Medical knowledge, Patient Education
Heart-Lung-Liver Multi-Organ Transplant
A heart–lung–liver multi-organ transplant is major surgery to replace your diseased heart, lungs, and liver with healthy organs. A condition called amyloidosis is the most common reason to have a heart–lung–liver transplant. Amyloidosis is a rare condition that results when a type of protein (amyloid) builds up in the body’s organs and interferes with the way they function. A heart–lung–liver transplant may be needed if no other treatments have been successful.
In this procedure, the diseased heart, lungs, and liver are surgically removed from your body at the same time and replaced with the donor organs. All three organs usually come from the same donor.
You will work with a team of health care providers (transplant team) to help you prepare for the procedure. Suitable donor organs need to be found that are a good match for your blood type and body size. Until then, you will be on an organ transplant waiting list.
Tell your health care provider about:
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Any allergies you have.
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All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
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Any problems you or family members have had with anesthetic medicines.
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Any blood disorders you have.
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Any surgeries you have had.
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Any medical conditions you have.
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Whether you are pregnant or may be pregnant.
What are the risks?
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Infection.
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Bleeding.
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Allergic reactions to medicines.
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Damage to nearby structures or organs.
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Rejection of the transplanted organs.
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Death.
What happens before the surgery?
Waiting list and notification
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You will be put on a transplant waiting list. When you are placed on the waiting list, the transplant team will tell you how to prepare for the time when the heart, lungs, and liver become available.
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While on the waiting list:
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Do not drink alcohol.
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Do not use any products that contain nicotine or tobacco. These products include cigarettes, chewing tobacco, and vaping devices, such as e-cigarettes. If you need help quitting, ask your health care provider.
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Once you are notified that the donor heart, lungs, and liver are available, you will be given instructions by the transplant team to come into the hospital right away or to await further instructions.
Staying hydrated
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Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.
Eating and drinking restrictions
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8 hours before the procedure – stop eating heavy meals or foods, such as meat, fried foods, or fatty foods.
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6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
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6 hours before the procedure – stop drinking milk or drinks that contain milk.
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2 hours before the procedure – stop drinking clear liquids.
Medicines
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Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
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Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
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Taking over-the-counter medicines, vitamins, herbs, and supplements.
Tests
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A physical exam.
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Blood or urine tests.
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Additional tests to help make sure you are fit enough to have this surgery.
General instructions
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How your surgery site will be marked.
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What steps will be taken to help prevent infection. These steps may include:
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Removing hair at the surgery site.
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Washing skin with a germ-killing soap.
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Taking antibiotic medicine.
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What happens during the surgery?
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An IV will be inserted into one of your veins.
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You will be given one or more of the following:
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A medicine to help you relax (sedative).
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A medicine to make you fall asleep (general anesthetic).
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The surgical team will make an incision to open your chest and remove the diseased heart and lungs. The new heart and lungs will then be sewn into place together as one group.
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During this surgery, you will be connected to a heart–lung bypass machine. This allows blood to continue to flow through your body.
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Next, an incision will be made in your abdomen, and the diseased liver will be removed.
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The surgeon will connect your blood vessels and bile ducts to the donor liver.
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After the donor organs are in place and connected, the chest and abdomen will be closed with stitches (sutures) or staples.
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Surgical drains may be placed to drain fluid and help you heal.
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Bandages (dressings) may be placed over your incisions.
The procedure may vary among health care providers and hospitals.
What happens after the surgery?
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Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until you leave the hospital.
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You will stay in the hospital for monitoring for several days.
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You will be started on medicines to prevent your body from rejecting the transplanted organs.
Where to find more information
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United Network for Organ Sharing (UNOS): unos.org/transplant
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Power2Save: power2save.org
Summary
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A heart–lung–liver multi-organ transplant is major surgery to replace your diseased heart, lungs, and liver with healthy organs.
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You may need a heart–lung–liver transplant if you have a rare condition called amyloidosis.
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A heart–lung–liver transplant may be needed if no other treatments have been successful.
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You will work with a team of health care providers (transplant team) to help you prepare for the procedure.
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In this procedure, your diseased heart, lungs, and liver are surgically removed from your body at the same time and replaced with the donor organs.
This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.
