Trend in Lung Transplantation in the U.S.: An Analysis of the UNOS Registry.

Freitas MC.

Clinical Transplants 2010, Chapter 2

Abstract

The number of lung transplants continues to increase in the U.S. The most significant change over the last decade occurred after the 2005 implementation of LAS. When the percentage of patients being transplanted increased even further, while time-to-transplant and the number of patients dying on the waiting list significantly declined. As a result of implementation of LAS in 2005, IPF recipients became the largest group to receive a lung transplant. And the number of transplants for patients age 60 and over has increased significantly. The number of DL transplants performed yearly increased while the number of SL transplants has remained relatively consistent throughout the last decade. Though the gender distribution of recipients has fluctuated each year, the proportion of females receiving lung transplant has decreased. Of the deceased-donor DL and SL transplant recipients, 69% had a cold ischemia time between 3-6 hrs. And 79% of primary DL and SL transplant recipients had a 0% PRA. 6. A higher number of HLA mismatches impacts unfavorably on graft survival rates; yet, surprisingly, zero HLA A-B-DR MM also have an unfavorable impact; Recipients with less than two hours of cold ischemia-time (n = 815, 4.3%) have the worst five-year graft survival; PRA levels greater than 25% have an unfavorable impact on graft survival.