Lung transplantation in Norway 1999-2020.

Area of Science:

• Pulmonology
• Transplant Surgery
• Public Health Policy

Background:

• Since 2009, higher lung transplant priority has been given to patients with rapidly progressing lung disease.
• Lung transplantation is a critical treatment for end-stage lung diseases.

Purpose of the Study:

• To analyze diagnosis distribution, waiting list times, mortality, and survival rates for lung transplant candidates between 1999 and 2020.
• To evaluate the impact of the 2009 policy change on lung transplant outcomes.

Main Methods:

• A retrospective, descriptive study design was employed.
• Data were collected and analyzed for two distinct periods: 1999-2008 and 2009-2020.
• Patient demographics, diagnoses, waiting times, mortality, and survival post-transplant were examined.

Main Results:

• Lung transplants increased from 185 (1999-2008) to 372 (2009-2020).
• Waiting list mortality decreased from 27% to 16%, notably for pulmonary fibrosis (45% to 22%) and cystic fibrosis (41% to 2%).
• Waiting times decreased across diagnoses, with chronic obstructive pulmonary disease (COPD)/emphysema patients experiencing the longest waits (median 381 days). Median survival post-transplant was ten years.

Conclusions:

• The 2009 policy change prioritizing rapidly progressing lung diseases likely reduced waiting list mortality for specific conditions like pulmonary fibrosis and cystic fibrosis.
• Lung transplant outcomes have improved, with reduced waiting list mortality and sustained long-term survival.