History of Lung Transplantation

Since the first lung transplant in 1963, over 25,000 lung transplants have been performed worldwide in patients with a variety of advanced lung diseases. Currently, nearly 4000 lung transplants occur each year worldwide. The growth in the number of transplant operations performed is rooted in several evolutions that have occurred in the field since the procedure’s inception and its eventual acceptance as a viable alternative to patients with advanced lung disease (ALD). All of the advancements resulted from careful attention to the challenges faced by the early pioneers; outcomes have improved as surgical techniques, donor and recipient selection, and medical therapies have been refined. The median survival of patients transplanted between 2000 and 2006 was 5.5 years compared to 4 years for those transplanted between 1988 and 1994 [1]. Outcomes have only improved slightly in more recent years and remain far from ideal as chronic rejection has emerged as the leading obstacle to better long-term survival. Given that lung transplant recipients still lag other solid organ transplants in terms of survival, additional advances are still needed. However, these innovations will only result from a clear understanding of the history of the procedure and how it evolved to where we are today. This chapter will discuss the history and the major milestones in the field.