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Cardiac Complications

The heart is the "bridge" between the lungs and the rest of the body. Both organs sit in the chest cavity with the heart surrounded by the lungs. The right side of the heart receives blood from the body and pumps it into the new lung. The new lung provides oxygen to the blood and removes carbon dioxide. The blood is then returned to the left side of the heart and pumped out to the rest of the body. As such, the heart and lungs function in tandem to supply and deliver oxygen to the rest of the body.

Despite this close relationship, long-term heart problems after a lung transplant are rare. The transplant team carefully screens for pre-existing heart disease prior to transplant to minimize problems.

You may, however, experience heart-related problems immediately following transplant. You will receive medication to counter low blood pressure, a common problem which occurs due to blood loss, dehydration, coming off the heart-lung machine or a shift in the heart's position within the chest cavity.

Arrhythmias (irregular heartbeats) may also occur post-operatively but usually are short lived and easily controlled with medication. Some patients take medication for arrhythmia on an ongoing basis.

Despite close scrutiny of the heart vessels prior to transplantation, myocardial infarctions (heart attacks) can still occur during or soon after the transplant procedure. This may be precipitated by prolonged low blood pressure or low oxygen levels.

Some of the immunosuppressive agents (steroids, tacrolimus, cyclosporin, rapamycin) can boost blood cholesterol and triglyceride levels. Patients may need a lipid-lowering agent as one of their long-term post-transplant medications. Interestingly, statins (a class of cholesterol-lowering agents) have been shown to decrease the incidence of rejection and are frequently taken by transplant recipients.

Infrequently, elevation of pressure in the lungs (pulmonary hypertension) may develop in the post-transplant period.