• Wash your hands often.

Heart-healthy diet and nutrition

The nutritionist on your heart-lung transplant team will work with you to create an eating plan. Certain foods can affect your medicines.

Your medicines can also affect your potassium, phosphorus, and magnesium levels. You'll need to be careful about eating foods high in these nutrients to keep them in the proper range.

Your meal plan will suggest foods for you based on your medications.

A heart-healthy diet means you should:

• Limit fat, sugar, and salt.
• Eat recommended fruits, veggies, and lean meats.
• Avoid salty snacks, canned soups, or premade meals that tend to be high in sodium (salt).

It's important that you follow these guidelines to heal faster and make sure your new heart and lung(s) are working the way they should.

Exercises for the heart and lungs

You will need to move around regularly after your heart transplant.

Follow these tips to help you recover and prevent blood clots:

• Attend a cardiac and pulmonary rehab program.
• Start with short walks and build up as you're able.
• Take short naps when you need to, but don't lie around in bed for long periods during the day.

Even after you've returned to daily living, the UPMC heart-lung transplant team is here for you for the rest of your life. We'll stay in contact with you in case you have any side effects, issues, or questions after your heart-lung transplant.

What’s the survival rate after heart-lung transplant surgery?

Research shows the average survival rate for people who have had a heart-lung transplant one year after surgery is 63%. The five-year postoperative survival rate is around 44%, and the 10-year survival rate is 31%. Of recipients who survived the first year after their heart-lung transplant, the median survival is 10 years.

Why Choose UPMC for Heart-Lung Transplant Surgery?

When you choose UPMC for heart-lung transplant surgery, you will have access to:

• Advanced VAD care — Our experts have pioneered ventricular assist device (VAD) technology for more than 40 years. Our surgeons implanted the second Jarvik Artificial Heart as a bridge to transplant in 1985. Additionally, UPMC was the first medical center to discharge a patient with a VAD in 1990. Since then, we have implanted more than 1,300 VADs.
• Best-in-class outcomes — The Scientific Registry of Transplant Recipients (SRTR) reports UPMC as a national leader in 90-day survival rate. It is among the top nationally for survival rates at 30 days and one year post-transplant.
• Experienced, board-certified surgeons — With a rich history that includes more than 1,700 heart transplants over more than 40 years, UPMC is among the most experienced programs in the world. UPMC has also performed more than 2,500 lung and heart-lung transplants.
• Multidisciplinary, groundbreaking care — For patients requiring multiple organ transplants, your team collaborates with experts across UPMC to perform heart-lung, heart-liver, and heart-kidney transplants. UPMC performed the world’s first heart-liver transplant in 1984, and the world’s first heart-liver-kidney transplant in 1989. UPMC also performed the nation’s first beating heart transplant.
• Second-opinion services for high-risk cases — UPMC experts offer second-opinion services even for those who have been deemed high risk and were turned down for a transplant at another center. Approximately 30% of UPMC lung transplant recipients have been declined for lung transplantation at other centers.
• Bloodless heart transplants — We perform heart transplants for adult patients who need a transplant but cannot or choose not to receive blood components, including plasma, platelets, red blood cells, and white blood cells. From transplant evaluation to post-transplant care, our team is here to support patients every step of the way.

By UPMC Editorial Staff. Last reviewed on 2025-12-09.