We report the medium-term result of the first domino heart-lung transplantation successfully performed in South East Asia. In January 1990, a 45-year-old female who was in severe respiratory distress and required continuous oxygen therapy for end-stage pulmonary fibrosis received the heart and lungs from a 21-year-old male with brain death due to head injury. The recipient's heart was transplanted to a 31-year-old male who was in severe congestive cardiac failure from cardiomyopathy. The heart-lung donor had blood group O and the other patients had blood group A. Both recipients are in good health 7 years after the surgery.
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