Lung transplantation: Current status and future prospects

Lung transplantation recently marked its 35th anniversary. The period has b een marked by 20 years of initially slow progress followed by 15 years of e xplosive growth and success. In 1997 the number of lung and heart-lung tran splants exceeded 1000 in the United States and 1400 worldwide. Current 1-ye ar survival exceeds 75% for most diagnoses. Functional results are excellen t and durable with first second expired volume (FEV1) improving from 15% to 20% of the predicted normal preoperatively to 75% to 80% of the predicted normal postoperatively in most diagnoses. Problems facing lung transplant p rograms during the next century include the unavailability of graft lung do nors, technical limitations of explanted graft lung preservation, and the p revention and treatment of bronchiolitis obliterans syndrome. Current statu s and future trends for lung transplantation are reviewed.