Lung retransplantation: walking a thin line between hope and false expectations

Lung transplantation is a recognized treatment for end-stage lung disease for selected patients for whom no other options are available (1). Since the introduction of calcineurin inhibitors in the 1980’s, lung transplantation became a reasonable treatment with improved outcomes (2). However, chronic rejection or chronic lung allograft dysfunction (CLAD) remains the major limitation for long-term survival (3,4), accounting for more than 40% of deaths beyond the first year after pulmonary transplantation (4). CLAD leads to a progressive and irreversible loss of function of the transplanted organ.