Tom Hall was told he had virtually no chance of surviving the lung transplant that was offered to him 30 years ago.

After all, 44 attempts had been made around the world; none of the patients had survived long.

But the idiopathic pulmonary fibrosis that was scarring his lungs, leaving him breathless and dependent on oxygen, was going to kill him soon anyway.

The response from the 58-year-old Etobicoke salesman still moves Dr. Joel Cooper, the surgeon making the offer: “I’m grateful for the opportunity to be 45.”

Hall not only survived the Nov. 7, 1983, surgery, he went back to work and, as the world’s first successful lung transplant patient, continued to embrace life for six more years. He died in 1990.

That milestone — and all the other world-record achievements in lung transplantation performed at Toronto General Hospital — will be celebrated Wednesday at a sold-out gala for 350 that will see 22 lung transplant recipients who have lived more than 20 years postsurgery.

Since Hall’s surgery, nearly 1,500 lung transplants have taken place at Toronto General Hospital and recipients now have a 95 per cent survival rate.

Cooper, 74, will also be on hand, travelling from his current post at the Hospital of the University of Pennsylvania, where he still performs lung surgery, though not transplants.

“Among the things that are relevant to this is the uniqueness of Canada,” he says. Hospital budgets here allowed for independence, whereas decisions in the U.S. depended on insurance companies or other distant bodies.

“The transplant could be done without concern over whether anyone was going to pay for it or not,” Cooper says. “I hope people in Canada will take some pride. It’s no accident that it initially happened there.”

Since that groundbreaking procedure, TGH has become the undisputed world leader in lung transplantation, says Dr. Shaf Keshavjee, 51, director of the Lung Transplant Program, part of the University Health Network.

“It’s the largest lung transplant enterprise in the world,” he says. “It’s state of the art facilities, bar none. And we’ve been able to do remarkable things.”

He lists a few: first single-lung transplant, first double lung transplant, first transplant for cystic fibrosis, first pediatric lung transplant, first pediatric transplant with mismatched blood types, first to use an XVIVO (outside the body) system to improve high-risk donor lungs, first to use the novalung ventilator to give those awaiting transplant more time.

Only 15 per cent of donated lungs are utilized elsewhere in the world, but 40 per cent are used at TGH. Keshavjee intends to boost that to 50 per cent.

“We continue to attract the best and the brightest from all over the world,” Keshavjee says.

But not long after those first successes, Toronto’s program nearly died itself. In 1988, Cooper became the first of several transplant surgeons to leave TGH.

“There was not much support and the reputation was not perhaps what it had been,” he says. “I never would have believed that the University of Toronto and the system there would generate the type of facility, the research and co-operation with industry.”

Full credit for saving the program belongs to Keshavjee, Cooper says. “I’m not sure that people appreciate the sacrifices he made,” he says. “He’s done many things better and I never would have thought, when I left, that that was in the cards.”

Keshavjee was a junior resident witnessing the first double lung transplant in 1986. “That’s all I ever wanted to do,” he says. “By the time I was finished my training, the place was a shadow of itself, everybody had left.

“The success of lung transplantation meant that every American centre wanted a Toronto lung transplant surgeon or Toronto thoracic surgeon,” he says.

But he was convinced TGH wanted to rebuild the program, so he stayed and began recruiting others.

Now, “Toronto is the place,” Keshavjee says. “The really important thing is that this is a Canadian celebration. We are clearly number one in the world in lung transplantation.”

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It’s also a celebration for the patients who otherwise would have been dead in a matter of months.

“I once heard someone describe a miracle as something that leaves you with an abiding sense of wonderment,” Cooper says. “To me, lung transplants have been that way. Seeing patients five, 10 and 20 years after they would have died, still highly functioning, is really remarkable.

“It’s still miraculous,” he says