Cardiopulmonary transplantation: current practice

Heart-lung transplantation has become an effective form of therapy for end-stage cardiopulmonary disease. Early results have steadily improved, and a 1-year survival rate of over 60% is now expected. The fact that lungs can be preserved for an extended period allows organs to be procured almost anywhere and this, in turn, has slightly improved the availability of organs for transplant. A diagnosis of lung rejection remains imprecise and progress still needs to be made in this area. Obliterative bronchiolitis of a variable degree remains the major medium-term complication, probably representing chronic graft rejection. Although long-term progress cannot yet be predicted, heart-lung transplantation remains the only option for a normal life for this special group of patients.