ABSTRACT
During the last decade, activity in lung transplantation increased rapidly to a plateau
of approximately 900 transplants per year in the United States, and it is unlikely
to increase further unless the supply of useable donor organs can be expanded. However,
the demand for lung transplantation has continued to rise, and the median waiting
time for lung transplantation in the United States is approaching 2 years. The main
indications for lung transplantation have been chronic obstructive pulmonary disease,
α1 -antitrypsin deficiency emphysema, cystic fibrosis, idiopathic pulmonary fibrosis,
primary pulmonary hypertension, and Eisenmenger's syndrome. Overall, survival after
lung transplantation has been good, with 1-, 3-, and 5-year survival rates of 75,
58, and 44%, respectively, and the results have been improving. Chronic rejection
and infection have been the main causes of medium-term mortality, and the high prevalence
of chronic rejection remains a barrier to better outcomes. Quality of life has been
enhanced by lung transplantation, but the posttransplantation immunosuppressive regimen
has been associated with considerable morbidity.
KEYWORD
Lung transplantation - organ allocation - lung transplant activity - lung transplant
outcomes
