The current status of the field over the past several years was summarized in the 2005 Official Report of the Registry of the International Society for Heart and Lung Transplantation (ISHLT) (1). The overall level of activity reported in 2003 was close to that of 2002, including 931 bilateraland 772 singlelung transplantations, and 74 heart–lung transplantations. The number of bilateral procedures surpassed the number of single procedures by a larger amount in 2003 than in 2002, and the number of heart–lung procedures continued to decrease. The primary indications were chronic obstructive pulmonary disease (COPD)/ 1-antitrypsin deficiency for 61.2% of all single procedures and 32% of all bilateral procedures, idiopathic pulmonary fibrosis (IPF) for 24% of all single procedures, and cystic fibrosis (CF) for 32% of all bilateral procedures. Survival rates at 3 yr have improved from 55.7% for patients undergoing transplantation surgery between 1988 and 1994 to 63.3% for patients undergoing transplantation between 2000 and June 2003.