Considering a lung transplant? Takeaways from the Lung Transplant Congress

by Eamonn Costello | Back to Blog

patientMpower attended the International Congress on Lung Transplantation.  It brought together a fantastic range of pulmonologists, nurses, scientists and other professionals from all over the world working to improve outcomes in Lung Transplantation. The topics covered were many and varied, so here we’ve condensed a few takeaways for people considering a lung transplant.

Age becoming less of a barrier to Lung Transplant

Dr Ramsey Hachem from Washington University School of Medicine presented data and experience of older lung transplant patients. In the USA, according to data from the official SRTR registry, older patients (65 or older) made up around 7% of transplants in 2005. In 2016, about 28% of patients were in older patients.  

Proportion of Lung Transplants by age groups
SRTR Annual report for 2016 – Published January 2018

Dr Hachem presented a case study from his Lung Transplant center of a 78 year old IPF patient who was successfully transplanted and is now 4.5 years post transplant and doing well.   Increasingly, centers are dropping absolute age limits and instead assessing a candidates health status and ability to recover from the surgery in order to assess if they are suitable for transplant. Although transplant survival is worse in age 70+, survival rates have improved greatly in this age group and are close to outcomes for patients in their 60s

Number of Lung Transplants is increasing

Dr Ramsey Hachem from Washington University School of Medicine presented data and experience of older lung transplant patients. In the USA, according to data from the official SRTR registry, older patients (65 or older) made up around 7% of transplants in 2005. In 2016, about 28% of patients were in older patients.

Total number of  USA Lung Transplants
SRTR Annual report for 2016 – Published January 2018

How to prioritize the waiting list ?

There were several presentations and discussions on different countries methods for deciding relative priority on the waiting list. Dr Andrew Fisher from Newcastle presented the UK’s recently implemented urgent and super-urgent lung allocation scheme.  Previously, patients were prioritized by individual centers with lungs primarily allocated based on regional zones. Patients who are rapidly deteriorating on waiting lists can now be registered for a super urgent or urgent lung transplant, giving patients most at risk of dying on the waiting list being given a higher priority for a transplant.
The USA uses a Lung Allocation Score (LAS) method to estimate each lung candidates’ medical urgency and expected post-transplant survival rate relative to other patients on the waiting list for a lung transplant.

More potential Lungs for transplant with Ex Vivo Lung Perfusion

There were several presentations from centers who have introduced ‘Ex Vivo Lung Perfusion’ (EVLP). Because so many donor lungs are damaged at the time of death, only 20-30% of donated lungs are usable for transplantation. EVLP, a process of evaluating and preparing donor lungs outside the body prior to transplant surgery, has the potential to increase the donor pool by restoring and repairing donor lungs.  Positive data was presented on the use of EVLP and it’s likely more centers will start using EVLP to increase the donor pool 

There were a a whole range of other talks across Pathology, Immunology,  Kidney Transplantation and big data – all with the focus on how to improve overall survival rates and outcomes in Lung Transplant.


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