Lung transplantation has a history of eight years in Iran. There are two official lung-transplantation centers; both of them are university-based and located in Tehran. The majority of transplantations are performed in Masih Daneshvari Hospital. During this period, Masih Daneshvari had passed its training curve for single and double lung transplantations. The hospital also established an organ procurement unit in 2004 and an organ donation database (Iran-Edha) in 2005. During these years, 24 patients were transplanted in Iran, 8 of them are still alive. The number of transplantation shows a gradual increase during this period. Waiting list for lung transplantation also shows a ten-fold increase during past four years and reached from 16 patients in 2004 to 53, 103, 139 and 173 in 2005, 2006, 2007 and 2008. Brain death organ procurement has been increased from 2004 till the present time and reached from 21 per year in 2005 to 43 per year in 2007 in our center. To ensure a sustained progress in organ donation and trans­plantation, especially lung transplantation, cultural development about organ transplantation was put into prospect and intensive efforts have been made during past several years. Providing financial and social support for lung transplanted patients were other developmental plans to help lung transplanted patients feel less pressure and focus on their health. Despite such efforts, the number of lung transplantation is not enough compared to expansion of the waiting list. This is caused by lack of donors instead of technical difficulties. We believe that further development of lung transplantation requires more cultural development, along with better social and governmental support.