The number of lung and heart-lung transplants performed in 1997 approached
1000 in the United States and exceeded 1350 worldwide. Current 1-year survi
val exceeds 75% for most diagnoses. Functional results are both excellent a
nd durable. Major obstacles facing lung transplant programs include the sca
rcity of graft lung donors, technical limitations of graft lung preservatio
n, and the prevention and treatment of bronchiolitis obliterans syndrome (B
OS), Current results and controversial aspects of lung transplantation are
reviewed.