Lung transplantation is an established treatment for patients with end-stage pulmonary disease from multiple causes (Orens and 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) were:

  • chronic obstructive pulmonary disease (COPD) (32%)
  • interstitial lung disease (ILD) (24%)
  • cystic fibrosis (16%)
  • α1-anti-trypsin deficiency (5%) (Yusen et al., 2015).

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%) (Yusen et al., 2015).

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 and Garrity, 2009; Fredericks et al., 2014).