Global reports for 2015 estimated that 126,670 solid organs were transplanted. This total comprised 84,347 kidney, 27,759 liver, 7,023 heart, 2,299 pancreas and 196 small bowel transplants. Although the total number of organs transplanted globally had increased by around 5.8% from 2014, this represents less than 10% of the global need for transplantation (Global Observatory on Donation and Transplantation, 2013).
In the US, the number of solid organ transplants (total 655,664) is shown in Figure 2 by organ type in the US from 1988–2016 (United Network for Organ Sharing [UNOS], 2016). Figure 3 shows the deficit in the transplant requirement in the US (Health Resources and Services Administration, 2016a). A total of 3,820 adult heart-lung transplants have been reported to the ISHLT from 1982 to June 2014, with annual transplant numbers being less than 100 since 2003 (Yusen et al., 2015).
Data from the eight countries comprising the Eurotransplant group show that, in 2014, 11,080 potential recipients were waiting for a kidney transplant; 1,164 for a heart transplant; 1,918 for a liver transplant; 766 for a lung transplant; and 413 for a pancreas transplant. The number of organs transplanted for the Eurotransplant group in 2014 was 4,732 for kidney (3,384 deceased; 1,348 living donor); 1,758 for liver (1,646 deceased; 112 living donor); 1,298 for lung; 635 for heart; and 230 for pancreas (Eurotransplant, 2014).
At the end of 2013, around 63,000 patients were on waiting lists for organ transplantation in the EU (population 508 million). This was broken down into: 50,000 for kidney; 6,700 for liver; 3,450 for heart; 2,100 for lung; 1,300 for pancreas; and 70 patients for small bowel. An estimated 4,100 patients in the EU died during 2013 while on a transplant waiting list (Journalist workshop on organ donation and transplantation, 2014).
In the UK, there remains a marked disparity between the need for organ transplantation and the supply of organs. However, in recent years, progress has been made to narrow the gap between supply and demand as shown in Figure 4.
The current policy of high-urgency kidney transplantation in the Eurotransplant Kidney Allocation System (ETKAS) has been recently questioned. Analysis of results from the 15-year Eurotransplant survey of 61 transplant centres involving 898 kidney transplant recipients showed that high-urgency kidney transplant recipients had reduced survival (p=0.0053) and increased mortality with a functioning graft (p<0.0001) than non-high urgency recipients. The authors proposed more restrictive criteria for individuals with vascular complications or repeated re-transplantation in order to support patients on the non-high-urgency waiting list who have improved long-term prognosis (Assfalg et al., 2016).
Annual HSCT European data show that in 2013, 39,209 transplants were performed in 34,809 patients, with 57% being autologous (n=19,859) and 43% allogeneic (n=14,950) (Passweg et al., 2015). The total number of HSCTs exceeded 40,000 in 2014 with 36,469 patients being treated (Passweg et al., 2016).
In the US, there were a reported 19,220 HSCTs performed in 2013, increasing from 18,534 in 2012. In the period from 2009 to 2013, 57% of HSCTs performed in the US were autologous (Health Resources and Services Administration, 2015).
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