[Heart and lung transplantation in acute organ failure]

Heart and lung transplantation represent a realistic therapeutical option in endstage cardiac and pulmonary diseases. Transplantation for acute organ failure, however, is limited due to the scarcity of suitable donors with respect to the shortage of time. Aside from pharmacological means a number of mechanical assist devices are available for bridging of those patients in acute myocardial or respiratory failure. Indications for acute organ transplantation are primary graft failure following heart or lung transplantation and acute myocardial insufficiency due to extensive myocardial infarction or after open heart surgery, respectively acute respiratory distress syndrome in selected cases. Initiation of mechanical support requires previous detailed patient evaluation with respect to indication and possible contraindication for the bridging procedure and a subsequent transplantation as well.