A heart-lung transplant is a major and rarely performed surgical procedure where a person's diseased heart and lungs are replaced with those of a recently deceased donor.

On average, only six heart-lung transplants are performed in the UK each year.

This is because there are very few suitable donor organs available and priority is generally given to people who only need a heart transplant.

When is a heart-lung transplant needed?

A heart-lung transplant is the only treatment available for people who have combined heart and lung failure when all other treatment options have failed.

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

Occasionally, a heart-lung transplant may be used to treat cystic fibrosis, a condition where the lungs and digestive system become clogged up with sticky mucus.

Who can have one?

The total number of available donor hearts and lungs is very small and the transplant operation places a major strain on the body. This means a heart-lung transplant will only be recommended after very careful consideration and an in-depth assessment of your physical and mental health.

A person is usually only considered to be a suitable candidate for a transplant if they are in relatively good health and have no other serious medical problems.

For example, a heart-lung transplant may not be recommended if you are elderly, have cancer, misuse alcohol or drugs, smoke, are obese, or have a long-term mental health condition.

Specific criteria for people requiring a heart-lung transplant are currently being developed. For now, recommendations are made after consultation with a panel of transplant experts and members of your transplant team.

The heart-lung transplant process

If it's thought you might benefit from a heart-lung transplant, you'll be asked to have an assessment in hospital to check whether you are a suitable candidate for the procedure.

This will involve a number of tests, which may include blood tests, urine tests, blood pressure tests, lung and heart function tests, X-rays and scans.

If a heart-lung transplant is recommended after your assessment, you'll go on the transplant list to wait until suitable donor organs become available. The length of time spent on the waiting list can vary, but it can be several months or even years.

When a set of donor heart and lungs becomes available, you'll be admitted to hospital for the operation, which usually takes several hours to complete. Most people need to stay in hospital for around three weeks after the procedure.

Read more about what happens before and during a heart-lung transplant and recovering from a heart-lung transplant.

What are the risks?

A heart-lung transplant is a major procedure that carries a high risk of complications, some of which can be fatal.

This is why the procedure is usually only carried out when all other treatment options have been exhausted and it's thought the potential benefits will outweigh the risks.

The main risk after a heart-lung transplant is your immune system recognising the donated organs as not belonging to you and attacking them, which can stop the organs working properly.

This can often be avoided by taking medication to suppress your immune system. However, these medications themselves can cause side effects, such as high blood pressure and increased vulnerability to infections.

Read more about the risks of having a heart-lung transplant.


The outcomes of heart-lung transplants have improved significantly since the operation was first carried out in the early 1980s, mainly because of the introduction of immunosuppressant medication.

In the UK, around 85% of people who have a heart-lung transplant are still alive after one year. For those who survive to one year, the outlook is generally quite good, with most people surviving for at least 10 years and some people potentially living for 25 years or more.

However, it's important to realise that survival rates are a guide and cannot predict outcomes for each person. There are many factors that could influence your own predicted survival, such as your age.

Your transplant team will be able to provide you with more detailed information.

Help and support

Finding out that you need to have a transplant, waiting for suitable donor organs to become available, and actually having the transplant can be emotionally demanding for both you and your family. Most transplant teams are able to offer counselling for this.

Alternatively, your GP may be able to refer you to a counsellor and provide you with information and advice about joining a support group in your area.

There are a number of support groups, charities and other organisations that offer support and advice. These include:

NHS Organ Donor Register

Because of the limited availability of suitable organs, there is a need for members of the public to join the NHS Organ Donor Register.

You can join the Organ Donor Register by completing a simple online form or calling the NHS Donor Line on 0300 123 23 23.

Page last reviewed: 25/03/2015

Next review due: 25/03/2017