Lung transplantation in Norway 1999-2020.

Abstract

Since 2009, patients with a rapidly progressing lung disease have been given a higher priority on the waiting list for a lung transplant. The purpose of our study was to examine diagnosis distribution, waiting list times, mortality and survival for patients on the waiting list in the period 1999-2020. We conducted a descriptive, retrospective study of patients on the waiting list for a lung transplant in the periods 1999-2008 and 2009-2020. A total of 557 lung transplants were performed: 185 in 1999-2008 (median of 17.5 per year) and 372 in 2009-2020 (median of 32.5 per year). In the periods 1999-2008 and 2009-2020, the proportion of patients with chronic obstructive pulmonary disease (COPD)/emphysema was 67% and 49%, respectively. The corresponding figures for pulmonary fibrosis were 13% and 23%, and for cystic fibrosis 5% and 11%. Waiting list mortality was 27% in 1999-2008 and 16% in 2009-2020. Correspondingly for the two periods, waiting list mortality for patients with pulmonary fibrosis was 45% and 22%, and for cystic fibrosis 41% and 2%. Waiting times were shorter for all diagnoses in the period after the change in priority and longest for patients with COPD/emphysema (median of 381 days). Median survival after lung transplantation during the study period was ten years. For patients with pulmonary fibrosis and cystic fibrosis, the change in transplant priority in 2009 may have played a role in reducing waiting list mortality.