["The three of us must hold together". Psychoanalytic considerations of experiences of heart-lung transplantation. A hermeneutic text reconstruction].

Progress in the pharmacological control of transplant rejection must not blind us to the fact that the psychic integration of an implanted organ makes very great demands on the psychological capacity of the person involved. The authors describe the case of a female patient who had to undergo a combined heart-lung transplant as a result of an innate cardiac defect. Months after the successful operation she developed a set of symptoms--coughing, night-time anxiety, feelings of suffocation--that were not susceptible of explanation in terms of organic medicine. The secondary symptoms of conversion neurosis demonstrate how difficult the patient found it to accept the implanted organ, experienced as both exciting and repellent, as part of her own body.