Thoracic transplantation in the United States: an analysis of UNOS Registry data

Within the last 15 years, annual heart transplants performed in the U.S. were relatively stable, with an average of 2280 per year. The total number of lung transplants has steadily increased every year, reaching 1406 in 2005; the trend of increasing annual case numbers seemed more obvious for double lung transplants, which have become dominant since 2002. Heart-lung transplantation remains a rare treatment procedure, with an annual average of 50 since 1988. Overall 10-year graft survival rates for heart, double lung, single lung, and heart-lung transplant recipients were 48.7%, 29.7%, 17.5%, and 25.8%, respectively. Both short-term (1-year) and long-term (5-year) graft survival rates were improved in heart and lung transplantation. The effect of the transplant year was more significant in short-term graft survival. Risk factors that have a significant impact on the graft survival of thoracic transplants include HLA mismatches, pre-transplant PRA, transfusions between listing and transplantation, previous transplantation, treated rejection within the first year post-transplant, donor CMV status, and drug-treated infection prior to transplantation or prior to discharge.