Heart/lung transplantation involves a coordinated triple operative procedure consisting of procurement of a donor heart-lung block, excision of the heart and lungs of the recipient, and implantation of the heart and lungs into the recipient.
Heart/lung transplantation may be considered medically necessary for selected individuals with end-stage cardiac and pulmonary disease including, but not limited to, the following conditions:
Heart/lung transplantation may be considered medically necessary with ONE of the following potential contraindications (not an all-inclusive list) subject to the judgement of the transplant center:
Absolute contraindications for transplant recipients include, but are not limited to, the following:
In addition to the above criteria and subject to the discretion of the transplant center, a Hepatitis C Virus (HCV) positive donor organ may be considered an acceptable organ option for an HCV negative adult recipient 18 years of age or older.
Heart/lung transplantation performed for any other condition or for individuals presenting with an absolute contraindication will be considered not medically necessary.
Heart/lung re-transplantation after a failed primary heart transplant is considered not medically necessary in individuals who do not meet criteria for heart/lung transplantation.
The International Society for Heart and Lung Transplantation-2014
The International Society for Heart and Lung Transplantation (2014) updated its consensus-based guidelines on the selection of lung transplant recipients. These guidelines made the following statements about lung transplantation:
“Lung transplantation should be considered for adults with chronic, end-stage lung disease who meet all the following general criteria:
For combined heart/lung transplant, the guidelines have stated that individuals with irreversible myocardial dysfunction or irreparable congenital defects in conjunction with intrinsic lung disease or severe pulmonary arterial hypertension are appropriate candidates for heart/lung transplantation. The guidelines also mentioned that isolated bilateral lung transplantation is associated with comparable or better outcomes in most individuals with pulmonary hypertension associated with right ventricular failure.