I am assuming when the Deputy refers to combined surgical procedures that he is talking about patients requiring a heart and lung transplant as against a lung transplant. I am advised by clinicians at the adult cystic fibrosis unit at St. Vincent's Hospital that since cystic fibrosis patients requiring transplant have mainly a loss of lung function, the tendency now is towards double lung transplantation rather than the more extensive heart and lung transplant. In many cases this is proving to be more effective both in terms of survival rates and better utilisation of donor organs, in that heart-lung blocks donated can now be used by more than one recipient.