Trend in Lung Transplantation in Europe 2015 - 2019, Type of Transplant and Organ Source

Abstract

Purpose NEWSLETTER TRANSPLANT provides annual lung donation and transplantation figures on a country basis, distributed per single and double lung transplantation and referencing Donors after Cardiac Death (DCD) as an organ source. These comprehensive data were used to analyze trends in lung transplantation (LTX) for the time-period 2015 - 2019, single versus double LTX and the impact of DCD on transplant volume. The focus was put on European countries. Methods Systematic review of all lung transplant data for the 5-year time-period for Europe defined as EU 27 countries plus Norway, Switzerland and United Kingdom was performed. Data was considered on a country level for overall transplant, single lung transplantation (SLTX) and double lung transplantation (DLTX). Countries allowing use of DCD organs were identified and the impact on total transplantation assessed. Results Number of lung transplantations moved from 1901 cases in 2015 to 2208 in 2019. This represents an increase of 307 transplants (14%). 16 out of 27 EU countries had active LTX programs in 2015. Further countries including Bulgaria, Hungary, Romania, and Slovenia started their own lung transplanting program in the time-period considered and reported their cases. SLTX keeps decreasing, from 296 cases to 260, accounting for only 11.8% of total LTX. Most single transplants are being performed in Spain and Ireland. All growth is coming from DLTX expanding from 1604 to 1945 cases in Europe. Most European countries adopted the opt-out system. This is the case for the leading transplanting countries. Five countries still have an opt-in ruling and Slovenia a mixed system. DCD organs account for 239 transplants or 10.8% of total LTX in 2019 compared to 7.3% in 2015. Eight out of 23 countries report transplantation of DCD organs in 2019. The contribution of DCD to total lung transplant in these eight countries varies from 2.6% to 43.8%. It is particularly high in The Netherlands with 44%, Belgium 28%, the United Kingdom 23%, and Spain 18%. Conclusion Europe has seen a substantial increase in lung transplantation between 2015 and 2019. Most countries have adopted the opt-out system. Eight countries reported the use of DCD organs, which have largely contributed to the overall growth and could play more of a role in the future. Overall growth has impacted only DLTX whereas SLTX keeps decreasing. New countries have joined the transplanting community. NEWSLETTER TRANSPLANT provides annual lung donation and transplantation figures on a country basis, distributed per single and double lung transplantation and referencing Donors after Cardiac Death (DCD) as an organ source. These comprehensive data were used to analyze trends in lung transplantation (LTX) for the time-period 2015 - 2019, single versus double LTX and the impact of DCD on transplant volume. The focus was put on European countries. Systematic review of all lung transplant data for the 5-year time-period for Europe defined as EU 27 countries plus Norway, Switzerland and United Kingdom was performed. Data was considered on a country level for overall transplant, single lung transplantation (SLTX) and double lung transplantation (DLTX). Countries allowing use of DCD organs were identified and the impact on total transplantation assessed. Number of lung transplantations moved from 1901 cases in 2015 to 2208 in 2019. This represents an increase of 307 transplants (14%). 16 out of 27 EU countries had active LTX programs in 2015. Further countries including Bulgaria, Hungary, Romania, and Slovenia started their own lung transplanting program in the time-period considered and reported their cases. SLTX keeps decreasing, from 296 cases to 260, accounting for only 11.8% of total LTX. Most single transplants are being performed in Spain and Ireland. All growth is coming from DLTX expanding from 1604 to 1945 cases in Europe. Most European countries adopted the opt-out system. This is the case for the leading transplanting countries. Five countries still have an opt-in ruling and Slovenia a mixed system. DCD organs account for 239 transplants or 10.8% of total LTX in 2019 compared to 7.3% in 2015. Eight out of 23 countries report transplantation of DCD organs in 2019. The contribution of DCD to total lung transplant in these eight countries varies from 2.6% to 43.8%. It is particularly high in The Netherlands with 44%, Belgium 28%, the United Kingdom 23%, and Spain 18%. Europe has seen a substantial increase in lung transplantation between 2015 and 2019. Most countries have adopted the opt-out system. Eight countries reported the use of DCD organs, which have largely contributed to the overall growth and could play more of a role in the future. Overall growth has impacted only DLTX whereas SLTX keeps decreasing. New countries have joined the transplanting community.