TY - JOUR T1 - Lung transplantation: beyond palliation JF - European Respiratory Journal JO - Eur Respir J SP - 721 LP - 722 DO - 10.1183/09031936.03.00073803 VL - 22 IS - 5 AU - R.D. Levy AU - M. Estenne AU - W. Weder AU - M.G. Cosio Y1 - 2003/11/01 UR - http://erj.ersjournals.com/content/22/5/721.abstract N2 - Some 4 decades ago, the first thoracic transplant of the modern era was performed. It was a heart, it was carried out in South Africa and although it did not last long, it opened a new door for treating patients dying of advanced cardiopulmonary conditions. Also, possibly a new door towards immortality? Perhaps that first heart transplant was too daring for its time, as surely there were many unknowns. However, it indisputably revealed the serious potential for clinical thoracic organ transplantation. Surgeons, physicians and immunologists were stimulated to work together towards improving the understanding of problems related to organ preservation, rejection and the optimising of recipient outcomes. The first successful lung transplants were reported ∼20 yrs ago, although a number of earlier bold attempts had been made. Lungs presented a special unique problem, related to continuous unprotected exposure of the allograft to the outside environment. After all, humans breathe over 7,200 L of air daily, along with its attendant microbes, particulates and pollutants. Could a new immunosuppressed lung handle that? It seems it most certainly can. Despite tentative early concerns, lung allografts perform remarkably well in both the short and longer term. Lung transplantation has become an important treatment option for certain carefully selected patients with a wide array of advanced cardiorespiratory diseases. Over 15,000 lung transplants have been performed in the 20 yrs since the procedure has become a clinical reality, and ∼1,400 new transplants are performed annually in approximately 100 centres worldwide. Lung transplantation has become a real therapeutic option, not just palliation, for certain patients suffering from advanced emphysema, cystic fibrosis, pulmonary … ER -