Figure 56-6a A, The left hilum is shown. The pulmonary artery and veins are divided, and the intact mainstem bronchus lies posteriorly. Division of the bronchus will allow completion of the recipient pneumonectomy. B, The donor lung is positioned within the recipient's left hemithorax. In this case, the hilar anastomosis begins with the left mainstem bronchus. (From Shumway SJ, Shumway NE: Operative techniques in lung transplants. In Thoracic Transplantation. Oxford, Blackwell Scientific, 1995, pp 183–186.)