目的　探讨心、肺联合移植术的手术方法及术后多器官功能衰竭的原因。方法　对 1例扩张型心肌病合并肺动脉高压、心功能衰竭患者施行心、肺联合移植术。供肺由膈神经前放入受者两侧胸腔 ,依次吻合主支气管、下腔静脉、主动脉 ,上腔静脉与右心耳吻合。结果　由于受者的胸膜与肺及后纵隔粘连严重 ,术中出血多 ,术后引流液多 ,行二次开胸止血。受者相继出现呼吸、循环、泌尿、消化等系统功能衰竭 ,并发深部多器官曲霉菌感染。受者因多器官功能衰竭于术后 1 4d死亡。结论　心、肺联合移植后的多器官功能衰竭是多因素综合所致 ,术中和术后出血多是重要原因之一 Objective To investigate the surgical methods of combined heart and lung transplantation and the causes of postoperative multiple organ failure. Methods One case of dilated cardiomyopathy with pulmonary hypertension and heart failure patients underwent heart and lung transplantation. For the lung by the phrenic nerve into the recipient on both sides of the chest, in turn anastomosis of the main bronchus, inferior vena cava, aorta, superior vena cava and right atrial appendage. Results Due to the recipient’s pleura and lung and posterior mediastinal adhesions serious, intraoperative bleeding, postoperative drainage and more, the line of second thoracotomy. Recipients have respiratory, circulatory, urinary tract, digestive system failure, complicated by multiple organs Aspergillus infection. Recipients died of multiple organ failure at 14 days after operation. Conclusions Multiple organ failure after combined heart and lung transplantation is caused by multifactorial synthesis. The intraoperative and postoperative bleeding is one of the most important causes