Lung transplantation is now an effective therapy for patients of less than 60 years-old with chronic end-stage lung diseases which life expectancy is less than 12 to18 months in spite of maximal medical therapy. The various surgical procedures (single or bilateral lung or heart-lung transplantation) offer an adapted solution to all the candidates whatever the cause of the respiratory disease. The early postoperative mortality is less than 10% and the survival rates regularly improve and reach 65 to 7% at 3 years and more than 50% at 5 years for experienced programmes. Primary graft dysfunction, infections and airways complications are the main causes of early morbidity. Bronchiolitis obliterans is the main limiting factor of the long-term survival. Malignancies and drug toxicity, such as renal or vascular complications, occur also at that time.