[Lung transplantation]

Lung transplantation. Lung transplantation is one therapeutic option for selected patients with end stage respiratory insufficiency secondary mainly to emphysema, pulmonary fibrosis and cystic fibro sis. Because of increased number of graft proposals, priority access to transplantation for the more severe patients (High Emergency program) and the ex vivo reperfusion, the annual number of lung transplantations rose in France up to 371 in 2016. Global survival greatly improved at first because of perioperative and early mortality reduction. Then the main challenges for the long term survival are the prevention and treatment of graft rejection including its cellular/humoral and acute/chronic component and the improvement of the preventive immunosuppressive treatment taking into account its increased risk of infectious, proliferative and metabolic complications. At least, with appropriate evaluation of risk/ benefit balance, lung transplantation is associated not only with an increased survival but also with a clear improvement of the quality of life.