Since 1993 a total of 101 living-donor bilateral lung transplants have been performed with acceptable results when compared with those utilizing cadaveric lung grafts. Though most recipients were patients with cystic fibrosis who were rapidly deteriorating, the indications for live-donor lung transplantation have been expanded to include some cystic fibrosis patients in a more elective setting, as well as select patients with other end-stage pulmonary diseases. One-year Kaplan-Meler recipient survival is 72%. Seventy-six percent of deaths occur within the first 2 months after transplantation. The most common cause of death is infection, which accounts for 62% of the 1-year mortality rate. The incidence of rejection is 0.8 episodes per patient. Thirty percent of rejection episodes are unilateral, and most tend to be mild. Altogether, 203 patients have undergone donor lobectomy, with a mean age of 37 +/- 12 years (range 18-56 years). Operations included left lower lobectomy (102 patents), right lower lobectomy (97 patients), and right middle and lower lobectomy (4 patients). There has been no donor mortality. Postoperative Rand 36 Question Quality of Life scores, rating physical function, social functioning, and role limitation due to physical and emotional health, are well over 92 (of a possible score of 100). Eighty-five percent of donors said that their health was no different or improved since donation.