Lung transplantation

End-stage respiratory diseases are the best indication to lung transplantation (heart-lung, single and double lung), on the other hand, systemic diseases are usually contraindication to transplant. The improvement in surgical technique, immunosuppressive therapies and in dealing infectious complications have contributed to the amelioration of survival of the transplanted patients. Nevertheless the shortage of organ donors and many clinical problems before and after lung transplantation suggest the need to have clear guidelines on mains topics. In particular, among patients with rheumatic diseases we should consider two kinds of problems: the indication to the lung transplantation, and the bone and muscle diseases interesting most patients with chronic respiratory failure. In this paper, the state of art on disease indications and contraindications, patients selection, pre-operative evaluation, awaiting list inclusion, treatment procedure choice and timing, and rehabilitation before and after lung transplantation are reviewed.