Laboratory and clinical experience with lung transplantation has defined the problems to be solved and has provided future routes of access to many of them. It has been established that (1) a single lung transplant can sustain a recipient; (2) a reimplantation response exists and can produce early transplant malfunction; (3) rejection is still a major obstacle to success; (4) there are two components to rejection, the alveolar and the vascular; (5) immunosuppression may attenuate the vascular component more than the alveolar; (6) reversal of rejection by methylprednisolone is possible; (7) better techniques for detection of lung rejection are needed; and (8) imperfect bronchial anastomotic healing and insufficient donor lungs remain serious problems. Because of the increasingly clear definition of these problems, and because progress is being made toward solving many of them, the future of the field can be looked on with guarded optimism.
Veith FJ, Koerner SK. The Present Status of Lung Transplantation. Arch Surg. 1974;109(6):734-740. doi:10.1001/archsurg.1974.01360060004002