Repeated success has now been obtained with single-lung transplantation for end-stage pulmonary fibrosis. Potential candidates for this procedure are individuals who are less than 60 years of age and who have progressive pulmonary deterioration with limited life expectancy. Since November 1983, eleven such transplantations have been performed; nine patients achieved discharge from the hospital and eight patients have remained alive up to 44 months after surgery. All of these recipients have good oxygenation on room air and good exercise tolerance and are capable of performing routine activities, including a return to previous employment. From our experience, it appears likely that single-lung transplantation can achieve the same success rates as other major organ transplantations.