An update on lung transplantation

Summary Over the last 25 years, lung transplantation has developed into a well-established treatment option for selected patients with very advanced lung disease.

In 2010, over a 12-month period, more than 3500 new lung transplant procedures were reported to the International Society of Heart and Lung Transplantation (ISHLT) Registry [1]. In 2011, 1830 lung transplants were performed in the USA [2]. In 2012, 690 were performed in the “Eurotransplant” region [3] and a further 170 within the UK [4]. New transplant programmes are now being established around Europe, increasing access to this life saving intervention and benefitting from sharing experience with more established centres. Although worldwide activity has increased year on year over the last decade (fig. 1), demand has also increased meaning the significant shortage of suitable donor lungs accounts for an unacceptably high waiting list mortality rate in many countries.

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Figure 1

The number of adult lung transplants reported to the ISHLT each year since 1985. Reproduced from [1] with permission from the publisher.

Clinical experience shared between transplant centres worldwide has helped refine the assessment process so that those added to a waiting list are those who are most likely to benefit. Furthermore, a meticulous approach to post-transplant management in the immediate post-operative period, in the early and long-term has contributed to continually improving long-term survival after lung transplantation.