Introduction

The seminal paper by Bruce Reitz and colleagues at Stanford University published in 1982 describing the first human heart-lung transplantation procedure presented a bold new step in multi-organ transplantation. [1] Devised as a means to treat intractable pulmonary hypertension, heart-lung transplantation has evolved to become an accepted modality for many other physiologic and anatomic issues that affect the heart and lungs, while it has also become an integral part of domino heart transplantation,[2] recently revived by Woo and colleagues[3] of Stanford University. The number of heart-lung transplantation procedures performed was higher than that of orthotopic heart transplantation. Nevertheless, 4,128 adult heart-lung transplants were performed through June 2018.[4] In this chapter, we will closely examine the historical background of heart-lung transplantation, as well as donor and recipient selection, operative conduct, and outcomes related to the procedure.