Cystic fibrosis (CF) is an incurable, autosomal recessive multisystem disorder that is associated with multiple complications, in particular progressive lung disease, chronic pulmonary infections, respiratory failure and reduced life expectancy [1, 2]. In this regard, lung transplantation is an established treatment option for end-stage CF lung disease, aiming to improve both quality of life and survival [3]. This study observed a pronounced decline of CF-related lung transplants up to −83% in 2021 compared to the mean number in the period between 2012 and 2019, following the broad accessibility of elexacaftor-tezacaftor-ivacaftor in Germany in August 2020 https://bit.ly/3Pl7N9Y