Artemis Hospitals, Gurugram, is a leading multispecialty hospital known for advanced pediatric cardiac, thoracic, and transplant care. Accredited by the Joint Commission International (JCI) and the National Accreditation Board for Hospitals & Healthcare Providers (NABH), the hospital follows internationally recognised standards of patient safety, clinical excellence, and quality care.
The hospital is equipped with advanced paediatric cardiac operation theaters, dedicated PICU facilities, ECMO support systems, paediatric cardiac catheterisation labs, advanced imaging technologies, and multidisciplinary critical care support for complex pediatric heart transplant and pediatric lung transplant procedures.
As one of the advanced pediatric heart transplant centers in the region, Artemis Hospitals offers comprehensive care through a multidisciplinary team of paediatric cardiologists, paediatric cardiothoracic surgeons, transplant specialists, pulmonologists, intensivists, anaesthetists, rehabilitation experts, and transplant coordinators. The team specialises in managing congenital heart disease, paediatric heart failure, pulmonary hypertension, and advanced thoracic conditions requiring transplant care.
Procedure at a Glance
Procedure Aspect | Details |
Procedures Performed | Pediatric heart transplant, pediatric lung transplant, combined heart-lung transplant |
Anaesthesia | General anaesthesia |
Average Surgery Duration | 6–12 hours depending on complexity |
Hospital Stay | Approximately 2–4 weeks |
ICU Requirement | Paediatric intensive care monitoring required |
Recovery Period | Several weeks to months |
Post-Transplant Care | Lifelong follow-up and immunosuppressive therapy |
Success Factors | Early diagnosis, donor compatibility, surgical expertise, and post-transplant care |
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Why is Pediatric Heart and Lung Transplant Performed?
Pediatric heart and lung transplant surgery is usually recommended for children with severe heart or lung disease when medications, corrective surgeries, or other treatments are no longer effective. The procedure helps improve organ function, survival outcomes, growth, and overall quality of life in children with advanced cardiac or pulmonary failure.
End-Stage Heart and Lung Failure in Children
Children with advanced heart or lung failure may experience severe breathing difficulty, poor growth, fatigue, recurrent infections, low oxygen levels, or repeated hospitalisations. In such cases, a pediatric heart transplant or pediatric lung transplant may become necessary.
Congenital Abnormalities Affecting Both Organs
Certain congenital heart defects can gradually damage the lungs and pulmonary blood vessels over time. When both the heart and lungs are severely affected, a combined heart-lung transplant may be considered.
Failure of Medical and Surgical Treatments
Many children undergo medications, catheter-based procedures, or multiple corrective surgeries before transplant is considered. If these treatments no longer provide adequate improvement, transplant surgery may offer the best long-term treatment option.
What are the Conditions Treated with Pediatric Heart and Lung Transplant?
Pediatric heart and lung transplant surgery may be recommended for children with advanced heart or lung diseases that no longer respond to medications, corrective surgeries, or supportive therapies. These procedures are typically considered in severe and life-threatening conditions affecting cardiac and respiratory function.
Congenital Heart Disease with Lung Complications
Certain congenital heart defects can increase pressure in the lungs and damage pulmonary blood vessels over time, leading to combined heart and lung failure.
Pulmonary Hypertension
Severe pulmonary hypertension can progressively affect both the lungs and the heart, causing breathing difficulty, reduced oxygen levels, and heart failure.
Cystic Fibrosis
Advanced cystic fibrosis may result in irreversible lung damage and chronic respiratory failure, making pediatric lung transplant necessary in selected cases.
Cardiomyopathy with Respiratory Failure
Children with severe cardiomyopathy may develop advanced heart failure that affects oxygen circulation and overall organ function.
Eisenmenger Syndrome
Eisenmenger syndrome develops when untreated congenital heart disease causes irreversible pulmonary hypertension and significant heart-lung complications.
Advanced Interstitial Lung Disease in Children
Rare paediatric lung disorders may lead to progressive scarring of lung tissue, reducing breathing capacity and oxygen exchange.
Condition | Recommended Transplant Procedure |
Cardiomyopathy | Pediatric heart transplant |
Pulmonary hypertension | Pediatric lung transplant or heart-lung transplant |
Cystic fibrosis | Pediatric lung transplant |
Eisenmenger syndrome | Combined heart-lung transplant |
Congenital heart disease | Pediatric heart transplant or heart-lung transplant |
Interstitial lung disease | Pediatric lung transplant |
How are Donor Organs Selected for Pediatric Transplant?
Donor organ selection is one of the most important factors that can influence transplant success and long term recovery. The transplant team carefully evaluated donor compatibility to reduce risk of rejection and improve organ function after surgery.
Blood Group Compatibility
Blood group matching between the donor and recipient is essential to minimize severe immune reactions and improve transplant outcomes.
Size Matching for Children
The donor heart or lungs must closely match the child’s body size and chest cavity to ensure proper functioning after transplantation.
Tissue Matching and Crossmatch Testing
Specialised laboratory tests are performed to evaluate immune compatibility between the donor and recipient. Crossmatch testing helps identify antibodies that may increase the risk of organ rejection.
Organ Allocation and Waiting List Process
Children requiring transplant surgery are registered on organ transplant waiting lists based on medical urgency, organ availability, blood group compatibility, and donor-recipient matching criteria.
Donor Selection Factor | Significance in Pediatric Transplant |
Blood group compatibility | Reduces rejection risk |
Size matching | Ensures proper organ fit |
Tissue compatibility | Improves transplant success |
Crossmatch testing | Detects immune reactions |
Waiting list priority | Determines organ allocation urgency |
Who Should Undergo Pediatric Heart and Lung Transplant?
Pediatric heart and lung transplant surgery is recommended only after detailed medical evaluation by a multidisciplinary transplant team. The decision depends on the severity of the disease, the child’s overall health, and the likelihood of long-term transplant success.
Severity of Organ Failure
Children with advanced heart or lung failure who no longer respond to medications, catheter-based procedures, or corrective surgeries may be considered for transplant surgery.
Child’s General Health Condition
Doctors assess the child’s nutritional status, kidney and liver function, infection risk, immune status, and overall physical condition before determining transplant eligibility.
Previous Surgeries and Treatment History
Many children undergoing pediatric heart transplant or pediatric lung transplant may already have a history of congenital heart surgeries, prolonged ICU care, or advanced medical treatment. Previous treatment outcomes are carefully reviewed during transplant planning.
Evaluation Factors | Significance |
Severity of heart or lung failure | Determines transplant urgency |
Overall health condition | Supports surgical recovery |
Previous surgeries | Influences surgical planning |
Response to medical treatment | Helps assess transplant need |
Infection and immune status | Reduces post-transplant complications |
Factors That Influence Paediatric Transplant
Age and Body Weight
The child’s age, growth pattern, and body weight play an important role in donor organ matching and surgical planning. Infants and low-weight children may require highly specialised transplant care.
Infection Risk
Active infections can increase the risk of serious complications after transplant surgery, especially because immunosuppressive medications weaken the body’s immune response. Infection control and screening are therefore essential before transplantation.
Nutritional Status and Immune Function
Good nutrition supports healing, recovery, and immune function after surgery. Children with severe malnutrition or weakened immunity may require medical optimisation before transplant.
What are the Surgical Approaches for Paediatric Heart and Lung Transplant?
Pediatric heart and lung transplant surgery is a highly specialised procedure performed using advanced surgical techniques, sophisticated monitoring systems, and dedicated paediatric critical care support. The surgical approach depends on the child’s condition, the organs involved, and the complexity of the disease.
Open Transplant Surgery
Most pediatric heart transplant and pediatric lung transplant procedures are performed through open chest surgery under general anaesthesia. During the procedure, the child is connected to a heart-lung bypass machine, which temporarily performs the function of the heart and lungs.
Key-Steps During Pediatric Heart Transplant
The procedure generally involves:
- Opening the chest through a surgical incision
- Connecting the child to a heart-lung bypass machine
- Carefully removing the diseased heart
- Preserving major blood vessels for donor heart attachment
- Implanting the healthy donor heart
- Reconnecting blood vessels to restore circulation
- Monitoring the donor heart function before closing the chest
Key-Steps During Pediatric Lung Transplant
The procedure may involve replacing one or both lungs
Key surgical steps include:
- Removal of the damaged lung or lungs
- Implantation of healthy donor lungs
- Reconnection of the airways and blood vessels
- Restoration of oxygen flow and breathing function
- Continuous monitoring of lung performance during surgery
Combined Organ Implantation Procedure
A combined heart-lung transplant is performed when both the heart and lungs are severely damaged and cannot function independently. This procedure may be recommended for conditions such as:
- Eisenmenger syndrome
- Severe pulmonary hypertension
- Complex congenital heart disease affecting the lungs
Key Steps in Combined Heart-Lung Transplant
- Removal of the diseased heart and lungs together
- Implantation of donor heart and lungs as one organ block
- Reconnection of major blood vessels and airway structures
- Restoration of blood circulation and respiratory function
- Intensive monitoring throughout the procedure
Combined transplantation is more complex and usually requires a longer operating time and extended ICU care.
Advanced Paediatric Surgical Monitoring Techniques
Advanced monitoring technologies are used throughout the surgery to improve precision, organ function, and patient safety.
Common Technologies Used During Surgery
Advanced Technology | Role During Surgery |
Heart-lung bypass machine | Maintains circulation and oxygenation |
ECMO support systems | Provides temporary heart and lung support |
Invasive haemodynamic monitoring | Tracks blood pressure and circulation |
Transoesophageal echocardiography | Evaluates donor heart function |
Advanced ventilatory support | Assists breathing and oxygen delivery |
Paediatric ICU monitoring systems | Supports recovery after surgery |
How Can Parents Prepare Their Child for Transplant Surgeries?
Preparing for pediatric heart transplant or pediatric lung transplant surgery involves medical, emotional, and logistical planning. Proper preparation helps improve surgical readiness, supports smoother recovery, and reduces stress for both the child and family.
Days Before Surgery
In the days leading up to the transplant procedure, the medical team performs detailed evaluations to assess the child’s overall condition and prepare for surgery.
Pre-Surgical Preparation May Include:
- Blood tests and imaging investigations
- Cardiac and lung function assessment
- Infection screening and vaccination review
- Nutritional assessment and dietary planning
- Medication review and adjustment
- Counselling sessions for parents and caregivers
- Discussion regarding ICU stay and recovery expectations
- Organ donor matching and transplant coordination
Important Steps for Parents
- Maintain regular communication with the transplant team
- Ensure prescribed medications are taken on time
- Inform doctors about fever, infection, or worsening symptoms
- Keep medical records and emergency contact information ready
- Prepare emotionally for surgery and recovery timelines
On the Day of Surgery
On the day of the transplant procedure, the child is admitted for final surgical preparation and monitoring
What Happens Before Surgery?
- Vital signs and oxygen levels are checked
- Intravenous lines and monitoring devices are placed
- The anaesthesia team evaluates the child before surgery
- The surgical team reviews donor organ compatibility and readiness
- Parents meet the transplant specialists for final counselling and consent
- The child is shifted to the transplant operating theatre
- Continuous monitoring of heart rate, blood pressure, and oxygen levels begins
- General anaesthesia is administered before the procedure starts
How is Pediatric Heart & Lung Transplant Surgery Performed?
Pediatric heart and lung transplant surgery is a complex procedure involving multiple stages, advanced surgical techniques, and continuous monitoring. The process is designed to replace diseased organs with healthy donor organs, restore normal heart and lung function, and support long-term survival.
Step-by-Step Transplant Procedure
Administration Of Anaesthesia
The child is placed under general anaesthesia to ensure unconsciousness and pain control throughout the process.
Preparation and Monitoring
Vital signs, oxygen levels, and heart function are continuously monitored.
The child may be connected to a heart-lung bypass machine or ECMO support if required.
Chest Access
The surgical team opens the chest through a median sternotomy (for heart) or thoracotomy (for lung) to access the diseased organs.
Removal of Diseased Organs
The failing heart, lungs, or both are carefully removed while preserving critical blood vessels and airway structures.
Implantation of Donor Organs
The healthy donor heart and/or lungs are implanted.
Surgeons reconnect major blood vessels, airways, and cardiac chambers to restore circulation and oxygenation.
Restoration of Circulation
The donor organs are gradually perfused and monitored for proper function before discontinuing bypass support.
Closure and Transfer to ICU
The chest is closed, and the child is transferred to the paediatric intensive care unit (PICU) for close post-operative monitoring.
Average Duration of the Procedure
Procedure Type | Typical Duration |
Pediatric heart transplant | 4–6 hours |
Pediatric lung transplant | 6–8 hours |
Combined heart-lung transplant | 8–12 hours |
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Pediatric Heart and Lung Transplant in Special Situations
Certain children requiring pediatric heart transplants or pediatric lung transplants may need highly individualised treatment planning due to age, previous surgeries, or underlying genetic conditions. These complex cases require specialised expertise, advanced surgical support, and multidisciplinary transplant care.
Transplant in Newborns and Infants
Heart and lung transplant surgery may occasionally be required in newborns and infants with severe congenital abnormalities or irreversible organ failure.
Challenges in Infant Transplant Surgery:
- Limited donor organ availability
- Size matching difficulties
- Higher surgical complexity
- Increased need for intensive monitoring and critical care support
Conditions that May Require Early Transplant:
- Complex congenital heart disease
- Severe cardiomyopathy in infancy
- Advanced pulmonary hypertension
- Irreversible lung disease in newborns
Repeat Transplant Surgery in Children
Some children may require repeat transplant surgery if the transplanted organ develops long-term complications or chronic rejection.
Reasons for Repeat Transplant
- Chronic organ rejection
- Failure of the transplanted organ
- Severe transplant-related complications
- Progressive damage affecting organ function
Repeat transplant procedures are generally more complex because of previous surgeries, scar tissue formation, and long-term immunosuppressive therapy.
Transplant in Children with Genetic Disorders
Certain inherited or genetic disorders can affect the heart, lungs, or both organs, eventually leading to advanced organ failure.
Genetic Conditions Associated with Transplant Need
- Inherited cardiomyopathies
- Cystic fibrosis
- Metabolic and mitochondrial disorders
- Genetic interstitial lung diseases
These cases require coordinated evaluation involving paediatric cardiologists, pulmonologists, genetic specialists, transplant surgeons, and critical care teams.
Special Situation | Additional Considerations |
Newborn and infant transplant | Size matching and intensive monitoring |
Repeat transplant surgery | Scar tissue and chronic rejection risk |
Genetic disorders | Multidisciplinary long-term management |
Complex congenital disease | Advanced surgical planning |
Severe pulmonary hypertension | Combined heart-lung transplant evaluation |
Pediatric Heart and Lung Transplant in Special Situations
While many pediatric heart transplant and pediatric lung transplant procedures are planned for older children with advanced heart or lung disease, some situations require more specialised evaluation and treatment planning. These cases are often more complex because of the child’s age, previous surgeries, or underlying genetic conditions.
Transplant in Newborns and Infants
In certain rare situations, newborns and infants may require transplant surgery soon after birth. This usually happens when the child is born with severe congenital heart disease or irreversible heart and lung failure that cannot be corrected through conventional surgery.
These procedures are technically challenging because:
- Donor organs for infants are limited
- Organ size matching is more complex
- Newborns require highly specialised ICU care and monitoring
- The risk of complications is higher in very small children
Despite these challenges, advancements in paediatric transplant surgery and neonatal intensive care have improved outcomes in selected infant transplant cases.
Repeat Transplant Surgery in Children
Some children who previously underwent transplant surgery may later require another transplant if the donor organ gradually loses function over time.
Repeat transplant surgery may be considered due to:
- Failure of the transplanted heart or lungs
- Severe transplant-related complications
- Progressive deterioration in organ function
Because these children have already undergone major surgery and long-term immunosuppressive treatment, repeat transplantation requires careful surgical planning and close monitoring.
Transplant in Children with Genetic Disorders
Certain inherited or genetic disorders can severely affect the heart, lungs, or both organs during childhood. In advanced stages, transplant surgery may become the most effective long-term treatment option.
Conditions that may require transplant evaluation include:
- Inherited cardiomyopathies
- Metabolic and mitochondrial disorders affecting heart function
These cases often require coordinated care involving paediatric cardiologists, pulmonologists, genetic specialists, transplant surgeons, nutrition experts, and critical care teams to ensure comprehensive long-term management.
What to Expect After Pediatric Heart and Lung Transplant Surgery?
Recovery after pediatric heart transplant or pediatric lung transplant surgery requires close monitoring, specialised critical care, and long-term follow-up. Every child recovers differently depending on the underlying condition, type of transplant performed, and overall health before surgery.
The recovery process usually takes place in stages, beginning with intensive care support immediately after surgery and gradually progressing toward rehabilitation and long-term recovery.
Immediately After Surgery
After the transplant procedure, the child is shifted to the Paediatric Intensive Care Unit (PICU) for continuous monitoring and supportive care.
During this phase, the medical team closely monitors:
- Heart and lung function
- Blood pressure and oxygen levels
- Breathing support requirements
- Signs of bleeding or infection
- Donor organ performance
- Response to immunosuppressive medications
Many children initially require ventilator support, intravenous medications, and specialised monitoring systems during the early recovery period.
First Few Days After Transplant
As the child stabilises, doctors gradually reduce ventilator and intensive support. The focus then shifts toward improving organ function, preventing complications, and supporting recovery. During this period, the transplant team monitors:
- Signs of organ rejection
- Infection risk
- Fluid balance and nutrition
- Breathing and circulation
- Physical activity and rehabilitation progress
Parents are also educated about medications, hygiene precautions, nutrition, and follow-up care during this stage.
Long-Term Recovery and Prognosis
Long-term recovery after pediatric heart transplant and pediatric lung transplant involves regular follow-up visits, medications, rehabilitation, and lifestyle monitoring. Most children gradually return to:
- School and routine activities
- Improved physical activity levels
- Better growth and development
- Improved breathing and energy levels
Families often ask, “does a transplanted heart grow with the child?” In many cases, the transplanted heart adapts as the child grows, allowing improved long-term function.
Another common concern relates to heart transplant life expectancy child outcomes. Advances in transplant surgery, immunosuppressive therapy, and paediatric critical care have significantly improved long-term survival and quality of life after transplant surgery.
Normal Recovery vs When to Call a Doctor
Some symptoms are expected during recovery, while others may require immediate medical attention.
Normal Recovery Signs | When Immediate Medical Attention is Needed |
Mild weakness and fatigue | High fever |
Temporary reduced appetite | Severe breathing difficulty |
Gradual improvement in activity | Bluish lips or skin |
Mild discomfort near incision | Chest pain or severe swelling |
Slow improvement in stamina | Sudden fatigue or fainting |
What Are The Benefits of Pediatric Heart and Lung Transplant?
Pediatric heart transplant and pediatric lung transplant surgery can significantly improve survival, organ function, and quality of life in children with advanced heart or lung disease. With advancements in surgical techniques, paediatric critical care, and post-transplant management, long-term transplant outcomes have improved considerably.
Key Benefits Include:
- Improved heart and lung function
- Better breathing and oxygen circulation
- Reduced fatigue and breathing difficulty
- Improved growth and physical development
- Better physical activity and stamina
- Reduced hospital admissions
- Improved quality of life
- Enhanced long-term survival outcomes
- Better participation in daily activities and schooling
Why Choose Artemis Hospital for Pediatric Heart and Lung Transplant in Gurgaon?
Artemis Hospitals, Gurugram is recognised for advanced paediatric cardiac, thoracic, and transplant care supported by modern infrastructure, multidisciplinary expertise, and child-focused critical care services. The hospital offers comprehensive evaluation, surgical management, intensive care, rehabilitation, and long-term follow-up for children requiring pediatric heart transplant or pediatric lung transplant surgery.
Advanced Paediatric Transplant Infrastructure
The hospital is equipped with:
- Dedicated paediatric cardiac operation theatres
- Advanced PICU and ECMO support systems
- Paediatric cardiac catheterization labs
- High-end imaging and monitoring technologies
- Child-focused intensive care and rehabilitation support
Experienced Paediatric Cardiology and Transplant Team
The multidisciplinary team includes:
The team specialises in managing congenital heart disease, paediatric heart failure, pulmonary hypertension, and complex thoracic transplant cases.
Comprehensive Child-Focused Critical Care Support
Artemis Hospitals provides:
- 24/7 paediatric critical care monitoring
- Advanced infection control protocols
- Long-term post-transplant follow-up programs
- Nutritional, rehabilitation, and psychological support
- Coordinated multidisciplinary treatment planning
As one of the advanced pediatric heart transplant centers, Artemis Hospitals focuses on delivering specialised transplant care with a strong emphasis on patient safety, surgical precision, and long-term recovery outcomes.
Reviewed by Dr. Aseem Srivastava
Chief - Pediatric CTVS and Adult Congenital Heart Diseases
Artemis Hospitals
