Is transplantation an option for adult Eisenmenger syndrome?Is the grass on the other side of fence greener?

Patients of Eisenmenger syndrome are a heterogeneous group of subjects with varying underlying cardiac defects, longevity, and quality of life. The optimal transplantation strategy, ie, single lung, bilateral lung with intra-cardiac repair, or combined heart-lung transplantation remains a matter of debate, requiring careful consideration of the specific cardiac defect, age at presentation, ventricular function, organ availability, and resources available at the treating centre. The introduction of pulmonary vasodilator therapy has improved the survival curves and led to better quality of life even without transplantation. This review aims to discuss the merits, demerits, optimal timing, and type of transplantation options for adult patients with ES, particularly in countries with resource limitations such as ours (India).