Lung transplantation is an established treatment for patients with end-stage pulmonary disease from multiple causes (Orens & Garrity, 2009). The most common primary indications for adult lung transplantation identified by registry data from the International Society for Heart and Lung Transplantation (ISHLT) (n=45,689) (Yusen et al., 2015) were:

  • chronic obstructive pulmonary disease (COPD) (32%)
  • interstitial lung disease (ILD) (24%)
  • cystic fibrosis (16%)
  • α1-anti-trypsin deficiency (5%); worldwide, between January 1982 and June 2014, ISHLT registry data for combined heart and lung transplants (n=3,356), showed that the most common indications were:
    • congenital heart disease (35%)
    • idiopathic pulmonary arterial hypertension (IPAH) (28%)
    • cystic fibrosis (14%).

Lung transplantation is associated with significant mortality and morbidity, and long-term survival is much lower than observed for patients receiving kidney, liver or heart transplants (Orens & Garrity, 2009; Fredericks et al., 2014).