Cooley performed the world’s first successful combined heart-lung transplant in 1968. The International Society for Heart and Lung Transplantation reported 4,884 combined heart-lung transplants worldwide from January 1982 to June 2018, with a peak of 284 transplants in 1989. Due to the shortage of donor organs and advances in surgical techniques, many of the early cases requiring combined heart-lung transplantation were followed by lung transplantation, with the number of combined heart-lung transplants decreasing each year after the 1990s. Combined heart-lung transplantation is commonly used for advanced lung disease combined with refractory left heart failure. Double lung transplantation can improve both severe pulmonary hypertension and right heart failure, and it is preferred if the left heart function is normal in patients with severe pulmonary hypertension. In some patients with end-stage lung disease combined with functional or structural heart abnormalities, cardiac surgery (e.g. congenital heart disease repair, coronary artery bypass grafting and heart valve replacement or repair) and double lung transplantation can be performed simultaneously without the need for combined heart-lung transplantation. To summarize: combined heart-lung transplantation may not be superior to double lung transplantation. Patients with advanced lung disease who only have combined right heart failure (note that it is not left heart failure), double lung transplantation can improve the patient’s heart and lung function without the need for combined heart-lung transplantation. This is a frequent question asked by many patients: Can our patient, who has problems with his own lungs in addition to his heart, have a lung transplant?