Major advancements in the field of lung transplantation have occurred over
the past thirty-Five years. Despite these advancements, limitations in our
ability to obtain sufficient numbers of organs and in our comprehension of
the problems associated with the procedure persist. The purpose of this art
icle is to review the current understanding of both the surgical procedure
and its most unfortunate complication, bronchiolitis obliterans. Even now,
after over three decades of experience, this complication remains the most
significant cause of morbidity and mortality following lung transplantation
. This article is not meant to be an exhaustive review, and certainly there
are important topics not covered herein. We have focused the discussion on
ongoing studies, which attempt to understand bronchiolitis obliterans at b
oth the clinical as well as the immunopathological level.