Lung transplantation in the United States: 1990-2005

The number of lung transplants reported to the OPTN/UNOS Registry has been increasing during the past 15 years. The increase is mainly due to a steady increase in transplants in the 50-64 age group. There is also a trend toward increasing lung transplants for older patients (> 65 yr) since 2001. Among whites, COPD, IPF, CF, alpha1-ATD, and PPH were the top 5 original diseases leading to lung transplantation; while for blacks, sarcoidosis, COPD, and IPF were the major original diseases. Recipients with IPF had significantly lower graft survival rates than COPD patients. One-year graft survival rates increased from 70% in the early 1990s to more than 80% in the most recent 3-year period, but the increase in long-term graft survival has been very limited. The negative effect of previous transplantation on graft survival was only significant within the first post transplant year; in contrast, the negative effect of HLA mismatches is more apparent on long-term graft survival. Acute rejection within the first year had a significant deleterious effect on long-term graft survival.