Cardiopulmonary transplantation

Heart-lung transplantation is now an established clinical procedure. Immediate problems include satisfactory donor procurement and the control of hemostasis in patients who have had extensive previous surgery. Immediate return of normal pulmonary function is good but is not maintained in all patients. Late dyspnea has occurred in some patients, one of whom had a successful retransplant procedure. Progress is now being made in the early detection and management of late pulmonary rejection, which are likely to improve late symptomatic results and survival.