Heart and lung transplantation

This article is a reflection of the present status of heart lung transplantation in UK and worldwide. Cardiac transplantation turned what was once thought a mystical concept into lifesaving clinical procedures. It has stood the test of time, and it remains as a benchmark against which all other modalities of treatment are compared for end-stage heart failure. The evolution of lung transplantation to current practice, as an accepted therapy for end-stage pulmonary disease, is a product of ingenuity, perseverance, and hallmark of research excellence and clinical skills.Combined heart and lung transplants are now rarely performed. The outcomes of transplantation are dependent upon the entirety of the transplantation process which consists of recipient factors, donor factors, organ retrieval, organ preservation, implantation factors, postoperative management and long-term management of all transplant related complications including infection, rejection, malignancy and immunosuppression.In the UK, the number of heart transplants performed has fallen to less than 150/year, significantly less than the numbers a decade ago. The reasons are multifactorial. This issue is being seriously addressed at present by initiation of various new strategies and there has been a significant increase in the current year. Lung transplantation is steadily increasing year by year and has now exceeded cardiac transplant activity.