<p>Lung transplantation (LuTx) is a&#xa0;treatment option for selected children and adolescents with irreversible, treatment-resistant lung diseases that can lead to organ failure. The aims of LuTx are to improve the quality of life and prolong survival. The three most frequent indications for LuTx before adulthood are cystic fibrosis, various forms of pulmonary hypertension and the heterogeneous group of diffuse parenchymal/interstitial lung diseases. The frequency of the indications and the age spectrum have changed in recent years due to the introduction of new highly effective drugs for cystic fibrosis, which was previously the most common indication and (especially in Germany) due to transplantation in increasingly younger children who often need a transplantation as an adolescent because of pulmonary hypertension or parenchymal lung diseases and not for cystic fibrosis. Despite improved survival times, the average life expectancy after LuTx is shorter than after transplantation of other solid organs. The most frequent causes of death are infections and chronic rejection reactions.</p>