A heart-lung transplant is performed for unsalvagable dual cardiac and pulmonary failure. An organ transplant is an established life-saving therapy for these patients. The most common underlying conditions requiring heart-lung transplants are congenital cardiac diseases with Eisenmenger syndrome and certain pulmonary hypertension disorders.

A heart-lung transplant is the only treatment available for people who have combined heart and lung failure. It is a treatment that carries high risks but can offer benefits. For this reason, it is only recommended when all other treatment options have failed. If the damage is severe in both organs, replacing the heart or lungs alone may not be possible.

The conditions that most often require a heart-lung transplant are:

• adult congenital heart disease (ACHD) – where an adult has one or more birth defects that affect their heart · Coronary Artery Disease (CAD), leading to heart attack and permanently damaged heart muscle
• Heart valve disease, such as with damage from rheumatic fever
• Infections of heart tissue, especially heart valves · Untreated, uncontrolled high blood pressure · Cardiomyopathies, secondary to multiple causes
• Congenital heart defects (certain heart defects that an individual is born with)
• Certain drugs
• Cystic fibrosis
• Eisenmenger syndrome, which is due to unoperated congenital heart defects
• Idiopathic pulmonary fibrosis
• pulmonary hypertension – where high blood pressure develops inside the blood vessels of the lungs, which can damage both the lungs and the heart

Acceptable donor criteria are as follows 

• Age younger than 65 years for lung transplantation and younger than 45 years for heart-lung transplantation
• Absence of severe chest trauma or infection
• Absence of prolonged cardiac arrest (heart-lung only)
• Minimal pulmonary secretions
• Negative screens for HIV, hepatitis C, and hepatitis B
• Blood type (ABO) compatibility
• Close match of lung size between donor and recipient
• PaO 2 > 300 mm Hg on 100% fraction of inspired oxygen (FiO2)
• Clear chest radiograph
• No history of malignant neoplasms