Prof. Dr. Ali Serdar Fak
Cardiac SurgeryVerified
- 29+years exp.
English · Turkish
FromPrice on request
Free quote
60 seconds · no obligationView Profile
Heart Surgery
Heart and lungs transplantation
What a combined heart and lungs transplantation is, why it is very rare and when double-lung or heart-only surgery is chosen instead, who is considered, how the operation is done, limits on access for foreign patients, approximate costs in Turkey against the UK, US and Germany, survival data, the long recovery, rejection and infection risks, and how to check a centre.
A written plan with the surgeon's name and the full price — usually within 24 hours.
- Category
- Heart Surgery
- Hospitals
- 2
- Verified
- 2
- Price from
- Price on request
Verified surgeons for Heart and Lungs Transplantation
2 doctors Compare doctors, ratings and prices — ask any of them for a free quote.
Dr. Bülent İlçöl
Cardiac SurgeryVerified
- 25+years exp.
English · Turkish
FromPrice on request
Free quote
60 seconds · no obligationView Profile
Heart and lungs transplantation: what it is and why it is rare
Heart and lungs transplantation is a single operation in which both the heart and both lungs are removed from a person with severe disease of both organs and replaced with a matched set from one deceased donor. It is one of the least common transplant procedures in the world, because few people have disease that cannot be treated by replacing only the lungs or only the heart, and because donor hearts and lungs rarely come together in a suitable condition. The recipient takes immune-suppressing medicine for life.
This guide explains when a combined transplant is considered, the alternatives, how the operation is done, the limits on access for international patients, approximate costs against the UK, US and Germany, survival data and recovery. For other heart procedures see our cardiology and heart surgery treatments in Turkey.
When is a heart and lungs transplant needed?
A combined transplant is considered when heart and lung failure are linked and neither can be fixed alone. The classic reasons are Eisenmenger syndrome, in which a congenital heart defect has damaged the lung vessels; pulmonary arterial hypertension with severe right heart failure that has not responded to modern drugs; and rare cases of advanced lung disease with heart muscle damage that cannot be repaired. Patients usually have breathlessness at rest, low oxygen levels, repeated admissions and a short expected survival without surgery.
Over the last two decades many patients who once needed a combined operation have been treated with a double-lung transplant, with the heart defect closed at the same time. This is why the heart-lung operation is now reserved for a small group.
Not everyone with heart and lung disease can be listed. Active cancer, serious infection, severe disease of the liver or kidneys, current smoking, substance misuse and an inability to follow a strict medication and clinic schedule usually rule a transplant out. Teams also look at nutrition, muscle strength and family support, because the months before and after surgery are demanding. A thorough assessment, often including right-heart catheterisation, lung-function tests and an echocardiogram, decides whether you are a candidate, and the answer may also be that another treatment is safer.
Heart-lung, double-lung or heart transplant: which one?
The transplant team chooses the smallest operation that will work, because every extra organ increases the risk and uses a scarce donor. A heart-only operation suits heart failure with healthy lungs; see our guide to heart transplantation. A double-lung transplant suits lung failure in which the heart is intact or repairable.
| Operation | Suits | Typical limits |
|---|---|---|
| Heart and lungs | Failure of both organs that cannot be repaired separately | Very few donors; highest surgical risk of the three |
| Double-lung | Severe lung disease, heart repairable or normal | Needs a heart that can recover after the lung change |
| Heart only | Heart failure with healthy lungs | Not an option when lung disease is advanced |
Defects that can be repaired, such as a faulty valve, may be handled by separate surgery such as aortic valve replacement before transplantation is considered.
Can foreign patients have a heart and lungs transplantation in Turkey?
Access is the first thing to check. Deceased-donor organs in Turkey are allocated through a national waiting list under Turkish transplant law, and in most cases the list serves citizens and residents rather than people who arrive for treatment only. A heart and lungs set cannot come from a living donor, so there is no family-donor route. Combined transplants are performed in very few centres, and a hospital that promises a donor on a fixed date to a non-resident should be questioned. Ask in writing whether you are eligible, under which rule and who authorises it, before you pay anything or travel. A full assessment, treatment of pulmonary hypertension and heart-failure care are often possible even where listing is not.
How does the operation work?
When a donor heart and lungs matched for blood group and chest size are available, the recipient is called in at short notice. Under general anaesthesia the surgeon opens the breastbone, connects the patient to a heart-lung machine, removes the diseased heart and both lungs and sews in the donor organs as a block: first the windpipe, then the upper heart chambers and the aorta. The new heart usually restarts when blood flows, and the machine is gradually withdrawn. The operation takes roughly six to ten hours. Intensive care follows, with a breathing tube for the first days and a first dose of immune-suppressing medicine.
Heart and lungs transplantation cost in Turkey compared with the UK, US and Germany
These are wide approximate ranges for the whole episode, not hospital quotes. Because the operation is so uncommon, a written itemised estimate after a records review matters more than any average.
| Country | Approximate cost range |
|---|---|
| Turkey | €100,000 – €250,000 |
| United Kingdom | €200,000 – €400,000 |
| United States | €600,000 – €1,500,000 |
| Germany | €200,000 – €400,000 |
What changes the price: the assessment and tests, the length of intensive-care and ward stay, time on a ventilator or circulatory support, treatment of complications, rejection checks and the first months of medicine. Ask what happens to the cost if recovery takes longer than planned.
Heart and lungs transplantation survival: what does the evidence say?
Registry data from the International Society for Heart and Lung Transplantation show that survival after a combined heart-lung transplant is lower than after a heart-only transplant, and that the largest risk is in the first year. Median survival is measured in years rather than decades, and people who survive the first year do considerably better. Long-term problems are mostly chronic rejection of the airways, known as bronchiolitis obliterans syndrome, along with infection and kidney damage from medicines. These are averages from small numbers of patients worldwide, so your own outlook depends on age, the underlying disease and other conditions. A centre should be able to state its own experience honestly, including how many combined transplants it has done.
Recovery after a heart and lungs transplant, step by step
Most patients spend two to four weeks in hospital, starting in intensive care. After discharge you stay close to the centre for the first weeks or months for frequent blood tests, lung-function tests, echocardiograms and biopsies. Breastbone healing takes six to eight weeks. Pulmonary rehabilitation, with breathing and walking programmes, starts early and continues for months. Recipients are taught to avoid infection exposure, and many return to light activity after three to six months; driving and work depend on the team's advice. Flying home is possible only when the team agrees, and long journeys in the first months are often avoided.
Rejection, infection and other risks
The main risks are acute and chronic rejection, serious infections, bleeding, narrowing at the windpipe join, kidney problems, high blood pressure, diabetes and certain cancers linked to long-term immune suppression. Because the lungs meet the outside air, lung infections are a particular concern. NHS Blood and Transplant, the British Heart Foundation and the ISHLT describe these risks and the need for lifelong follow-up. Ask who will manage your medicines and monitoring when you are home.
How to choose a transplant centre, red flags and questions to ask
Look for a centre with an established heart and lung transplant programme, a multidisciplinary team, its own intensive-care unit and an openly stated record. Red flags include a promised donor or date, a price given without an assessment, no written confirmation of legal eligibility, a vague team and no plan for follow-up. Read how our process works and use the free quote page so the hospital can review your records.
- Am I eligible for listing as a non-resident, and under which rule?
- How many combined transplants has the team performed, and what were the results?
- Would a double-lung or heart-only operation be enough for my condition?
- What does the estimate include, and what if the stay is longer?
- Who monitors my lungs and medicines once I am back home?
Hospitals with Cardiac Surgery in Turkey
Frequently asked questions
It is one operation that replaces both the heart and both lungs with a matched set from a deceased donor. It is reserved for people with severe disease of both organs that cannot be treated by replacing only the heart or only the lungs.
Usually people with Eisenmenger syndrome, severe pulmonary arterial hypertension with heart failure, or advanced lung disease with irreparable heart damage. Many patients who once needed a combined operation now have a double-lung transplant instead. The transplant team always checks first whether a less extensive operation would be enough.
Access is limited. Donor organs are allocated through a national waiting list that in most cases serves citizens and residents. Ask the hospital in writing whether you are eligible and under which rule before planning travel.
A wide approximate range is €100,000 to €250,000 for the whole episode, against about €200,000 to €400,000 in the UK. The price depends on assessment, intensive-care stay and complications, so ask for an itemised written estimate.
Registry data show lower survival than after heart-only transplants, with the highest risk in the first year. Median survival is measured in years, and people who pass the first year generally do better. Your own outlook depends on your age, the underlying disease and your other conditions.
Hospital stay is usually two to four weeks, followed by months of close monitoring and pulmonary rehabilitation. Breastbone healing takes six to eight weeks, and many people resume light activity after three to six months.
A double-lung transplant replaces only the lungs and keeps the patient's own heart, which may be repaired during surgery. A heart-lung transplant replaces all three organs and is used only when the heart cannot be saved.
Rejection, infection, narrowing at the windpipe join, kidney damage from medicines and certain cancers are the main concerns. Chronic rejection of the airways is the main long-term problem, so lifelong follow-up is essential. Ask the team how infections will be prevented and treated.
Plan for several weeks to months. After two to four weeks in hospital you normally stay near the centre for frequent checks before the team agrees you can travel home. The exact length depends on how you recover, and the hospital should explain this before you commit.
Patient stories