[Lung transplantation]

Three different ways of pulmonary transplants are feasible: heart and lungs together, one single lung or both lungs. While concerning the primitive or secondary pulmonary arterial hypertension, only the cardio-pulmonary transplant is possible, concerning the respiratory deficiency; the respective indications of each of these transplants are not yet clearly defined. During the postoperative period, rejection and bacteriological, viral, fungal or parasitical infections are responsible for a mortality of about 30%. In the long term, the transplant patients are in danger of respiratory insufficiency by obliterating bronchiolitis due to untreated chronic rejection. The development of these transplants is considerably limited by the rarity of donors whose lungs are usable and by the frequency of isolated heart removals to the prejudice of the cardiopulmonary bloc transplants.