Combined heart and lung transplantation.

Combined heart-lung transplantation has now been carried out in 27 patients at Stanford University Medical Center. All recipients had suffered from pulmonary hypertension, either primary or the result of Eisenmenger's syndrome. The one-year survival has been approximately 70%. All survivors returned to normal activity, though later respiratory difficulty has been encountered in some of these patients and has required retransplantation in one. These late occurrences are likely the result of inadequate control of rejection. Heart and lung transplantation has been shown to be an effective therapy for otherwise progressively fatal pulmonary conditions, and, in the case of Eisenmenger's syndrome, has presented a therapeutic avenue for the first time. The late complications encountered in some of these patients can probably be averted with increased experience.