Although the median survival for patients with cystic fibrosis (CF) has improved steadily over the past several decades, many patients go on to develop respiratory failure from progressive lung disease, eventually requiring lung transplantation for extended survival.1 Although many years have elapsed since the first lung transplants were performed for CF, the field is not without controversy.2 The paper recently published by Liou et al is one recent example, suggesting that lung transplant for most children with CF under 18 years of age offers no survival advantage.2 The complex statistical methodology and conclusions have since been challenged and rebutted by several lung transplant experts.3^–5 Controversial issues like this often reflect the shortage of randomised controlled trials for many aspects of lung transplant. Although there is much published material related to lung transplant, many protocols are based on retrospective data, or are rather centre or region specific. Although impure because of multiple confounding factors, such as small sample sizes, and varying surgical and medical protocols, these data do provide a reasonable template to formulate and update lung transplant protocols.

Two such datasets6 7 are published in this issue of Thorax (see pages 725 and 732). The first represents the experience of a single centre in the UK, accounting for a large proportion of lung transplants for CF in Britain,6 while the second paper from France addresses a difficult issue—that is, the risks of performing lung transplantation in patients infected with Burkholderia cepacia complex (BCC) organisms.7 The papers are complementary: the UK experience is a general report, excluding a detailed analysis of outcomes in patients with BCC (these data are promised shortly), while the French paper is BCC specific.

The Newcastle Lung Transplant Centre can take pride in its achievements as …