Transplantation of the lung has gained increasing importance during the last years and is now an established therapy for end stage lung disease. After a 3 years period of preparation the first single lung transplantation (SLTX) was performed at the Second Surgical Department of the University of Vienna in November 1989, followed by the first double lung transplantation (DLTX) in April 1990. Until the end of 1990 11 patients underwent SLTX and 6 DLTX. 7 of the 11 SLTX patients and 4 of the 6 DLTX patients are at present alive with significantly improved lung function and therefore markedly improved quality of life.