Pulmonary aspergillosis developed in a 52-year-old man 2 months after heart transplantation for ischemic cardiomyopathy. Conventional amphotericin B therapy caused marked deterioration of his already compromised kidney function after only 10% of the projected total dose. Conversion to liposomal encapsulated amphotericin B was associated with reversal of the kidney dysfunction and clearing of the pulmonary infiltrate. It is now 16 months since completion of therapy, and there is no evidence of recurrent infection.