Frequently Asked Questions

What is a lung or combined heart-lung transplant?

A lung transplant is a surgery in which your child’s sick or damaged lungs are replaced with healthy lungs from a deceased donor. A heart-lung transplant is a surgery where both the heart and the lungs are replaced at the same time. With both surgeries, the donor organs are usually placed “en bloc,” all together as one from the same donor.

When is a lung or heart-lung transplant necessary for a child?

Lung/heart-lung transplant surgeons, along with pulmonologists and cardiologists when needed, may recommend lung or combined heart-lung transplantation when a child has end-stage lung disease with possible heart failure, and when all other treatments for the child have been tried and are no longer working, and all alternative treatments to transplantation have been considered.

What is the best time for my child to be evaluated for lung or combined heart-lung transplant?

Early transplant evaluation has benefits over waiting until your child is in crisis. An early evaluation, before end stage disease, helps provide time for you to understand transplant and make plans for when the time comes. It can also provide a window of time for our experts to try to support and stabilize your child’s health (supporting them to breathe well, gain weight, eat well, and manage any outside health concerns, including heart disease). Having a transplant when your child’s health is stable is more likely to result in a good transplant outcome.

How does congenital heart disease lead to the need for a heart-lung transplant in children?

Many parents wonder if their child’s heart condition is affecting their lungs. In certain circumstances, the workload of the heart can impact how the lungs work. The heart and lungs work together to deliver oxygenated blood to the heart and the body. If one is not working well, it can affect the other. That’s why specific congenital heart defects, such as Eisenmenger syndrome, or congenital heart disease with pulmonary hypertension in children, might require a pediatric heart-lung transplant instead of just a lung transplant.

Why should I choose Stanford Children’s for my child’s transplant care?

Our leading Pediatric Transplant Center treats more pediatric lung and heart-lung patients than any other transplant program/center in the Western United States. Stanford Children’s Health’s transplant outcomes are consistently comparable to or better than those of many of the top pediatric centers in the nation. Our transplant center is known for its innovative research, leading-edge technology, and world-renowned experts.

Is lung transplantation an option for children with cystic fibrosis?

Cystic fibrosis commonly affects the lungs. Often, pediatric cystic fibrosis can be managed with new revolutionary treatments, such as what is provided within our multispecialty Cystic Fibrosis program. Yet, in some children, lung transplantation is needed when modulator therapy is not an option, when their treatments stop working, and when their disease progresses to end stage.

What happens if you decide my child is not ready for transplant?

Once we evaluate your child for lung or heart-lung transplant, we consider them an ongoing patient and provide comprehensive care on a continuum until adulthood. We can partner with your child’s local doctor to guide medical management near home. As needed, we reevaluate your child for lung or heart-lung transplant candidacy and the right timing for placing them on the waiting list.

How long is the wait for pediatric lung transplant or heart-lung transplant?

Donor-organ waiting times are hard to predict. Some children wait only a few weeks or months. However, the waiting time can be as long as a few years. Several factors influence pediatric waiting list time, including a child’s health, age, size, blood type, and human leukocyte antigens (HLAs) sensitization status.

What is the long-term quality of life for a child after a lung or heart-lung transplant?

Most children who receive a lung or heart-lung transplant are glad they received a transplant, because of the improvements they experience in their overall health and ability to live a more active, normal life. However, children need ongoing medical care after transplant to manage immunosuppressive medications and navigate any complications that may arise.

What is the pediatric lung or combined heart-lung transplant recovery process?

After a lung or heart-lung transplant, your child will spend at least a few weeks in the hospital recovering and gaining strength, and then they will be required to stay near the hospital for a few months so our doctors can closely monitor their organ function and watch for signs of organ rejection. During this time, many of our families stay at the Ronald McDonald House at Stanford. After several weeks, your child will begin returning to normal activities as they grow stronger.

Because your child’s immune system is suppressed after transplant, it’s important to take extra care, including avoiding food-borne and environmental exposures to protect against illness. It is also important to get all recommended vaccinations to provide an extra level of protection against illnesses.

What are your outcomes for pediatric lung and combined heart-lung transplant recipients?

At Stanford Children’s we are proud to achieve exceptional outcomes. Our lung and combined heart-lung transplant patient survival rate is above the national average. We performed seven lung transplants on children in 2025, many with unique indications and surgical considerations for transplant, highlighting our advanced expertise and ability to take on highly complex patients.