Heart/heart-lung transplantation. The domino procedure.

Orthotopic heart transplantation has become an accepted therapeutic modality limited only by availability of donor organs. Heart-lung transplantation is also being performed with increasing frequency due to improvements in distant procurement techniques. Although the majority of patients requiring heart-lung transplantation have cardiac dysfunction, there is a subset with no cardiac compromise that can serve as donors of cardiac allografts before heart-lung transplantation. We report a technique for sequential heart/heart-lung transplantation in such a subset of patients.