Lung transplant recipients, doctors and nurses are celebrating the 30th anniversary of the world's first successful lung transplant in Toronto.

In 1983, Tom Hall was the 45th patient in the world to receive a single lung at what was then Toronto General Hospital.

Tom Hall visits Paris, five years after his lung transplant. Before his successful operation, transplant recipients had not lived beyond a few days or weeks. (University Health Network)

Hall lived more than six years — the first to survive for more than days or weeks after receiving the organ.

"Most people don't recognize that Canada is No. 1 in some things and this [lung transplants] is one of them," Dr. Shaf Keshavjee, director of the lung transplant program, said in an interview.

On Wednesday, Toronto's University Health Network gathered health professionals and patients to mark the anniversary and to chronicle the challenges of lung transplants, noting how far the field has come and what's next.

In a video presentation, doctors recalled carefully describing how risky the operation was, why their research gave them optimism and Hall's courageous decision to go ahead, which they credited to his stamina and force of will.

A series of steps have improved the survival rate for lung recipients to 97 per cent, says Dr. Shaf Keshavjee. (CBC)

"I said, Tom, there have been about 44 attempts thus far and no one has survived. Are you sure you want to go ahead with it?" Dr. Joel Cooper, now chief of the thoracic surgery division at the Hospital of the University of Pennsylvania, said in an interview. "He said, 'I am grateful to be number 45.' That is exactly what he said. He was an upbeat person."

"Tom was not a quitter," his widow, Barbara Hall, recalls in a hospital YouTube video.

Why are lungs so difficult to transplant? Dr. Shaf Keshavjee said several features of lungs make them more difficult to transplant, including: Fragility of the organ.

Need to restore blood supply to not only the organ but also the airways.

Preservation challenges.

Keshavjee, then a medical student, heard about the transplant success on the radio and was inspired to enter the field. In 1986, he scrubbed in for the first double lung transplant, also at Toronto General.

In the early 1990s, there was a 50/50 chance of surviving to leave hospital after lung transplantation. Now, Keshavjee said, they have a 97 per cent survival rate.

Katie Sutherland from London, Ont., received a lung transplant in Toronto five years ago. Before the transplant, she would run out of breath walking down the street or up a flight of stairs.

"I'm playing sports again," Sutherland said. "I'm just living a normal life for someone who is 21. I'm doing everything I dreamed of doing."

Before her transplant, Sutherland benefited from a Novalung, an external artificial lung. Other improvements in the field include transplants for cystic fibrosis and the development of ex vivo repair, a system that treats and improves high-risk donor lungs so they can be used for transplant.

"Can we engineer super lungs, if you will?" said Keshavjee, who is also surgeon-in-chief at the University Health Network's Sprott surgery department.

Researchers are developing strategies to use gene therapy to modify the lungs to better handle the stresses of transplant, as well as testing stem cells for repairing the organs.