20 ANNIVERSARY OF 1ST LUNG TX

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20th Anniversary of First Successful Lung Transplant Noted

With more than 1,000 lung transplants now performed in the United States each year, doctors paused this week to recall that it was only 20 years ago that the first successful lung transplant was performed at Toronto General Hospital.

Dr. , who performed that transplant, is now chief of cardiothoracic surgery at -Jewish Hospital in St. Louis. Jewish has done more lung transplants than any other U.S. center, performing its 700th lung transplant in August.

Looking back on the situation in 1983, said a review of 38 unsuccessful lung transplants performed up to that time showed that nine of the patients had lived longer than 14 days after surgery -- but all died after their airway connections failed to heal.

Animal experiments suggested that the problem was being caused by prednisone, a steroid often given to transplant patients to prevent rejection of the new organ by the body's immune system.

After the immunosuppressive drug cyclosporine became widely available in 1983, repeated the experiment, and this time the airway connections healed.

But at that point, recalled, he faced a new challenge.

"When you've had failure after failure, who are you going to transplant?" he said. "Who's going to want to be the next person?"

The volunteer who became the first successful lung transplant recipient was Tom Hall, 58, who had been diagnosed with pulmonary fibrosis, but was not yet ventilator-dependent.

Hall lived six years after the transplant ultimately dying of kidney failure.

Three years later, performed the first successful double lung transplant.

said he remains awed by the the miracle of transplantation.

"I once heard someone describe a miracle as something which leaves you with an abiding sense of astonishment," said. "At least for me, transplantation is that way. It's still miraculous."