Chest is opened to expose the diseased heart and lung to be removed (A). Heart and lung function is taken over by a heart-lung machine. Major blood vessels are severed, and the heart is removed (B). Bronchus and blood vessels leading to the lung are severed, and the lung is removed (C). Donor heart and lung are placed in the patient's the chest cavity (D). They are sutured to their appropriate connections, and the heart is restarted before the patient is taken off the heart-lung machine (E). (Illustration by GGS Inc.)