[Heart, heart-lung and lung transplantation, 1994 status]

In recent years, heart transplantation has become a clinically routine means of treating patients with terminal cardiac disease. One-year survival rates of more than 80%, and five-year rates of about 70% vindicate the clinical acceptance of this form of treatment. Combined heart and lung transplantation has been practiced for the past ten years. Following the introduction of unilateral and bilateral lung transplantation in 1985, the combined heart/lung approach is now rarely indicated. In the treatment of interstitial, but also pulmonary vascular, diseases, unilateral and bilateral lung transplantation has been increasingly employed. Currently, the one-year survival rate of single-lung transplantation is 70%, that of two-lung or heart-lung transplantation about 60%. The main complications of such procedures remain the high incidence of infection and graft rejection. The lack of availability of suitable donor organs continues to be the major factor limiting the number of transplantations performed.