Global reports for 2015 estimated that 126,670 solid organs were transplanted. This comprised of 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 increased by around 5.8% from 2014, this represents less than 10% of the global need for transplantation (Global Observatory on Donation and Transplantation).
The figure below shows the number of solid organ transplants (total 655,664) by organ type in the USA from 1988–2016 (United Network for Organ Sharing (UNOS), 2016). A total of 3,820 adult heart-lung transplants were reported to the ISHLT from 1982 to June 2014, with annual numbers being less than 100 since 2003 (Yusen et al., 2015).
The figure below shows the deficit in the transplant requirement in the USA.
Data from eight countries which constitute 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 whilst on a transplant waiting list (Journalist workshop on organ donation and transplantation, 2014).
In the UK, there is also a marked disparity between the need for organ transplantation and the supply of organs, although progress has been made in recent years to narrow the gap between supply and demand. This is shown in the figure below.
The current policy of high-urgency kidney transplantation in the Eurotransplant Kidney Allocation System (ETKAS) was 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 regarding individuals with vascular complications or repeated re-transplantations, 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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