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Lung

OPTN/SRTR 2015 Annual Data Report: Lung

Abstract

In 2015, 2409 active candidates aged 12 years or older were added to the lung transplant waiting list; 2072 transplants were performed, the most of any year. The median waiting time for candidates listed in 2015 was 3.4 months; the shortest waiting time was for diagnosis group D. Despite the highest recorded transplant rate of 157 per 100 waitlist years, waitlist mortality continued a steady decade-long rise to a high of 16.5 deaths per 100 waitlist years. Measures of short- and long-term survival showed no trend toward improved overall survival in the past 5 years, except that 6-month death rates decreased from 9.4% in 2005 to 7.9% in 2014. At 5 years posttransplant, 55.5% of recipients remained alive. In 2015, 23 new child (ages 0-11 years) candidates were added to the list; 17 transplants were performed. Incidence of death was 6.1% at 6 months and 8.2% at 1 year for transplants in 2013-2014. Important policy changes will affect access to transplant. In February 2015, OPTN implemented a comprehensive revision of the lung allocation score to better reflect mortality risk. Broader geographic sharing of donor lungs for pediatric candidates and allowance for selected transplants across blood types for candidates aged younger than 2 years have been approved and are expected to improve pediatric access to transplant. The impact of these changes on lung transplant trends will be observed in the coming years.

Introduction

Lung transplant remains an important and increasingly used option for the treatment of patients who have end-stage lung diseases. Lungs are allocated to US transplant candidates aged younger than 12 years based on age, geography, ABO blood type and priority status. For candidates aged 12 years or older, allocation is based on age, geography, blood type (ABO) compatibility, the lung allocation score (LAS), and, if necessary, waiting time.

Implemented in 2005, the LAS calculation largely reflects the risk of waitlist mortality while avoiding transplants in candidates with poor likelihood of posttransplant survival. The LAS applies to adolescent (aged 12-17 years) and adult (aged 18 years or older) candidates. As part of the development of the LAS system, pulmonary diagnoses for candidates aged 12 years or older were categorized into four main groups based on survival probability and pathophysiology of the underlying disease. The four groups are: group A, obstructive lung disease (e.g., chronic obstructive lung disease/emphysema); group B, pulmonary vascular disease (e.g., idiopathic pulmonary arterial hypertension); group C, cystic fibrosis and immunodeficiency disorders; and group D, restrictive lung disease (e.g., idiopathic pulmonary fibrosis).

The Organ Procurement and Transplantation Network (OPTN) implemented the first comprehensive revision of the LAS calculation in February 2015. This revision includes modifications to the variables used in the LAS calculation and to the relative weight of the variables used to predict risk of death in the next year without transplant and in the first year posttransplant. In this chapter, we refer to the revised LAS as the LAS-R. We caution readers about comparing the LAS-R with the LAS in the figures. Given the differences in how these scores are calculated, they may not be comparable. In time, the full impact of the LAS-R on waitlist and posttransplant outcomes will be evident. In 2016, OPTN approved policies to improve access to lung transplant for pediatric lung transplant candidates. These include broader geographic sharing of donor lungs to pediatric candidates aged younger than18 years. Also, candidates who were listed before age 2 can be considered for donor lungs of any blood type, because infants do not have sensitivity to “incompatible” blood types. The pediatric policies have been approved but are not yet implemented.

In this report, all lung transplant candidates and recipients aged 12 years or older are included under Adult Lung Transplant, and those aged 0 to 11 years are included under Lung Transplant in Children. Heart-lung patients are included in all tabulations.

Adult Lung Transplant

Waiting List

Characteristics of US candidates waiting for a lung transplant

In 2015, lung transplant waitlist trends were comparable to trends in prior years, with 2409 candidates added to the waiting list (Figure LU 1). By the end of the year, 1519 candidates were waiting for a lung transplant (Figure LU 2), 1459 for lung-only transplant and only 50 for heart-lung transplant (Table LU 1). Distinct trends attributable to implementation of the LAS also persisted. Lung transplant candidates were listed at increasingly older ages, were more likely to have restrictive lung disease, and were likely sicker at listing.

Approximately 75% of candidates on the waiting list were aged 50 years or older in 2015 (Figure LU 3). Those aged 50 to 64 years continued to make up the largest proportion of the waiting list, at 49.0%. Candidates aged 60 years or older made up higher proportions of the waiting list every year in the past decade, and they represented 25.7% of the list in 2015. With this trend comes the correlate decline in proportions of younger candidates. Candidates aged 35 to 49 years made up 13.7%, 18 to 34 years 10.3 %, and 12 to 17 years 1.4% of the waiting list.

The proportion of candidates with restrictive lung disease (diagnosis group D) increased every year from 2005-2014, then stabilized in 2015 at 49.6% of the list (Figure LU 5). Candidates from the other three diagnostic groups made up smaller proportions of the waiting list, and proportions have been mostly stable over the past 5 years: group A, 33.3%; group B, 5.0%; and group C, 12.2%.

Whether the trend toward listing sicker candidates for transplant has stabilized is unclear. Snapshots of lung transplant recipients in 2010 and 2015 show similar findings: 8% to 9% were supported by a ventilator or extracorporeal membrane oxygenation (ECMO) at the time of transplant (Table LU 4). The LAS distribution on the waiting list rose steadily toward higher scores from LAS implementation in 2005 to 2014; median LAS at the time of transplant was 36.7 in 2005 and 44.4 in 2014 (Figure LU 38). The lower median LAS-R of 41.6 in 2015 cannot be compared with the LAS in years prior because the LAS-R calculation differs from the LAS calculation. The score distribution among candidates showed a similar pattern of increases; the LAS was 50-100 for 31.6% of candidates in 2014, compared with 5.7% in 2005 (Figure LU 7). In 2015, the LAS-R was 50-100 for 27.6% of candidates. Again, the distribution of the LAS-R in 2015 cannot be compared with the distribution of the LAS in prior years.

Outcome of US candidates listed for lung transplant

In 2015, we saw the highest lung transplant rate ever in the US, at 157 per 100 waitlist years (Figure LU 10). Most candidates underwent transplant by 1 year after listing (Figure LU 15). For example, of candidates listed for transplant in 2014, 45.1% underwent transplant by 3 months, 56.7% by 6 months, and 67.4% by 1 year (Figure LU 15). The overall median waiting time to transplant for candidates listed in 2015 was 3.4 months, varying from 2.4 months for group D candidates to 4.9 months for group A candidates. Fewer than half of the group B candidates listed in 2015 underwent transplant by year end, so the median waiting time was not observed, but the median among group B candidates listed in 2014 was 7.7 months. (Figure LU 14). Transplant rates were highest for candidates in diagnosis group D, at 224.2 per 100 active waitlist years, continuing a trend in evidence since implementation of the LAS (Figure LU 10); these candidates also had the highest median LAS compared with other diagnosis groups during the LAS era. Candidates in group B had the lowest transplant rate, at 89.3 per 100 active waitlist years (Figure LU 10). Both trends may change in coming years with implementation of the LAS-R; group B candidates had the highest median LAS-R at transplant in 2015 (Figure LU 39). Height correlates with access to transplant up to 175 cm, with the shortest candidates (< 160 cm) consistently experiencing the lowest transplant rates (Figure LU 12). Geography, according to donation service area (DSA), continued to affect access to transplant (Figure LU 16). Percentages of candidates who underwent transplant varied from 53.0% to 80.9% by DSA (Figure LU 16).

Despite the highest ever transplant rates in 2015, the 2014-2015 mortality rate of 16.5 deaths per 100 waitlist years was also the highest, compared with 8.6 in 2004-2005 (Figure LU 18). This increase is likely due to the increasingly sick candidate pool, as described. Waitlist mortality rates in 2014-2015 remained highest for candidates aged 12 to 17 years, at 40.0 deaths per 100 waitlist years; rates for candidates aged 18 to 34 and 65 years or older were similar, at 19.0 and 20.0 deaths per 100 waitlist years (Figure LU 17). This is likely due to small numbers of appropriately sized donors for candidates in this age group, who tend to be of smaller stature. Despite their preferential access to transplant, candidates from diagnosis group D continued to have the highest waitlist morality rate, at 26.6 deaths per 100 waitlist years (Figure LU 20). The waitlist mortality rate was 174.0 per 100 waitlist years for candidates with LAS 50 or higher, well above the 16.3 deaths per 100 waitlist years for candidates with LAS 40 to less than 50 (Figure LU 21).

Transplant

Characteristics of US lung transplant recipients

In 2015, 2072 total lung transplants were performed, including adult, pediatric, and multi-organ transplant recipients, the most ever in a single year since lung transplants have been performed (Figure LU 31). The preferred procedure remained bilateral lung transplant, which constituted a stable proportion of 68.0% to 71.2% of transplants over the past 5 years (Figure LU 31).

In 2015, transplant trends attributable to implementation of the LAS persisted. Lung transplant recipients were increasingly older, were more likely to be men, were more likely to have restrictive lung disease, and were likely sicker at transplant (Table LU 4).

Of all US lung recipients in 2015, including children, 47.0% were aged 50 to 64 years, 28.7% 65 years or older, 12.2% 35 to 49 years, and 10.0% 18 to 34 years. Pediatric lung transplants remained an extremely small proportion of lung transplants; recipients aged younger than 18 years made up 2.1% of all transplants in 2015 (computed from counts in Figure LU 32). The proportion of female lung transplant recipients decreased since LAS implementation and remained stable in 2015 at 41% of transplants (Figure LU 33), a trend likely explained by the lower prevalence of female candidates with the highest LAS (data not shown). The proportion of lung transplant recipients from group D was consistently more than 50% over the past 5 years, and 58% in 2015 (computed from counts in Figure LU 35). As mentioned, it is unclear whether the trend toward sicker candidates undergoing transplant observed until 2014 continued in 2015 (Figure LU 36).

Outcomes of US lung transplant recipients

More lung transplant recipients, 12,111, were alive in 2015 than ever before; 7967 were aged 50 years or older, 3739 18 to 49 years, and 405 younger than 18 years at the time of transplant (Figure LU 54). For recipients aged 12 years or older who underwent transplant in 2008-2010, posttransplant survival was 92.9% at 3 months, 84.6% at 1 year, 67.8% at 3 years, and 55.5% at 5 years. Survival was lowest for recipients aged 65 years or older and 12 to 17 years (Figure LU 47), and those with LAS 60 or higher (Figure LU 49). In this unadjusted analysis, bilateral lung transplant appeared to confer a survival advantage (Figure LU 50). The most common documented cause of death was infection at every time point up to 5 years posttransplant (Figure LU 57, Figure LU 58). The incidence of acute rejection 1 year posttransplant has remained stable at 16.6% to 18.6% since 2009 (Figure LU 55). Chronic rejection or bronchiolitis obliterans was reported in 7.3% of recipients by 1 year and in 43.7% by 5 years posttransplant (computed from Table LU 6). The most prevalent complications of lung transplant at 5 years were diabetes (27.9%), malignancy (22.9%), and chronic kidney disease (14.0% with creatinine > 2.5 mg/dL, 2.4% on maintenance dialysis, 0.9% requiring renal transplant).

Measures of short- and long-term survival showed no trend toward improved overall survival in the past 5 years, except that 6-month death rates decreased from 9.4% in 2005 to 7.9% in 2014 (Figure LU 53). This plateau in survival gains may be due to transplants in increasingly sicker candidates, who received preferential access to transplant under the LAS system. The impact of the LAS-R on survival remains to be seen.

Lung Transplant in Children

Waiting List

In 2015, 23 new child (ages 0-11 years) candidates were added to the lung transplant waiting list, and all but two were active at the time of listing (Figure LU 59). The number of prevalent child candidates (i.e., on the waiting list on December 31 of a given year) steadily decreased from a peak of 127 in 2004 to 20 in 2015 (Figure LU 60). The largest age group of child candidates waiting during 2015 was 6 to 11 years; these candidates made up 57.5% of the waiting list, followed by candidates aged 1 to 5 years at 30.0% and younger than 1 year at 12.5% (Figure LU 61). Most child lung candidates were white (65.0%), followed by Hispanic (20.0%) and black and Asian (both 7.5%, Figure LU 62). Of child lung candidates in 2015, 65.0% were on the waiting list for less than 6 months, 17.5% for 6 months to less than 1 year, 12.5% for 1 to less than 2 years, and 5.0% for 2 or more years (Figure LU 64). Snapshots of child lung candidates on December 31, 2005, and December 31, 2015, revealed changes in the waiting list. Seventy-one candidates who were listed before their twelfth birthdays were waiting at year-end 2005, but only 17 at year-end 2015. Regarding age distribution, the proportion of children aged younger than 1 year increased from none in 2005 to 1 (5.9%) in 2015 (Table LU 7). At year-end 2015, 23.6% of candidates were on the waiting list for 60 days or less, compared with 9.8% in 2005. In 2015, all candidates were listed for lung-only transplant, compared with 84.5% in 2005.

Of 32 patients removed from the waiting list in 2015, 17 (53.1%) were removed due to undergoing transplant, 8 (25.0%) due to death, 2 (6.3%) due to improved condition, and 2 (6.3%) due to being too sick to undergo transplant (Table LU 9). Regarding 3-year outcomes for child lung transplant candidates listed in 2012, 72.0% underwent deceased donor transplant, 20.0% died waiting, and 8.0% were removed from the list for reasons other than transplant or death (Figure LU 65). The overall child lung transplant rate peaked in 2013 at 170.1 per 100 waitlist years, and declined in 2015 to 121.8 (Figure LU 66). Pretransplant mortality increased in 2014-2015 to 36.5 deaths per 100 waitlist years for all candidates aged 0 to 11 years (Figure LU 67). Rates were higher for candidates aged younger than 6 years than for those aged 6 to 11 years, 49.4 versus 29.0 per 100 waitlist years.

Transplant

In 2015, a total of 17 lung transplants were performed in recipients aged 0 to 11 years, 1 in a recipient aged younger than 1 year, 6 in recipients aged 1 to 5 years, and 10 in recipients aged 6 to 11 years (Figure LU 68). Eight out of 68 centers were performing pediatric-only (recipients aged 0-17 years) lung transplants in 2015, compared with 49 performing adult-only transplants (Figure LU 69). In 2012-2015, the proportion of child transplant recipients aged 1 to 5 years was larger than in 2002-2005, and there were more Hispanic recipients, more pulmonary fibrosis and other vascular diagnoses, and fewer cystic fibrosis diagnoses (Table LU 10). More recipients in 2012-2015 were on a ventilator, ECMO, or both at the time of transplant (42.3%) than in 2002-2005 (28.6%). The procedure of choice was bilateral transplant, performed in all patients in 2012-2015.

Pediatric Immunosuppression and Outcomes

Substantial changes in immunosuppression occurred in lung transplantation compared with a decade prior. In 2014-2015, the most common induction therapy was interleukin-2 receptor antagonists, used in 43.9% of lung transplant recipients, followed by T-cell depleting agents in 41.5%. No induction therapy was reported in 19.5% of recipients (Figure LU 70). The initial immunosuppression agents used most commonly in 2014-2015 were tacrolimus (97.6%, Figure LU 71), mycophenolate (97.6%, Figure LU 72), and steroids (100%, Figure LU 73). Steroid use at 1 year posttransplant was reported in 100% of recipients (Figure LU 73). The overall incidence of first acute rejection in the first posttransplant year was 14.5% for child lung transplant recipients in 2009-2014 (data not shown). The incidence of posttransplant lymphoproliferative disorder among Epstein-Barr virus (EBV)-negative recipients who underwent transplant in 2003-2013 was 8.4% at 5 years posttransplant, compared with 1.1% among EBV-positive recipients (Figure LU 75). Incidence of death was 6.1% at 6 months and 8.2% at 1 year for transplants in 2013-2014, 15.5% at 3 years for transplants in 2011-2012, 32.6% at 5 years for transplants in 2009-2010, and 56.4% at 10 years for transplants in 2003-2004 (Figure LU 76). For children who underwent transplant in 2003-2010, overall 1-, 3-, and 5-year patient survival was 80.7%, 63.2%, and 56.8%, respectively (Figure LU 77). By age, patient survival rates were highest for recipients aged 6 to 11 years at all time points. The diagnosis of cystic fibrosis was associated with higher survival rates compared with the diagnosis of pulmonary hypertension (Figure LU 78). At 1 year posttransplant, infection was the leading documented cause of death (4.7%, Figure LU 79), and at 5 years, graft failure was the leading documented cause (12.4%), followed by respiratory (7.3%), infection (5.1%) and cerebro/cardiovascular causes (4.4%, Figure LU 80).

Among pediatric lung transplant recipients in 2011-2015, 57.9% were cytomegalovirus (CMV) negative and 48.4% were EBV negative (Table LU 11). The combination of a CMV-positive donor and CMV-negative recipient occurred in 20.0% of transplants; this combination for EBV occurred in 32.6% of transplants.

Complication rates in child lung transplant recipients increased with time posttransplant, including bronchiolitis obliterans syndrome (5.6% at 1 year to 38.1% at 5 years), diabetes (2.8% to 7.1%), and malignancy (1.4% to 2.4%) (Table LU 12). For most surviving child lung transplant recipients (92.9%), functional status was reported as fully active at 5 years posttransplant (Table LU 12).

Figure List

Waiting list

Figure LU 1. New candidates aged 12 years or older added to the lung transplant waiting list
Figure LU 2. Candidates aged 12 years or older waiting for lung transplant
Figure LU 3. Distribution of candidates aged 12 years or older actively waiting for lung transplant by age
Figure LU 4. Distribution of candidates aged 12 years or older actively waiting for lung transplant by race
Figure LU 5. Distribution of candidates aged 12 years or older actively waiting for lung transplant by diagnosis group
Figure LU 6. Distribution of candidates aged 12 years or older actively waiting for lung transplant by waiting time
Figure LU 7. Distribution of candidates aged 12 years or older actively waiting for lung transplant by LAS
Figure LU 8. Distribution of candidates aged 12 years or older actively waiting for lung transplant by blood type
Figure LU 9. Deceased donor lung transplant rates among active waitlist candidates aged 12 years or older by age
Figure LU 10. Deceased donor lung transplant rates among active waitlist candidates aged 12 years or older by diagnosis group
Figure LU 11. Deceased donor lung transplant rates among active waitlist candidates aged 12 years or older by blood type
Figure LU 12. Deceased donor lung transplant rates among active waitlist candidates aged 12 years or older by height
Figure LU 13. Three-year outcomes for candidates aged 12 years or older waiting for lung transplant, new listings in 2012
Figure LU 14. Median months to lung transplant for waitlisted candidates aged 12 years or older
Figure LU 15. Percentage of adults who underwent deceased donor lung transplant within a given time period of listing
Figure LU 16. Percentage of candidates aged 12 years or older who underwent deceased donor lung transplant within 1 year of listing in 2014 by DSA
Figure LU 17. Pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant by age
Figure LU 18. Pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant by race
Figure LU 19. Pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant by sex
Figure LU 20. Pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant by diagnosis group
Figure LU 21. Pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant by LAS
Figure LU 22. Pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant by blood type
Figure LU 23. Pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant in 2013-2015, by DSA
Figure LU 24. Deaths within six months after removal among adult lung walitlist candidates aged 12 years or older

Deceased donation

Figure LU 25. Deceased lung donors by age
Figure LU 26. Deceased lung donors by race
Figure LU 27. Deceased donor lung donation rates (per 1000 deaths) by state, 2012-2014
Figure LU 28. Rates of lungs recovered for transplant and not transplanted by age
Figure LU 29. Lung donors with a smoking history of 20 pack-years or more
Figure LU 30. Cause of death among deceased lung donors

Transplant

Figure LU 31. Total lung transplants
Figure LU 32. Total lung transplants by age
Figure LU 33. Total lung transplants by sex
Figure LU 34. Total lung transplants by race
Figure LU 35. Total lung transplants by diagnosis group
Figure LU 36. Total lung transplants by LAS
Figure LU 37. Total lung transplants by CPRA
Figure LU 38. Median LAS at transplant
Figure LU 39. Median LAS at transplant by diagnosis group
Figure LU 40. Bilateral transplants among lung recipients aged 12 years or older by diagnosis
Figure LU 41. Induction agent use in lung transplant recipients aged 12 years or older
Figure LU 42. Calcineurin inhibitor use in lung transplant recipients aged 12 years or older
Figure LU 43. Anti-metabolite use in lung transplant recipients aged 12 years or older
Figure LU 44. mTOR inhibitor use in lung transplant recipients aged 12 years or older
Figure LU 45. Steroid use in lung transplant recipients aged 12 years or older
Figure LU 46. Total HLA A, B, and DR mismatches among deceased donor lung transplant recipients aged 12 years or older, 2011-2015

Outcomes

Figure LU 47. Patient survival among lung transplant recipients aged 12 years or older, 2008-2010, by age
Figure LU 48. Patient survival among lung transplant recipients aged 12 years or older, 2008-2010, by race
Figure LU 49. Patient survival among lung transplant recipients aged 12 years or older, 2008-2010, by LAS
Figure LU 50. Patient survival among lung transplant recipients aged 12 years or older, 2008-2010, by transplant type
Figure LU 51. Patient survival among lung transplant recipients aged 12 years or older, 2008-2010, by diagnosis group
Figure LU 52. Patient survival among lung transplant recipients aged 12 years or older, 2008-2010, by diagnosis and transplant type
Figure LU 53. Patient death among lung transplant recipients aged 12 years or older
Figure LU 54. Recipients alive with a functioning lung graft on June 30 of the year, by age at transplant
Figure LU 55. Incidence of acute rejection by 1 year posttransplant among lung transplant recipients aged 12 years or older by age
Figure LU 56. Incidence of PTLD among lung transplant recipients aged 12 years or older by recipient EBV status at transplant, 2009-2013
Figure LU 57. One-year cumulative incidence of death by cause among lung recipients aged 12 years or older, 2013-2014
Figure LU 58. Five-year cumulative incidence of death by cause among lung recipients aged 12 years or older, 2009-2010

Pediatric transplant

Figure LU 59. New candidates aged 0-11 years added to the lung transplant waiting list
Figure LU 60. Candidates aged 0-11 years waiting for lung transplant
Figure LU 61. Distribution of candidates aged 0-11 years actively waiting for lung transplant, by age
Figure LU 62. Distribution of candidates aged 0-11 years actively waiting for lung transplant by race
Figure LU 63. Distribution of candidates aged 0-11 years actively waiting for lung transplant by sex
Figure LU 64. Distribution of candidates aged 0-11 years actively waiting for lung transplant by waiting time
Figure LU 65. Three-year outcomes for newly listed candidates aged 0-11 years waiting for lung transplant, 2012
Figure LU 66. Lung transplant rates among active waitlist candidates listed when aged younger than 12 years
Figure LU 67. Pretransplant mortality rates among candidates aged 0-11 years waitlisted for lung transplant by age
Figure LU 68. Lung transplants, recipients aged 0-11 years by age
Figure LU 69. Number of centers performing pediatric and adult lung transplants by center's age mix
Figure LU 70. Induction agent use in lung transplant recipients aged 0-11 years
Figure LU 71. Calcineurin inhibitor use in lung transplant recipients aged 0-11 years
Figure LU 72. Anti-metabolite use in lung transplant recipients aged 0-11 years
Figure LU 73. Steroid use in lung transplant recipients aged 0-11 years
Figure LU 74. Total HLA A, B, and DR mismatches among deceased donor lung transplant recipients aged 0-11 years, 2011-2015
Figure LU 75. Incidence of PTLD among lung transplant recipients aged 0-11 years by recipient EBV status at transplant, 2003-2013
Figure LU 76. Patient death among lung transplant recipients aged 0-11 years
Figure LU 77. Patient survival among lung transplant recipients aged 0-11 years, 2003-2010, by age
Figure LU 78. Patient survival among lung transplant recipients aged 0-11 years, 2003-2010, by diagnosis
Figure LU 79. One-year cumulative incidence of death by cause among lung transplant recipients aged 0-11 years, 2004-2014
Figure LU 80. Five-year cumulative incidence of death by cause among lung transplant recipients aged 0-11 years, 2004-2010

Table List

Waiting list

Table LU 1. Characteristics of candidates aged 12 years or older on the lung transplant waiting list on December 31, 2010, and December 31, 2015
Table LU 2. Lung transplant waitlist activity among candidates aged 12 years or older
Table LU 3. Removal reason among lung transplant candidats aged 12 years or older

Transplant

Table LU 4. Characteristics of lung transplant recipients aged 12 years or older, 2010 and 2015
Table LU 5. Donor-recipient serology matching among lung transplant recipients aged 12 years or older, 2011-2015.

Outcomes

Table LU 6. Posttransplant events among lung transplant recipients aged 12 years or older,

Pediatric transplant

Table LU 7. Characteristics of candidates aged 0-11 years on the lung transplant waiting list on December 31, 2005, and December 31, 2015
Table LU 8. Lung transplant waitlist activity among candidates aged 0-11 years
Table LU 9. Removal reason among lung transplant candidates aged 0-11 years
Table LU 10. Characteristics of lung transplant recipients aged 0-11 years, 2002-2005 and 2012-2015
Table LU 11. Donor-recipient serology matching among lung transplant recipients aged 0-11 years, 2011-2015
Table LU 12. Posttransplant events among lung transplant recipients aged 0-11 years

A line plot for new candidates aged 12 years or older added to the lung transplant waiting list; the active category increases by 30.8% from 1842 candidates at 2004 to 2409 candidates at 2015; the inactive category increases by 179.3% from 29 candidates at 2004 to 81 candidates at 2015; and the all category increases by 33.1% from 1871 candidates at 2004 to 2490 candidates at 2015.

Figure LU 1. New candidates aged 12 years or older added to the lung transplant waiting list
A new candidate is one who first joined the list during the given year, without having been listed in a previous year. Previously listed candidates who underwent transplant and subsequently relisted are considered new. Candidates concurrently listed at multiple centers are counted once. Active and inactive patients are included.


A line plot for candidates aged 12 years or older waiting for lung transplant; the active category decreases by 43.5% from 2145 candidates at 2004 to 1211 candidates at 2015; the inactive category decreases by 81.4% from 1659 candidates at 2004 to 308 candidates at 2015; and the all category decreases by 60.1% from 3804 candidates at 2004 to 1519 candidates at 2015.

Figure LU 2. Candidates aged 12 years or older waiting for lung transplant
Candidates concurrently listed at multiple centers are counted once. Those with concurrent listings and active at any program are considered active.


A line plot for distribution of candidates aged 12 years or older actively waiting for lung transplant by age; the 12 to 17 category decreases by 55.9% from 3.1 percent at 2004 to 1.4 percent at 2015; the 18 to 34 category decreases by 36.6% from 16.2 percent at 2004 to 10.3 percent at 2015; the 35 to 49 category decreases by 45.1% from 24.9 percent at 2004 to 13.7 percent at 2015; the 50 to 64 category is 51.9 percent at 2004 and remains relatively constant with a value of 49 percent at 2015; and the greater than or equal to 65 category increases by 549.3% from 4 percent at 2004 to 25.7 percent at 2015.

Figure LU 3. Distribution of candidates aged 12 years or older actively waiting for lung transplant by age
Candidates waiting for transplant at any time in the given year. Candidates listed concurrently at multiple centers are counted once. Age is determined at the later of listing date or January 1 of the given year. Only candidates who were active for at least 1 day are included.


A line plot for distribution of candidates aged 12 years or older actively waiting for lung transplant by race; the white category is 84.1 percent at 2004 and remains relatively constant with a value of 79.2 percent at 2015; the black category is 9.2 percent at 2004 and remains relatively constant with a value of 9.7 percent at 2015; the hispanic category increases by 51.9% from 5 percent at 2004 to 7.6 percent at 2015; the asian category increases by 142.0% from 1.2 percent at 2004 to 2.9 percent at 2015; and the other/unknown category increases by 15.6% from 0.5 percent at 2004 to 0.6 percent at 2015.

Figure LU 4. Distribution of candidates aged 12 years or older actively waiting for lung transplant by race
Candidates waiting for transplant at any time in the given year. Candidates listed concurrently at multiple centers are counted once. Only candidates who were active for at least 1 day are included.


A line plot for distribution of candidates aged 12 years or older actively waiting for lung transplant by diagnosis group; the a category decreases by 20.9% from 42.1 percent at 2004 to 33.3 percent at 2015; the b category decreases by 53.3% from 10.6 percent at 2004 to 5 percent at 2015; the c category decreases by 25.0% from 16.2 percent at 2004 to 12.2 percent at 2015; and the d category increases by 59.6% from 31.1 percent at 2004 to 49.6 percent at 2015.

Figure LU 5. Distribution of candidates aged 12 years or older actively waiting for lung transplant by diagnosis group
Candidates waiting for transplant at any time in the given year. Candidates listed concurrently at multiple centers are counted once. Only candidates who were active for at least 1 day are included.


A line plot for distribution of candidates aged 12 years or older actively waiting for lung transplant by waiting time; the less than 31 days category increases by 222.7% from 7.6 percent at 2004 to 24.5 percent at 2015; the 31 to less than 90 days category increases by 103.4% from 9.9 percent at 2004 to 20.2 percent at 2015; the 3 to less than 6 months category increases by 15.7% from 13.8 percent at 2004 to 16 percent at 2015; the 6 to less than 12 months category decreases by 25.3% from 20.3 percent at 2004 to 15.2 percent at 2015; the 1 to less than 2 years category decreases by 48.9% from 24.9 percent at 2004 to 12.7 percent at 2015; and the greater than or equal to 2 years category decreases by 51.3% from 23.4 percent at 2004 to 11.4 percent at 2015.

Figure LU 6. Distribution of candidates aged 12 years or older actively waiting for lung transplant by waiting time
Candidates waiting for transplant at any time in the given year. Candidates listed concurrently at multiple centers are counted once. Time on the waiting list is determined at the earlier of December 31 or removal from the waiting list. Only candidates who were active for at least 1 day are included.


A line plot for distribution of candidates aged 12 years or older actively waiting for lung transplant by las; the less than 30 category is NA percent at 2004 and is percent at 2015; the 30 to less than 35 category is NA percent at 2004 and is percent at 2015; the 35 to less than 40 category is NA percent at 2004 and is percent at 2015; the 40 to less than 50 category is NA percent at 2004 and is percent at 2015; the greater than or equal to 50 category is NA percent at 2004 and is percent at 2015; and the no las category decreases by 99.5% from 100 percent at 2004 to 0.5 percent at 2015.

Figure LU 7. Distribution of candidates aged 12 years or older actively waiting for lung transplant by LAS
Candidates waiting for transplant at any time in the given year. Candidates listed concurrently at multiple centers are counted once. Lung allocation score (LAS) is the most severe during the year. Only candidates who were active for at least 1 day are included.


A line plot for distribution of candidates aged 12 years or older actively waiting for lung transplant by blood type; the a category is 37.6 percent at 2004 and remains relatively constant with a value of 39.3 percent at 2015; the b category increases by 13.6% from 10.1 percent at 2004 to 11.5 percent at 2015; the ab category is 3.7 percent at 2004 and remains relatively constant with a value of 3.4 percent at 2015; and the o category is 48.7 percent at 2004 and remains relatively constant with a value of 45.8 percent at 2015.

Figure LU 8. Distribution of candidates aged 12 years or older actively waiting for lung transplant by blood type
Candidates waiting for transplant at any time in the given year. Candidates listed concurrently at multiple centers are counted once. Only candidates who were active for at least 1 day are included.


A line plot for deceased donor lung transplant rates among active waitlist candidates aged 12 years or older by age; the 12 to 17 category increases by 352.4% from 42.4 transplants per 100 wait-list years at 2004 to 191.8 transplants per 100 wait-list years at 2015; the 18 to 34 category increases by 214.9% from 46.4 transplants per 100 wait-list years at 2004 to 146 transplants per 100 wait-list years at 2015; the 35 to 49 category increases by 235.6% from 37.5 transplants per 100 wait-list years at 2004 to 126 transplants per 100 wait-list years at 2015; the 50 to 64 category increases by 165.0% from 55.8 transplants per 100 wait-list years at 2004 to 147.8 transplants per 100 wait-list years at 2015; and the greater than or equal to 65 category increases by 92.1% from 106.7 transplants per 100 wait-list years at 2004 to 205 transplants per 100 wait-list years at 2015.

Figure LU 9. Deceased donor lung transplant rates among active waitlist candidates aged 12 years or older by age
Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of active wait time in a given year. Individual listings are counted separately. Age is determined at the later of listing date or January 1 of the given year. Rates with less than 10 patient-years of exposure are not shown.


A line plot for deceased donor lung transplant rates among active waitlist candidates aged 12 years or older by diagnosis group; the a category increases by 93.8% from 53.3 transplants per 100 wait-list years at 2004 to 103.3 transplants per 100 wait-list years at 2015; the b category increases by 300.2% from 22.3 transplants per 100 wait-list years at 2004 to 89.3 transplants per 100 wait-list years at 2015; the c category increases by 204.0% from 51.7 transplants per 100 wait-list years at 2004 to 157.1 transplants per 100 wait-list years at 2015; the d category increases by 314.5% from 54.1 transplants per 100 wait-list years at 2004 to 224.2 transplants per 100 wait-list years at 2015; and the all category increases by 211.2% from 50.4 transplants per 100 wait-list years at 2004 to 157 transplants per 100 wait-list years at 2015.

Figure LU 10. Deceased donor lung transplant rates among active waitlist candidates aged 12 years or older by diagnosis group
Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of active wait time in a given year. Individual listings are counted separately. Rates with less than 10 patient-years of exposure are not shown.


A line plot for deceased donor lung transplant rates among active waitlist candidates aged 12 years or older by blood type; the a category increases by 211.6% from 51.4 transplants per 100 wait-list years at 2004 to 160.2 transplants per 100 wait-list years at 2015; the b category increases by 161.8% from 64.4 transplants per 100 wait-list years at 2004 to 168.6 transplants per 100 wait-list years at 2015; the ab category increases by 177.9% from 66.8 transplants per 100 wait-list years at 2004 to 185.5 transplants per 100 wait-list years at 2015; and the o category increases by 226.7% from 45.9 transplants per 100 wait-list years at 2004 to 149.8 transplants per 100 wait-list years at 2015.

Figure LU 11. Deceased donor lung transplant rates among active waitlist candidates aged 12 years or older by blood type
Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of active wait time in a given year. Individual listings are counted separately. Rates with less than 10 patient-years of exposure are not shown.


A line plot for deceased donor lung transplant rates among active waitlist candidates aged 12 years or older by height; the less than 160 cm category increases by 99.2% from 42.7 transplants per 100 wait-list years at 2004 to 85 transplants per 100 wait-list years at 2015; the 160 to less than 168 category increases by 195.7% from 45.9 transplants per 100 wait-list years at 2004 to 135.8 transplants per 100 wait-list years at 2015; the 168 to less than 175 category increases by 256.0% from 51.6 transplants per 100 wait-list years at 2004 to 183.7 transplants per 100 wait-list years at 2015; the 175 to less than 183 category increases by 347.6% from 61.2 transplants per 100 wait-list years at 2004 to 274 transplants per 100 wait-list years at 2015; and the greater than or equal to 183 category increases by 234.1% from 66.7 transplants per 100 wait-list years at 2004 to 222.7 transplants per 100 wait-list years at 2015.

Figure LU 12. Deceased donor lung transplant rates among active waitlist candidates aged 12 years or older by height
Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of active wait time in a given year. Individual listings are counted separately. Rates with less than 10 patient-years of exposure are not shown.


A line plot for three-year outcomes for candidates aged 12 years or older waiting for lung transplant, new listings in 2012; the still waiting category decreases by 96.1% from 100 percent at 0 Months postlisting to 3.9 percent at 36 Months postlisting; the removed from list category increases by 24800.0% from 0 percent at 0 Months postlisting to 11.1 percent at 36 Months postlisting; the died category is 0 percent at 0 Months postlisting and is percent at 36 Months postlisting; and the dd transplant category is 0 percent at 0 Months postlisting and is percent at 36 Months postlisting.

Figure LU 13. Three-year outcomes for candidates aged 12 years or older waiting for lung transplant, new listings in 2012
Candidates aged 12 years or older waiting for lung transplant and first listed in 2012. Candidates concurrently listed at more than one center are counted once, from the time of earliest listing to the time of latest removal. DD, deceased donor.


A line plot for median months to lung transplant for waitlisted candidates aged 12 years or older; the a category decreases by 18.9% from 6 median months to transplant at 2006 to 4.9 median months to transplant at 2015; the b category decreases by 62.8% from 20.7 median months to transplant at 2006 to 7.7 median months to transplant at 2014; the c category decreases by 22.6% from 5.1 median months to transplant at 2006 to 3.9 median months to transplant at 2015; the d category decreases by 13.0% from 2.8 median months to transplant at 2006 to 2.4 median months to transplant at 2015; and the all category decreases by 23.1% from 4.4 median months to transplant at 2006 to 3.4 median months to transplant at 2015.

Figure LU 14. Median months to lung transplant for waitlisted candidates aged 12 years or older
Observations censored on December 31, 2015; Kaplan-Meier competing risk methods used to estimate time to transplant. Analysis performed per candidate, not per listing. If an estimate is not plotted, 50% of the cohort listed in that year had not undergone transplant by the censoring date. Only the first transplant is counted.


A line plot for percentage of adults who underwent deceased donor lung transplant within a given time period of listing; the 3 to month category increases by 176.9% from 16.3 percent at 2004 to 45.1 percent at 2014; the 6 to month category increases by 134.0% from 24.2 percent at 2004 to 56.7 percent at 2014; the 1 to year category increases by 81.7% from 37.1 percent at 2004 to 67.4 percent at 2014; the 3 to year category increases by 43.6% from 51.6 percent at 2004 to 74.1 percent at 2012; the 5 to year category increases by 36.7% from 54.5 percent at 2004 to 74.5 percent at 2010; and the 10 to year category increases by 25.5% from 55.9 percent at 2004 to 70.1 percent at 2005.

Figure LU 15. Percentage of adults who underwent deceased donor lung transplant within a given time period of listing
Candidates concurrently listed at more than one center are counted once, from the time of earliest listing to the time of latest removal.


A map of percentage of candidates aged 12 years or older who underwent deceased donor lung transplant within 1 year of listing in 2014 by dsa, the values range from 0.00 to 100.00.

Figure LU 16. Percentage of candidates aged 12 years or older who underwent deceased donor lung transplant within 1 year of listing in 2014 by DSA
Candidates listed concurrently in a single DSA are counted once in that DSA, from the time of earliest listing to the time of latest removal; candidates listed in multiple DSAs are counted separately per DSA.


A line plot for pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant by age; the 12 to 17 category increases by 261.3% from 11.1 deaths per 100 wait-list years at 2004-2005 to 40 deaths per 100 wait-list years at 2014-2015; the 18 to 34 category increases by 98.8% from 9.6 deaths per 100 wait-list years at 2004-2005 to 19 deaths per 100 wait-list years at 2014-2015; the 35 to 49 category increases by 109.1% from 7.8 deaths per 100 wait-list years at 2004-2005 to 16.2 deaths per 100 wait-list years at 2014-2015; the 50 to 64 category increases by 69.1% from 8.5 deaths per 100 wait-list years at 2004-2005 to 14.3 deaths per 100 wait-list years at 2014-2015; and the greater than or equal to 65 category increases by 82.7% from 11 deaths per 100 wait-list years at 2004-2005 to 20 deaths per 100 wait-list years at 2014-2015.

Figure LU 17. Pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant by age
Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Individual listings are counted separately. Rates with less than 10 patient-years of exposure are not shown. Age is determined at the later of listing date or January 1 of the given year.


A line plot for pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant by race; the white category increases by 89.7% from 8.2 deaths per 100 wait-list years at 2004-2005 to 15.5 deaths per 100 wait-list years at 2014-2015; the black category increases by 87.0% from 9.4 deaths per 100 wait-list years at 2004-2005 to 17.6 deaths per 100 wait-list years at 2014-2015; the hispanic category increases by 60.0% from 13.9 deaths per 100 wait-list years at 2004-2005 to 22.2 deaths per 100 wait-list years at 2014-2015; the asian category increases by 264.9% from 9.4 deaths per 100 wait-list years at 2004-2005 to 34.4 deaths per 100 wait-list years at 2014-2015; and the all category increases by 91.5% from 8.6 deaths per 100 wait-list years at 2004-2005 to 16.5 deaths per 100 wait-list years at 2014-2015.

Figure LU 18. Pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant by race
Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Individual listings are counted separately. Rates with less than 10 patient-years of exposure are not shown.


A line plot for pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant by sex; the male category increases by 126.0% from 8.6 deaths per 100 wait-list years at 2004-2005 to 19.5 deaths per 100 wait-list years at 2014-2015; and the female category increases by 69.1% from 8.6 deaths per 100 wait-list years at 2004-2005 to 14.6 deaths per 100 wait-list years at 2014-2015.

Figure LU 19. Pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant by sex
Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Individual listings are counted separately. Rates with less than 10 patient-years of exposure are not shown.


A line plot for pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant by diagnosis group; the a category is 5.5 deaths per 100 wait-list years at 2004-2005 and remains relatively constant with a value of 5.8 deaths per 100 wait-list years at 2014-2015; the b category increases by 196.0% from 6.6 deaths per 100 wait-list years at 2004-2005 to 19.6 deaths per 100 wait-list years at 2014-2015; the c category increases by 116.9% from 9.6 deaths per 100 wait-list years at 2004-2005 to 20.9 deaths per 100 wait-list years at 2014-2015; and the d category increases by 111.5% from 12.6 deaths per 100 wait-list years at 2004-2005 to 26.6 deaths per 100 wait-list years at 2014-2015.

Figure LU 20. Pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant by diagnosis group
Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Individual listings are counted separately. Rates with less than 10 patient-years of exposure are not shown.


A line plot for pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant by las; the less than 30 category is NA deaths per 100 wait-list years at 2004-2005 and is deaths per 100 wait-list years at 2014-2015; the 30 to less than 35 category is NA deaths per 100 wait-list years at 2004-2005 and is deaths per 100 wait-list years at 2014-2015; the 35 to less than 40 category is NA deaths per 100 wait-list years at 2004-2005 and is deaths per 100 wait-list years at 2014-2015; the 40 to less than 50 category is NA deaths per 100 wait-list years at 2004-2005 and is deaths per 100 wait-list years at 2014-2015; and the greater than or equal to 50 category is NA deaths per 100 wait-list years at 2004-2005 and is deaths per 100 wait-list years at 2014-2015.

Figure LU 21. Pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant by LAS
Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Individual listings are counted separately. Rates with less than 10 patient-years of exposure are not shown.


A line plot for pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant by blood type; the a category increases by 78.3% from 8.4 deaths per 100 wait-list years at 2004-2005 to 15 deaths per 100 wait-list years at 2014-2015; the b category increases by 161.0% from 8.1 deaths per 100 wait-list years at 2004-2005 to 21.1 deaths per 100 wait-list years at 2014-2015; the ab category increases by 267.9% from 6.1 deaths per 100 wait-list years at 2004-2005 to 22.5 deaths per 100 wait-list years at 2014-2015; and the o category increases by 80.1% from 9.1 deaths per 100 wait-list years at 2004-2005 to 16.4 deaths per 100 wait-list years at 2014-2015.

Figure LU 22. Pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant by blood type
Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Individual listings are counted separately. Rates with less than 10 patient-years of exposure are not shown.


A map of pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant in 2013-2015, by dsa, the values range from 4.87 to 36.41.

Figure LU 23. Pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant in 2013-2015, by DSA
Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Individual listings are counted separately. Rates with less than 10 patient-years of exposure are not shown.


A line plot for deaths within six months after removal among adult lung walitlist candidates aged 12 years or older; the all category increases by 74.0% from 18 percent at 2004 to 31.3 percent at 2015; the a category is 11.6 percent at 2004 and remains relatively constant with a value of 12.2 percent at 2015; the b category increases by 420.0% from 9.6 percent at 2004 to 50 percent at 2015; the c category increases by 34.4% from 18.6 percent at 2004 to 25 percent at 2015; and the d category increases by 77.2% from 24.7 percent at 2004 to 43.7 percent at 2015.

Figure LU 24. Deaths within six months after removal among adult lung walitlist candidates aged 12 years or older
Denominator includes only candidates removed from the waiting list for reasons other than transplant or death while on the list.


A line plot for deceased lung donors by age; the less than 12 category decreases by 67.9% from 3.4 percent at 2004 to 1.1 percent at 2015; the 12 to 17 category decreases by 47.8% from 14.4 percent at 2004 to 7.5 percent at 2015; the 18 to 34 category increases by 10.0% from 41.8 percent at 2004 to 46 percent at 2015; the 35 to 49 category is 26.9 percent at 2004 and remains relatively constant with a value of 26.5 percent at 2015; and the greater than or equal to 50 category increases by 39.8% from 13.5 percent at 2004 to 18.8 percent at 2015.

Figure LU 25. Deceased lung donors by age
Deceased donors with at least one lung recovered for transplant. Donors whose lungs were recovered en-bloc are counted once, and donors whose lungs were recovered separately are counted twice.


A line plot for deceased lung donors by race; the white category is 65 percent at 2004 and remains relatively constant with a value of 60.7 percent at 2015; the black category increases by 37.2% from 14.7 percent at 2004 to 20.1 percent at 2015; the hispanic category is 16.5 percent at 2004 and remains relatively constant with a value of 15.5 percent at 2015; and the other/unknown category is 3.8 percent at 2004 and remains relatively constant with a value of 3.7 percent at 2015.

Figure LU 26. Deceased lung donors by race
Deceased donors with at least one lung recovered for transplant. Donors whose lungs were recovered en-bloc are counted once, and donors whose lungs were recovered separately are counted twice.


A map of deceased donor lung donation rates (per 1000 deaths) by state, 2012-2014, the values range from 0.37 to 5.28.

Figure LU 27. Deceased donor lung donation rates (per 1000 deaths) by state, 2012-2014
Numerator: Deceased donors aged < 70 years, by state of death, whose lungs were recovered for transplant from 2012 through 2014. Denominator: US deaths aged < 70 years, by state of death, from 2012 through 2014. State death data by age obtained through agreement with NAPHSIS (http://www.naphsis.org/programs/vital-statistics-data-research-request-process). Donors whose lungs were recovered en-bloc are counted once, and donors whose lungs were recovered separately are counted twice.


A line plot for rates of lungs recovered for transplant and not transplanted by age; the 12 to 17 category increases by 77.1% from 4.3 percent at 2004-2005 to 7.5 percent at 2014-2015; the 18 to 34 category increases by 23.2% from 4.9 percent at 2004-2005 to 6 percent at 2014-2015; the 35 to 49 category increases by 109.1% from 3.7 percent at 2004-2005 to 7.7 percent at 2014-2015; and the greater than or equal to 50 category increases by 19.7% from 6.3 percent at 2004-2005 to 7.6 percent at 2014-2015.

Figure LU 28. Rates of lungs recovered for transplant and not transplanted by age
Percentages of lungs not transplanted out of all lungs recovered for transplant. Lungs recovered en-bloc are counted once, and lungs recovered separately are counted twice.


A line plot for lung donors with a smoking history of 20 pack-years or more; the percent category decreases by 68.5% from 21.4 percent at 2004 to 6.7 percent at 2015.

Figure LU 29. Lung donors with a smoking history of 20 pack-years or more
All deceased donors whose lungs were transplanted in the given year.


A line plot for cause of death among deceased lung donors; the anoxia category increases by 212.1% from 7.9 percent at 2004 to 24.7 percent at 2015; the cva/stroke category decreases by 11.5% from 34.1 percent at 2004 to 30.2 percent at 2015; the head trauma category decreases by 23.1% from 55.2 percent at 2004 to 42.5 percent at 2015; the cns tumor category decreases by 38.9% from 0.8 percent at 2004 to 0.5 percent at 2015; and the other category is 2 percent at 2004 and remains relatively constant with a value of 2.1 percent at 2015.

Figure LU 30. Cause of death among deceased lung donors
Deceased donors whose lungs were transplanted. Each donor is counted once. CNS, central nervous system; CVA, cerebrovascular accident.


A line plot for total lung transplants; the single category increases by 15.3% from 518 transplants at 2004 to 597 transplants at 2015; the bilateral category increases by 112.5% from 694 transplants at 2004 to 1475 transplants at 2015; and the all category increases by 71.0% from 1212 transplants at 2004 to 2072 transplants at 2015.

Figure LU 31. Total lung transplants
All lung transplant recipients, including adult and pediatric, retransplant, and multi-organ recipients.


A line plot for total lung transplants by age; the less than 12 category decreases by 10.5% from 19 transplants at 2004 to 17 transplants at 2015; the 12 to 17 category decreases by 34.1% from 41 transplants at 2004 to 27 transplants at 2015; the 18 to 34 category increases by 10.1% from 189 transplants at 2004 to 208 transplants at 2015; the 35 to 49 category increases by 12.0% from 225 transplants at 2004 to 252 transplants at 2015; the 50 to 64 category increases by 48.2% from 657 transplants at 2004 to 974 transplants at 2015; and the greater than or equal to 65 category increases by 633.3% from 81 transplants at 2004 to 594 transplants at 2015.

Figure LU 32. Total lung transplants by age
All lung transplant recipients, including adult and pediatric, retransplant, and multi-organ recipients.


A line plot for total lung transplants by sex; the male category increases by 102.3% from 605 transplants at 2004 to 1224 transplants at 2015; and the female category increases by 39.7% from 607 transplants at 2004 to 848 transplants at 2015.

Figure LU 33. Total lung transplants by sex
All lung transplant recipients, including adult and pediatric, retransplant, and multi-organ recipients.


A line plot for total lung transplants by race; the white category increases by 60.4% from 1040 transplants at 2004 to 1668 transplants at 2015; the black category increases by 112.4% from 89 transplants at 2004 to 189 transplants at 2015; the hispanic category increases by 149.2% from 65 transplants at 2004 to 162 transplants at 2015; the asian category increases by 272.7% from 11 transplants at 2004 to 41 transplants at 2015; and the other/unknown category increases by 71.4% from 7 transplants at 2004 to 12 transplants at 2015.

Figure LU 34. Total lung transplants by race
All lung transplant recipients, including adult and pediatric, retransplant, and multi-organ recipients.


A line plot for total lung transplants by diagnosis group; the a category is 547 transplants at 2004 and remains relatively constant with a value of 567 transplants at 2015; the b category increases by 13.2% from 68 transplants at 2004 to 77 transplants at 2015; the c category is 211 transplants at 2004 and remains relatively constant with a value of 231 transplants at 2015; the d category increases by 245.0% from 347 transplants at 2004 to 1197 transplants at 2015; and the other/unknown category decreases by 100.0% from 39 transplants at 2004 to 0 transplants at 2015.

Figure LU 35. Total lung transplants by diagnosis group
All lung transplant recipients, including adult and pediatric, retransplant, and multi-organ recipients.


A line plot for total lung transplants by las; the less than 35 category is NA transplants at 2004 and is transplants at 2015; the 35 to less than 40 category is NA transplants at 2004 and is transplants at 2015; the 40 to less than 50 category is NA transplants at 2004 and is transplants at 2015; the 50 to less than 60 category is NA transplants at 2004 and is transplants at 2015; and the 60 to 100 category is NA transplants at 2004 and is transplants at 2015.

Figure LU 36. Total lung transplants by LAS
All lung transplant recipients, including adult and pediatric, retransplant, and multi-organ recipients.


A line plot for total lung transplants by cpra; the less than 1% category increases by 50.8% from 794 transplants at 2004 to 1197 transplants at 2015; the 1 to less than 20% category increases by 28.2% from 195 transplants at 2004 to 250 transplants at 2015; the 20 to less than 80% category increases by 379.1% from 43 transplants at 2004 to 206 transplants at 2015; the 80 to 100% category increases by 73.7% from 19 transplants at 2004 to 33 transplants at 2015; and the unknown category increases by 139.8% from 161 transplants at 2004 to 386 transplants at 2015.

Figure LU 37. Total lung transplants by CPRA
All lung transplant recipients, including adult and pediatric, retransplant, and multi-organ recipients.


A line plot for median las at transplant; the 75th percentile category increases by 27.4% from 42.5 las at 2005 to 54.1 las at 2015; the median las category increases by 13.5% from 36.7 las at 2005 to 41.6 las at 2015; and the 25th percentile category is 33.5 las at 2005 and remains relatively constant with a value of 35.3 las at 2015.

Figure LU 38. Median LAS at transplant
Recipients aged 12 years or older; last LAS before transplant.


A line plot for median las at transplant by diagnosis group; the a category is 33.2 las at 2005 and remains relatively constant with a value of 33.8 las at 2015; the b category increases by 34.2% from 36.3 las at 2005 to 48.7 las at 2015; the c category increases by 11.7% from 38.5 las at 2005 to 43 las at 2015; and the d category increases by 12.3% from 41.1 las at 2005 to 46.2 las at 2015.

Figure LU 39. Median LAS at transplant by diagnosis group
Recipients aged 12 years or older; last LAS before transplant.


A line plot for bilateral transplants among lung recipients aged 12 years or older by diagnosis; the alpha to 1 category increases by 17.5% from 78.7 percent at 2004 to 92.4 percent at 2015; the copd category increases by 85.4% from 35.2 percent at 2004 to 65.3 percent at 2015; the ipf category increases by 42.5% from 38.9 percent at 2004 to 55.5 percent at 2015; and the other category is 84.5 percent at 2004 and remains relatively constant with a value of 83.3 percent at 2015.

Figure LU 40. Bilateral transplants among lung recipients aged 12 years or older by diagnosis
Heart-lung transplants are excluded. COPD, chronic obstructive pulmonary disease; IPF, idiopathic pulmonary fibrosis.


A line plot for induction agent use in lung transplant recipients aged 12 years or older; the il2 to ra category increases by 62.6% from 37.4 percent at 2004 to 60.8 percent at 2015; the t to cell depleting category decreases by 22.3% from 12.8 percent at 2004 to 10 percent at 2015; and the none category decreases by 41.2% from 50.3 percent at 2004 to 29.6 percent at 2015.

Figure LU 41. Induction agent use in lung transplant recipients aged 12 years or older
Immunosuppression at transplant reported to the OPTN. IL2-RA, interleukin-2 receptor antagonist.


A line plot for calcineurin inhibitor use in lung transplant recipients aged 12 years or older; the cyclosporine category decreases by 89.8% from 29.1 percent at 2004 to 3 percent at 2015; and the tacrolimus category increases by 36.7% from 68.8 percent at 2004 to 94.1 percent at 2015.

Figure LU 42. Calcineurin inhibitor use in lung transplant recipients aged 12 years or older
Immunosuppression at transplant reported to the OPTN.


A line plot for anti-metabolite use in lung transplant recipients aged 12 years or older; the azathioprine category decreases by 78.7% from 42.4 percent at 2004 to 9 percent at 2015; and the mycophenolate category increases by 81.1% from 47.5 percent at 2004 to 86 percent at 2015.

Figure LU 43. Anti-metabolite use in lung transplant recipients aged 12 years or older
Immunosuppression at transplant reported to the OPTN. Mycophenolate includes mycophenolate mofetil and mycophenolate sodium.


A line plot for mtor inhibitor use in lung transplant recipients aged 12 years or older; the at transplant category decreases by 85.7% from 1.4 percent at 2004 to 0.2 percent at 2015; and the 1 year posttransplant category is 8.5 percent at 2004 and remains relatively constant with a value of 7.9 percent at 2014.

Figure LU 44. mTOR inhibitor use in lung transplant recipients aged 12 years or older
Immunosuppression at transplant reported to the OPTN. One-year posttransplant data are limited to patients alive with graft function at 1 year posttransplant. mTOR, mammalian target of rapamycin.


A line plot for steroid use in lung transplant recipients aged 12 years or older; the at transplant category is 95.5 percent at 2004 and remains relatively constant with a value of 93.4 percent at 2015; and the 1 year posttransplant category is 99 percent at 2004 and remains relatively constant with a value of 96.3 percent at 2014.

Figure LU 45. Steroid use in lung transplant recipients aged 12 years or older
Immunosuppression at transplant reported to the OPTN. One-year posttransplant data are limited to patients alive with graft function at 1 year posttransplant.


A bar plot for total hla a, b, and dr mismatches among deceased donor lung transplant recipients aged 12 years or older, 2011-2015, the 0 group is 0.13 percent; the 1 group is 0.53 percent; the 2 group is 2.85 percent; the 3 group is 10.81 percent; the 4 group is 24.47 percent; the 5 group is 33.49 percent; the 6 group is 20.29 percent; and the unk. group is 7.43 percent.

Figure LU 46. Total HLA A, B, and DR mismatches among deceased donor lung transplant recipients aged 12 years or older, 2011-2015
Donor and recipient antigen matching is based on OPTN antigen values and split equivalences policy as of 2015.


A line plot for patient survival among lung transplant recipients aged 12 years or older, 2008-2010, by age; the 12 to 17 category decreases by 51.0% from 100 percent at 0 Months posttransplant to 49 percent at 60 Months posttransplant; the 18 to 34 category decreases by 44.6% from 100 percent at 0 Months posttransplant to 55.4 percent at 60 Months posttransplant; the 35 to 49 category decreases by 36.2% from 100 percent at 0 Months posttransplant to 63.8 percent at 60 Months posttransplant; the 50 to 64 category decreases by 42.4% from 100 percent at 0 Months posttransplant to 57.6 percent at 60 Months posttransplant; the greater than or equal to 65 category decreases by 54.3% from 100 percent at 0 Months posttransplant to 45.7 percent at 60 Months posttransplant; and the all category decreases by 44.5% from 100 percent at 0 Months posttransplant to 55.5 percent at 60 Months posttransplant.

Figure LU 47. Patient survival among lung transplant recipients aged 12 years or older, 2008-2010, by age
Patient survival estimated using unadjusted Kaplan-Meier methods. For recipients of more than one transplant during the period, only the first is considered.


A line plot for patient survival among lung transplant recipients aged 12 years or older, 2008-2010, by race; the white category decreases by 45.6% from 100 percent at 0 Months posttransplant to 54.4 percent at 60 Months posttransplant; the black category decreases by 39.9% from 100 percent at 0 Months posttransplant to 60.1 percent at 60 Months posttransplant; the hispanic category decreases by 39.8% from 100 percent at 0 Months posttransplant to 60.2 percent at 60 Months posttransplant; the asian category decreases by 34.2% from 100 percent at 0 Months posttransplant to 65.8 percent at 60 Months posttransplant; and the other/unknown category decreases by 41.2% from 100 percent at 0 Months posttransplant to 58.8 percent at 60 Months posttransplant.

Figure LU 48. Patient survival among lung transplant recipients aged 12 years or older, 2008-2010, by race
Patient survival estimated using unadjusted Kaplan-Meier methods. For recipients of more than one transplant during the period, only the first is considered.


A line plot for patient survival among lung transplant recipients aged 12 years or older, 2008-2010, by las; the less than 35 category decreases by 42.8% from 100 percent at 0 Months posttransplant to 57.2 percent at 60 Months posttransplant; the 35 to less than 40 category decreases by 44.2% from 100 percent at 0 Months posttransplant to 55.8 percent at 60 Months posttransplant; the 40 to less than 50 category decreases by 44.1% from 100 percent at 0 Months posttransplant to 55.9 percent at 60 Months posttransplant; the 50 to less than 60 category decreases by 44.4% from 100 percent at 0 Months posttransplant to 55.6 percent at 60 Months posttransplant; and the 60 to 100 category decreases by 48.8% from 100 percent at 0 Months posttransplant to 51.2 percent at 60 Months posttransplant.

Figure LU 49. Patient survival among lung transplant recipients aged 12 years or older, 2008-2010, by LAS
Patient survival estimated using unadjusted Kaplan-Meier methods. For recipients of more than one transplant during the period, only the first is considered.


A line plot for patient survival among lung transplant recipients aged 12 years or older, 2008-2010, by transplant type; the single left category decreases by 53.8% from 100 percent at 0 Months posttransplant to 46.2 percent at 60 Months posttransplant; the single right category decreases by 51.0% from 100 percent at 0 Months posttransplant to 49 percent at 60 Months posttransplant; and the bilateral category decreases by 40.9% from 100 percent at 0 Months posttransplant to 59.1 percent at 60 Months posttransplant.

Figure LU 50. Patient survival among lung transplant recipients aged 12 years or older, 2008-2010, by transplant type
Patient survival estimated using unadjusted Kaplan-Meier methods. For recipients of more than one transplant during the period, only the first is considered.


A line plot for patient survival among lung transplant recipients aged 12 years or older, 2008-2010, by diagnosis group; the a category decreases by 42.4% from 100 percent at 0 Months posttransplant to 57.6 percent at 60 Months posttransplant; the b category decreases by 45.2% from 100 percent at 0 Months posttransplant to 54.8 percent at 60 Months posttransplant; the c category decreases by 41.7% from 100 percent at 0 Months posttransplant to 58.3 percent at 60 Months posttransplant; and the d category decreases by 46.7% from 100 percent at 0 Months posttransplant to 53.3 percent at 60 Months posttransplant.

Figure LU 51. Patient survival among lung transplant recipients aged 12 years or older, 2008-2010, by diagnosis group
Patient survival estimated using unadjusted Kaplan-Meier methods. For recipients of more than one transplant during the period, only the first is considered.


A line plot for patient survival among lung transplant recipients aged 12 years or older, 2008-2010, by diagnosis and transplant type; the alpha to 1 single category decreases by 47.8% from 100 percent at 0 Months posttransplant to 52.2 percent at 60 Months posttransplant; the alpha to 1 bilateral category decreases by 33.6% from 100 percent at 0 Months posttransplant to 66.4 percent at 60 Months posttransplant; the ipf single category decreases by 54.4% from 100 percent at 0 Months posttransplant to 45.6 percent at 60 Months posttransplant; the ipf bilateral category decreases by 41.3% from 100 percent at 0 Months posttransplant to 58.7 percent at 60 Months posttransplant; the copd single category decreases by 49.5% from 100 percent at 0 Months posttransplant to 50.5 percent at 60 Months posttransplant; and the copd bilateral category decreases by 39.5% from 100 percent at 0 Months posttransplant to 60.5 percent at 60 Months posttransplant.

Figure LU 52. Patient survival among lung transplant recipients aged 12 years or older, 2008-2010, by diagnosis and transplant type
Patient survival estimated using unadjusted Kaplan-Meier methods. For recipients of more than one transplant during the period, only the first is considered. COPD, chronic obstructive pulmonary disease; IPF, idiopathic pulmonary fibrosis.


A line plot for patient death among lung transplant recipients aged 12 years or older; the 6 to month category decreases by 67.3% from 24.2 percent at 1992 to 7.9 percent at 2014; the 1 to year category decreases by 59.5% from 32.6 percent at 1992 to 13.2 percent at 2014; the 3 to year category decreases by 40.5% from 49.1 percent at 1992 to 29.2 percent at 2012; the 5 to year category decreases by 28.6% from 62.3 percent at 1992 to 44.5 percent at 2010; and the 10 to year category decreases by 20.2% from 81 percent at 1992 to 64.7 percent at 2005.

Figure LU 53. Patient death among lung transplant recipients aged 12 years or older
All recipients aged 12 years or older of deceased donor lungs, including multi-organ transplants. Patients are followed until the earlier of death or December 31, 2015. Estimates computed with Cox proportional hazards models adjusted for age, sex, and race.


A line plot for recipients alive with a functioning lung graft on june 30 of the year, by age at transplant; the less than 18 category increases by 43.6% from 0.3 patients (in thousands) at 2004 to 0.4 patients (in thousands) at 2015; the 18 to 49 category increases by 56.8% from 2.4 patients (in thousands) at 2004 to 3.7 patients (in thousands) at 2015; the greater than or equal to 50 category increases by 173.6% from 2.9 patients (in thousands) at 2004 to 8 patients (in thousands) at 2015; and the all category increases by 117.1% from 5.6 patients (in thousands) at 2004 to 12.1 patients (in thousands) at 2015.

Figure LU 54. Recipients alive with a functioning lung graft on June 30 of the year, by age at transplant
Recipients are assumed to be alive with function unless a death or graft failure is recorded. A recipient may experience a graft failure and be removed from the cohort, undergo retransplant, and re-enter the cohort.


A bar plot for incidence of acute rejection by 1 year posttransplant among lung transplant recipients aged 12 years or older by age, the 12 to 17 age group is 17.11 percent for 2009-10, 14.58 percent for 2011 to 12, and 19.18 percent for 2013 to 14; the 18 to 34 age group is 22.25 percent for 2009-10, 22.79 percent for 2011 to 12, and 20.87 percent for 2013 to 14; the 35 to 49 age group is 18.87 percent for 2009-10, 20.70 percent for 2011 to 12, and 20.35 percent for 2013 to 14; the 50 to 64 age group is 16.10 percent for 2009-10, 17.19 percent for 2011 to 12, and 15.80 percent for 2013 to 14; the greater than or equal to 65 age group is 18.11 percent for 2009-10, 18.55 percent for 2011 to 12, and 14.49 percent for 2013 to 14; and the all age group is 17.74 percent for 2009-10, 18.63 percent for 2011 to 12, and 16.55 percent for 2013 to 14.

Figure LU 55. Incidence of acute rejection by 1 year posttransplant among lung transplant recipients aged 12 years or older by age
Acute rejection is defined as a record of acute or hyperacute rejection, as reported on the OPTN Transplant Recipient Registration or Transplant Recipient Follow-up Form. Only the first rejection event is counted. Cumulative incidence is estimated using the Kaplan-Meier competing risk method.


A line plot for incidence of ptld among lung transplant recipients aged 12 years or older by recipient ebv status at transplant, 2009-2013; the ebv to category is 0 percent at 0 Months posttransplant and is percent at 60 Months posttransplant; the ebv+ category is 0 percent at 0 Months posttransplant and is percent at 60 Months posttransplant; the ebv unknown category is 0 percent at 0 Months posttransplant and is percent at 60 Months posttransplant; and the all category is 0 percent at 0 Months posttransplant and is percent at 60 Months posttransplant.

Figure LU 56. Incidence of PTLD among lung transplant recipients aged 12 years or older by recipient EBV status at transplant, 2009-2013
Cumulative incidence is estimated using the Kaplan-Meier competing risk method. PTLD is identified as a reported complication or cause of death on the OPTN Transplant Recipient Follow-up Form or the Posttransplant Malignancy Form as polymorphic PTLD, monomorphic PTLD, or Hodgkin disease. Only the earliest date of PTLD diagnosis is considered. EBV, Epstein-Barr virus; PTLD, posttransplant lymphoproliferative disorder.


A line plot for one-year cumulative incidence of death by cause among lung recipients aged 12 years or older, 2013-2014; the graft failure category is 0 percent at 0 Months since transplant and is percent at 12 Months since transplant; the infection category is 0 percent at 0 Months since transplant and is percent at 12 Months since transplant; the cardio/cerebrovascular category is 0 percent at 0 Months since transplant and is percent at 12 Months since transplant; the malignancy category is 0 percent at 0 Months since transplant and is percent at 12 Months since transplant; and the respiratory category is 0 percent at 0 Months since transplant and is percent at 12 Months since transplant.

Figure LU 57. One-year cumulative incidence of death by cause among lung recipients aged 12 years or older, 2013-2014
Primary cause of death is as reported on the OPTN Transplant Recipient Registration and Follow-up Forms. Other causes of death include hemorrhage, trauma, nonadherence, unspecified other, unknown, etc. Cumulative incidence is estimated using Kaplan-Meier competing risk methods.


A line plot for five-year cumulative incidence of death by cause among lung recipients aged 12 years or older, 2009-2010; the graft failure category is 0 percent at 0 and is percent at 5; the infection category is 0 percent at 0 and is percent at 5; the cardio/cerebrovascular category is 0 percent at 0 and is percent at 5; the malignancy category is 0 percent at 0 and is percent at 5; and the respiratory category is 0 percent at 0 and is percent at 5.

Figure LU 58. Five-year cumulative incidence of death by cause among lung recipients aged 12 years or older, 2009-2010
Primary cause of death is as reported on the OPTN Transplant Recipient Registration and Follow-up Forms. Other causes of death include hemorrhage, trauma, nonadherence, unspecified other, unknown, etc. Cumulative incidence is estimated using Kaplan-Meier competing risk methods.


A line plot for new candidates aged 0-11 years added to the lung transplant waiting list; the active category decreases by 61.1% from 54 candidates at 2004 to 21 candidates at 2015; the inactive category is 0 candidates at 2004 and is candidates at 2015; and the all category decreases by 57.4% from 54 candidates at 2004 to 23 candidates at 2015.

Figure LU 59. New candidates aged 0-11 years added to the lung transplant waiting list
Candidates concurrently listed at multiple centers are counted once. Candidates who are active at at least one program are considered active; otherwise they are inactive. A new patient is one who first joined the list during the given year without ever listing in a prior year, or one who listed and underwent transplant in a prior year and relisted in the given year. Patients on the list on December 31 were aged 0-11 years at listing.


A line plot for candidates aged 0-11 years waiting for lung transplant; the active category decreases by 82.4% from 74 candidates at 2004 to 13 candidates at 2015; the inactive category decreases by 86.8% from 53 candidates at 2004 to 7 candidates at 2015; and the all category decreases by 84.3% from 127 candidates at 2004 to 20 candidates at 2015.

Figure LU 60. Candidates aged 0-11 years waiting for lung transplant
Candidates concurrently listed at multiple centers are counted once. Those with concurrent listings and active at any program are considered active.


A line plot for distribution of candidates aged 0-11 years actively waiting for lung transplant, by age; the less than 1 category increases by 85.9% from 6.7 percent at 2004 to 12.5 percent at 2015; the 1 to 5 category increases by 48.7% from 20.2 percent at 2004 to 30 percent at 2015; and the 6 to 11 category decreases by 21.4% from 73.1 percent at 2004 to 57.5 percent at 2015.

Figure LU 61. Distribution of candidates aged 0-11 years actively waiting for lung transplant, by age
Candidates waiting for transplant any time in the given year. Candidates listed concurrently at multiple centers are counted once. Age is determined at the later of listing date or January 1 of the given year. Only candidates who were active for at least 1 day are included.


A line plot for distribution of candidates aged 0-11 years actively waiting for lung transplant by race; the white category is 67.2 percent at 2004 and remains relatively constant with a value of 65 percent at 2015; the black category increases by 27.5% from 5.9 percent at 2004 to 7.5 percent at 2015; the hispanic category is 21 percent at 2004 and remains relatively constant with a value of 20 percent at 2015; the asian category increases by 123.1% from 3.4 percent at 2004 to 7.5 percent at 2015; and the other/unknown category decreases by 100.0% from 2.5 percent at 2004 to 0 percent at 2015.

Figure LU 62. Distribution of candidates aged 0-11 years actively waiting for lung transplant by race
Candidates waiting for transplant any time in the given year. Candidates listed concurrently at multiple centers are counted once. Only candidates who were active for at least 1 day are included.


A line plot for distribution of candidates aged 0-11 years actively waiting for lung transplant by sex; the male category increases by 28.3% from 42.9 percent at 2004 to 55 percent at 2015; and the female category decreases by 21.3% from 57.1 percent at 2004 to 45 percent at 2015.

Figure LU 63. Distribution of candidates aged 0-11 years actively waiting for lung transplant by sex
Candidates waiting for transplant any time in the given year. Candidates listed concurrently at multiple centers are counted once. Only candidates who were active for at least 1 day are included.


A line plot for distribution of candidates aged 0-11 years actively waiting for lung transplant by waiting time; the less than 31 days category is 11.8 percent at 2004 and remains relatively constant with a value of 12.5 percent at 2015; the 31 to less than 90 days category increases by 251.6% from 9.2 percent at 2004 to 32.5 percent at 2015; the 3 to less than 6 months category increases by 32.2% from 15.1 percent at 2004 to 20 percent at 2015; the 6 to less than 12 months category is 16 percent at 2004 and remains relatively constant with a value of 17.5 percent at 2015; the 1 to less than 2 years category decreases by 25.6% from 16.8 percent at 2004 to 12.5 percent at 2015; and the greater than or equal to 2 years category decreases by 83.9% from 31.1 percent at 2004 to 5 percent at 2015.

Figure LU 64. Distribution of candidates aged 0-11 years actively waiting for lung transplant by waiting time
Candidates waiting for transplant any time in the given year. Candidates listed concurrently at multiple centers are counted once. Time on the waiting list is determined at the earlier of December 31 or removal from the waiting list. Only candidates who were active for at least 1 day are included.


A line plot for three-year outcomes for newly listed candidates aged 0-11 years waiting for lung transplant, 2012; the still waiting category decreases by 100.0% from 100 percent at 0 Months postlisting to 0 percent at 36 Months postlisting; the removed from list category is 0 percent at 0 Months postlisting and is percent at 36 Months postlisting; the died category is 0 percent at 0 Months postlisting and is percent at 36 Months postlisting; and the dd transplant category is 0 percent at 0 Months postlisting and is percent at 36 Months postlisting.

Figure LU 65. Three-year outcomes for newly listed candidates aged 0-11 years waiting for lung transplant, 2012
Candidates aged 0-11 who joined the lung or heart-lung waitlist in 2012. Candidates concurrently listed at more than one center are counted once, from the time of earliest listing to the time of latest removal. DD, deceased donor.


A line plot for lung transplant rates among active waitlist candidates listed when aged younger than 12 years; the overall category increases by 236.0% from 36.3 transplants per 100 wait-list years at 2004 to 121.8 transplants per 100 wait-list years at 2015.

Figure LU 66. Lung transplant rates among active waitlist candidates listed when aged younger than 12 years
Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of active waiting in a given year. Individual listings are counted separately. Rates with less than 10 patient-years of exposure are not shown.


A line plot for pretransplant mortality rates among candidates aged 0-11 years waitlisted for lung transplant by age; the overall category increases by 277.7% from 9.7 deaths per 100 wait-list years at 2004-2005 to 36.5 deaths per 100 wait-list years at 2014-2015; the less than 6 category increases by 204.4% from 16.2 deaths per 100 wait-list years at 2004-2005 to 49.4 deaths per 100 wait-list years at 2014-2015; and the 6 to 11 category increases by 267.6% from 7.9 deaths per 100 wait-list years at 2004-2005 to 29 deaths per 100 wait-list years at 2014-2015.

Figure LU 67. Pretransplant mortality rates among candidates aged 0-11 years waitlisted for lung transplant by age
Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Individual listings are counted separately. Age is determined at the later of listing date or January 1 of the given year. Rates with less than 10 patient-years of exposure are not shown.


A line plot for lung transplants, recipients aged 0-11 years by age; the less than 1 category decreases by 75.0% from 4 transplants at 2004 to 1 transplants at 2015; the 1 to 5 category increases by 100.0% from 3 transplants at 2004 to 6 transplants at 2015; the 6 to 11 category decreases by 16.7% from 12 transplants at 2004 to 10 transplants at 2015; and the all category decreases by 10.5% from 19 transplants at 2004 to 17 transplants at 2015.

Figure LU 68. Lung transplants, recipients aged 0-11 years by age
All lung transplant recipients aged 0-11 years, including retransplant, and multi-organ recipients.


A line plot for number of centers performing pediatric and adult lung transplants by center

Figure LU 69. Number of centers performing pediatric and adult lung transplants by center's age mix
Adult centers transplanted only recipients aged 18 years or older. Functionally adult centers transplant 80% adults or more, and the remainder were children aged 15-17 years. Mixed included adults and children of any age groups. Child only centers transplanted recipeints aged 0-17 years, and small number of adults up to age 21 years.


A line plot for induction agent use in lung transplant recipients aged 0-11 years; the il2 to ra category increases by 11.0% from 39.5 percent at 2004 to 43.9 percent at 2014; the t to cell depleting category increases by 98.1% from 20.9 percent at 2004 to 41.5 percent at 2014; and the none category decreases by 55.8% from 44.2 percent at 2004 to 19.5 percent at 2014.

Figure LU 70. Induction agent use in lung transplant recipients aged 0-11 years
Immunosuppression at transplant reported to the OPTN. IL2-RA, interleukin-2 receptor antagonist.


A line plot for calcineurin inhibitor use in lung transplant recipients aged 0-11 years; the cyclosporine category decreases by 95.0% from 48.8 percent at 2004-2005 to 2.4 percent at 2014-2015; and the tacrolimus category increases by 82.4% from 53.5 percent at 2004-2005 to 97.6 percent at 2014-2015.

Figure LU 71. Calcineurin inhibitor use in lung transplant recipients aged 0-11 years
Immunosuppression at transplant reported to the OPTN.


A line plot for anti-metabolite use in lung transplant recipients aged 0-11 years; the azathioprine category decreases by 100.0% from 18.6 percent at 2004-2005 to 0 percent at 2014-2015; and the mycophenolate category increases by 35.3% from 72.1 percent at 2004-2005 to 97.6 percent at 2014-2015.

Figure LU 72. Anti-metabolite use in lung transplant recipients aged 0-11 years
Immunosuppression at transplant reported to the OPTN. Mycophenolate includes mycophenolate mofetil and mycophenolate sodium.


A line plot for steroid use in lung transplant recipients aged 0-11 years; the at transplant category is 95.3 percent at 2004-2005 and remains relatively constant with a value of 100 percent at 2014-2015; and the 1 year posttransplant category is 100 percent at 2004-2005 and remains relatively constant with a value of 100 percent at 2014-2015.

Figure LU 73. Steroid use in lung transplant recipients aged 0-11 years
Immunosuppression at transplant reported to the OPTN. One-year posttransplant data are limited to patients alive with graft function at 1 year posttransplant.


A bar plot for total hla a, b, and dr mismatches among deceased donor lung transplant recipients aged 0-11 years, 2011-2015, the 0 group is 0.00 percent; the 1 group is 0.00 percent; the 2 group is 0.00 percent; the 3 group is 5.26 percent; the 4 group is 13.68 percent; the 5 group is 13.68 percent; the 6 group is 20.00 percent; and the unk. group is 47.37 percent.

Figure LU 74. Total HLA A, B, and DR mismatches among deceased donor lung transplant recipients aged 0-11 years, 2011-2015
Donor and recipient antigen matching is based on OPTN antigen values and split equivalences policy as of 2015.


A line plot for incidence of ptld among lung transplant recipients aged 0-11 years by recipient ebv status at transplant, 2003-2013; the ebv to category is 0 percent at 0 Months posttransplant and is percent at 60 Months posttransplant; the ebv+ category is 0 percent at 0 Months posttransplant and is percent at 60 Months posttransplant; and the all category is 0 percent at 0 Months posttransplant and is percent at 60 Months posttransplant.

Figure LU 75. Incidence of PTLD among lung transplant recipients aged 0-11 years by recipient EBV status at transplant, 2003-2013
Cumulative incidence is estimated using the Kaplan-Meier competing risk method. Posttransplant lymphoproliferative disorder (PTLD) is identified as a reported complication or cause of death on the OPTN Transplant Recipient Follow-up Form or on the Posttransplant Malignancy Form as polymorphic PTLD, monomorphic PTLD, or Hodgkin disease. Only the earliest date of PTLD diagnosis is considered. EBV, Epstein-Barr virus.


A line plot for patient death among lung transplant recipients aged 0-11 years; the 6 to month category decreases by 76.6% from 26.2 percent at 1992-1996 to 6.1 percent at 2013-2014; the 1 to year category decreases by 74.3% from 32 percent at 1992-1996 to 8.2 percent at 2013-2014; the 3 to year category decreases by 68.2% from 48.7 percent at 1992-1996 to 15.5 percent at 2011-2012; the 5 to year category decreases by 43.7% from 57.9 percent at 1992-1996 to 32.6 percent at 2009-2010; and the 10 to year category decreases by 20.1% from 70.3 percent at 1992-1996 to 56.2 percent at 2003-2004.

Figure LU 76. Patient death among lung transplant recipients aged 0-11 years
All deceased donor lung recipients aged 0-11 years, including multi-organ transplants. Patients are followed until the earlier of death or December 31, 2015. Estimates computed with Cox proportional hazards models reporting, adjusted for age, sex, and race.


A line plot for patient survival among lung transplant recipients aged 0-11 years, 2003-2010, by age; the less than 1 category decreases by 50.0% from 100 percent at 0 Months post-transplant to 50 percent at 60 Months post-transplant; the 1 to 5 category decreases by 48.8% from 100 percent at 0 Months post-transplant to 51.2 percent at 60 Months post-transplant; the 6 to 11 category decreases by 37.2% from 100 percent at 0 Months post-transplant to 62.8 percent at 60 Months post-transplant; and the all category decreases by 43.2% from 100 percent at 0 Months post-transplant to 56.8 percent at 60 Months post-transplant.

Figure LU 77. Patient survival among lung transplant recipients aged 0-11 years, 2003-2010, by age
Recipient survival estimated using unadjusted Kaplan-Meier methods.


A line plot for patient survival among lung transplant recipients aged 0-11 years, 2003-2010, by diagnosis; the cystic fibrosis category decreases by 38.9% from 100 percent at 0 Months post-transplant to 61.1 percent at 60 Months post-transplant; the ph category decreases by 48.4% from 100 percent at 0 Months post-transplant to 51.6 percent at 60 Months post-transplant; and the other category decreases by 43.2% from 100 percent at 0 Months post-transplant to 56.8 percent at 60 Months post-transplant.

Figure LU 78. Patient survival among lung transplant recipients aged 0-11 years, 2003-2010, by diagnosis
Recipient survival estimated using unadjusted Kaplan-Meier methods. PH, pulmonary hypertension.


A line plot for one-year cumulative incidence of death by cause among lung transplant recipients aged 0-11 years, 2004-2014; the graft failure category is 0 percent at 0 Months since transplant and is percent at 12 Months since transplant; the infection category is 0 percent at 0 Months since transplant and is percent at 12 Months since transplant; the cardio/cerebrovascular category is 0 percent at 0 Months since transplant and is percent at 12 Months since transplant; the malignancy category is 0 percent at 0 Months since transplant and is percent at 12 Months since transplant; and the respiratory category is 0 percent at 0 Months since transplant and is percent at 12 Months since transplant.

Figure LU 79. One-year cumulative incidence of death by cause among lung transplant recipients aged 0-11 years, 2004-2014
Primary cause of death is as reported on the OPTN Transplant Recipient Registration and Follow-up Forms. Other causes of death include hemorrhage, trauma, nonadherence, unspecified other, unknown, etc. Cumulative incidence is estimated using Kaplan-Meier competing risk methods.


A line plot for five-year cumulative incidence of death by cause among lung transplant recipients aged 0-11 years, 2004-2010; the graft failure category is 0 percent at 0 and is percent at 5; the infection category is 0 percent at 0 and is percent at 5; the cardio/cerebrovascular category is 0 percent at 0 and is percent at 5; the malignancy category is 0 percent at 0 and is percent at 5; and the respiratory category is 0 percent at 0 and is percent at 5.

Figure LU 80. Five-year cumulative incidence of death by cause among lung transplant recipients aged 0-11 years, 2004-2010
Primary cause of death is as reported on the OPTN Transplant Recipient Registration and Follow-up Forms. Other causes of death include hemorrhage, trauma, nonadherence, unspecified other, unknown, etc. Cumulative incidence is estimated using Kaplan-Meier competing risk methods.


Table LU 1 Characteristics of candidates aged 12 years or older on the lung transplant waiting list on December 31, 2010, and December 31, 2015
Candidates waiting for transplant on December 31, 2010, and 2015, regardless of first listing date; active/inactive status is on this date, and multiple listings are not counted. All candidates with unknown LAS in are inactive.
Characteristic 2010, N 2010, Percent 2015, N 2015, Percent
Age: 12-17 years 35 2.0% 14 0.9%
Age: 18-34 years 223 12.6% 154 10.1%
Age: 35-49 years 288 16.3% 235 15.5%
Age: 50-64 years 922 52.2% 756 49.8%
Age: ≥65 years 299 16.9% 360 23.7%
Sex: Female 1057 59.8% 926 61.0%
Sex: Male 710 40.2% 593 39.0%
Race/ethnicity: White 1428 80.8% 1189 78.3%
Race/ethnicity: Black 189 10.7% 164 10.8%
Race/ethnicity: Hispanic 106 6.0% 103 6.8%
Race/ethnicity: Asian 27 1.5% 51 3.4%
Race/ethnicity: Other/unknown 17 1.0% 12 0.8%
Diagnosis group: A 836 47.3% 651 42.9%
Diagnosis group: B 154 8.7% 121 8.0%
Diagnosis group: C 228 12.9% 174 11.5%
Diagnosis group: D 548 31.0% 573 37.7%
Diagnosis group: Other/unknown 1 0.1% 0 0.0%
LAS: < 30 46 2.6% 126 8.3%
LAS: 30-< 35 940 53.2% 615 40.5%
LAS: 35-< 40 363 20.5% 413 27.2%
LAS: 40-< 50 227 12.8% 259 17.1%
LAS: 50-< 60 66 3.7% 59 3.9%
LAS: ≥ 60 52 2.9% 47 3.1%
LAS: Unknown 73 4.1% 0 0.0%
Blood type: A 690 39.0% 575 37.9%
Blood type: B 181 10.2% 183 12.0%
Blood type: AB 40 2.3% 45 3.0%
Blood type: O 856 48.4% 716 47.1%
Height: < 150 cm 83 4.7% 59 3.9%
Height: 150-<160 cm 372 21.1% 351 23.1%
Height: 160-<170 cm 666 37.7% 574 37.8%
Height: 170-<180 cm 443 25.1% 357 23.5%
Height: ≥ 180 cm 199 11.3% 177 11.7%
Height: Unknown 4 0.2% 1 0.1%
Wait time: < 31 days 171 9.7% 180 11.8%
Wait time: 31-60 days 136 7.7% 133 8.8%
Wait time: 61-90 days 100 5.7% 106 7.0%
Wait time: 3-< 6 months 267 15.1% 239 15.7%
Wait time: 6-< 12 months 319 18.1% 251 16.5%
Wait time: 1-< 2 years 299 16.9% 284 18.7%
Wait time: 2-< 3 years 147 8.3% 142 9.3%
Wait time: ≥ 3 years 328 18.6% 184 12.1%
Waitlist status: Active 1350 76.4% 1211 79.7%
Waitlist status: Inactive 417 23.6% 308 20.3%
Transplant history: First 1714 97.0% 1484 97.7%
Transplant history: Retransplant 53 3.0% 35 2.3%
Tx type: Lung only 1693 95.8% 1459 96.1%
Tx type: Heart-lung 55 3.1% 50 3.3%
Other 19 1.1% 10 0.7%
All candidates 1767 100.0% 1519 100.0%



Table LU 2 Lung transplant waitlist activity among candidates aged 12 years or older
Candidates concurrently listed at more than one center are counted once, from the time of earliest listing to the time of latest removal. Candidates who are listed, undergo transplant, and are relisted are counted more than once. Candidates are not considered to be on the list on the day they are removed; counts on January 1 may differ from counts on December 31 of the prior year. Candidates listed for multi-organ transplants are included.
Waiting list state 2013 2014 2015
Patients at start of year 1589 1577 1636
Patients added during year 2391 2515 2490
Patients removed during year 2397 2453 2607
Patients at end of year 1583 1639 1519



Table LU 3 Removal reason among lung transplant candidats aged 12 years or older
Removal reason as reported to the OPTN. Candidates with death dates that precede removal dates are assumed to have died waiting.
Removal reason 2013 2014 2015
Deceased donor transplant 1900 1916 2047
Living donor transplant 1 0 0
Patient died 216 271 243
Patient refused transplant 13 14 10
Improved, transplant not needed 49 38 42
Too sick for transplant 135 132 148
Other 83 82 117



Table LU 4 Characteristics of lung transplant recipients aged 12 years or older, 2010 and 2015
Lung transplant recipients aged 12 years or older, including retransplants. ECMO, extracorporeal membrane oxygenation.
Characteristic 2010, N 2010, Percent 2015, N 2015, Percent
Age: 12-17 years 31 1.7% 27 1.3%
Age: 18-34 years 214 12.0% 208 10.1%
Age: 35-49 years 285 16.0% 252 12.3%
Age: 50-64 years 817 45.8% 974 47.4%
Age: ≥65 years 438 24.5% 594 28.9%
Sex: Female 730 40.9% 843 41.0%
Sex: Male 1055 59.1% 1212 59.0%
Race/ethnicity: White 1474 82.6% 1655 80.5%
Race/ethnicity: Black 159 8.9% 188 9.1%
Race/ethnicity: Hispanic 103 5.8% 159 7.7%
Race/ethnicity: Asian 32 1.8% 41 2.0%
Race/ethnicity: Other/unknown 17 1.0% 12 0.6%
Diagnosis group: A 507 28.4% 566 27.5%
Diagnosis group: B 102 5.7% 72 3.5%
Diagnosis group: C 216 12.1% 227 11.0%
Diagnosis group: D 960 53.8% 1190 57.9%
LAS: < 30 4 0.2% 3 0.1%
LAS: 30-< 35 403 22.6% 477 23.2%
LAS: 35-< 40 414 23.2% 445 21.7%
LAS: 40-< 50 474 26.6% 484 23.6%
LAS: 50-< 60 154 8.6% 218 10.6%
LAS: ≥ 60 335 18.8% 428 20.8%
LAS: Unknown 1 0.1% 0 0.0%
Blood type: A 684 38.3% 818 39.8%
Blood type: B 212 11.9% 231 11.2%
Blood type: AB 70 3.9% 79 3.8%
Blood type: O 819 45.9% 927 45.1%
Wait time: < 31 days 586 32.8% 701 34.1%
Wait time: 31-60 days 254 14.2% 316 15.4%
Wait time: 61-90 days 158 8.9% 187 9.1%
Wait time: 3-< 6 months 297 16.6% 311 15.1%
Wait time: 6-< 12 months 275 15.4% 267 13.0%
Wait time: 1-< 2 years 139 7.8% 164 8.0%
Wait time: 2-< 3 years 42 2.4% 56 2.7%
Wait time: ≥ 3 years 34 1.9% 53 2.6%
Medical condition: Hospitalized in ICU 150 8.4% 267 13.0%
Medical condition: Hospitalized, not ICU 148 8.3% 242 11.8%
Medical condition: Not hospitalized 1487 83.3% 1530 74.5%
Medical condition: Hospitalization unkno 0 0.0% 16 0.8%
Vent/ECMO at transplant: Vent + ECMO 22 1.2% 63 3.1%
Vent/ECMO at transplant: Vent only 130 7.3% 64 3.1%
Vent/ECMO at transplant: ECMO only 7 0.4% 33 1.6%
Vent/ECMO at transplant: Neither 1626 91.1% 1895 92.2%
Procedure: Single 539 30.2% 597 29.1%
Procedure: Bilateral 1246 69.8% 1458 70.9%
Donor type: DBD 1771 99.2% 1993 97.0%
Donor type: DCD 14 0.8% 62 3.0%
Transplant history: First 1699 95.2% 1988 96.7%
Transplant history: Retransplant 86 4.8% 67 3.3%
Insurance: Private 945 52.9% 985 47.9%
Insurance: Medicare 623 34.9% 828 40.3%
Insurance: Other government 206 11.5% 203 9.9%
Insurance: Unknown 11 0.6% 39 1.9%
Tx type: Lung only 1738 97.4% 2029 98.7%
Tx type: Heart-lung 39 2.2% 15 0.7%
Tx type: Other 8 0.4% 11 0.5%
All recipients 1785 100.0% 2055 100.0%



Table LU 5 Donor-recipient serology matching among lung transplant recipients aged 12 years or older, 2011-2015.
Donor serology is reported on the OPTN Donor Registration Form and recipient serology on the OPTN Transplant Recipient Registration Form. There may be multiple fields per serology. Any evidence for a positive serology is treated as positive for that serology. If all fields are unknown, incomplete, or pending, the person is categorized as unknown for that serology; otherwise, serology is assumed negative. CMV, cytomegalovirus; EBV, Epstein-Barr virus; HB, hepatitis B; HCV, hepatitis C virus; HIV, human immunodeficiency virus.
Donor Recipient CMV EBV
D- R- 12.8% 0.6%
D- R+ 15.7% 5.3%
D- R unk 8.3% 0.4%
D+ R- 20.8% 9.4%
D+ R+ 29.1% 77.8%
D+ R unk 13.2% 6.5%
D unk R- 0.1% 0.0%
D unk R+ 0.1% 0.1%
D unk R unk 0.0% 0.0%



Table LU 6 Posttransplant events among lung transplant recipients aged 12 years or older,
Posttransplant morbidities are recorded on the OPTN Transplant Recipient Follow-up Form and are included in the table if they were reported anytime on or before 1-year and 5-year follow-up. One-year events are reported for recipients in 2012-2014 and 5-year events for recipients in 2008-2010. Recipients of more than one transplant are counted separately per transplant. For bronchiolitis obliterans syndrome (BOS), the most severe complication recorded for each transplant is counted.
Event One-year, N One-year, Pct Five-year, N Five-year, Pct
BOS Grade 3 35 0.7% 142 5.6%
BOS Grade 2 30 0.6% 126 5.0%
BOS Grade 1 47 1.0% 246 9.8%
BOS Grade OP 154 3.2% 300 11.9%
BOS Grade unk. 84 1.8% 288 11.4%
No BOS 4167 87.2% 1413 56.1%
Unknown BOS status 261 5.5% 5 0.2%
Creatinine > 2.5 mg/dl 213 4.5% 352 14.0%
Chronic dialysis 59 1.2% 61 2.4%
Renal transplant 4 0.1% 22 0.9%
Diabetes 466 9.8% 704 27.9%
Malignancy 182 3.8% 577 22.9%
Re-hospitalization 2327 48.7% 2000 79.4%
Functional status: No assistance needed 3970 83.1% 2004 79.5%
Functional status: Some assistance needed 348 7.3% 173 6.9%
Functional status: Total assistance needed 88 1.8% 38 1.5%
Functional status: Unknown 372 7.8% 305 12.1%
All recipients 4778 100.0% 2520 100.0%



Table LU 7 Characteristics of candidates aged 0-11 years on the lung transplant waiting list on December 31, 2005, and December 31, 2015
Candidates aged younger than 12 years at listing waiting for transplant on December 31, 2005, and December 31, 2015, regardless of first listing date; active/inactive status is on this date, and multiple listings are not counted.
Characteristic 2005, N 2005, Percent 2015, N 2015, Percent
Age: < 1 year 0 0.0% 1 5.9%
Age: 1-5 years 19 26.8% 3 17.6%
Age: 6-11 years 52 73.2% 13 76.5%
Sex: Female 37 52.1% 8 47.1%
Sex: Male 34 47.9% 9 52.9%
Race/ethnicity: White 47 66.2% 11 64.7%
Race/ethnicity: Black 5 7.0% 0 0.0%
Race/ethnicity: Hispanic 13 18.3% 5 29.4%
Race/ethnicity: Asian 5 7.0% 1 5.9%
Race/ethnicity: Other/unknown 1 1.4% 0 0.0%
Blood type: A 22 31.0% 4 23.5%
Blood type: B 9 12.7% 4 23.5%
Blood type: AB 3 4.2% 0 0.0%
Blood type: O 37 52.1% 9 52.9%
Height: < 70 cm 5 7.0% 2 11.8%
Height: 70-< 90 cm 16 22.5% 2 11.8%
Height: 90-< 110 cm 15 21.1% 4 23.5%
Height: 110-< 130 cm 26 36.6% 7 41.2%
Height: ≥ 130 cm 9 12.7% 2 11.8%
Wait time: < 31 days 4 5.6% 2 11.8%
Wait time: 31-60 days 3 4.2% 2 11.8%
Wait time: 61-90 days 2 2.8% 0 0.0%
Wait time: 3-< 6 months 6 8.5% 2 11.8%
Wait time: 6-< 12 months 9 12.7% 3 17.6%
Wait time: 1-< 2 years 21 29.6% 3 17.6%
Wait time: 2-< 3 years 5 7.0% 0 0.0%
Wait time: ≥ 3 years 21 29.6% 5 29.4%
Waitlist status: Active 50 70.4% 13 76.5%
Waitlist status: Inactive 21 29.6% 4 23.5%
Transplant history: First 71 100.0% 17 100.0%
Tx type: Lung only 60 84.5% 17 100.0%
Tx type: Heart-lung 11 15.5% 0 0.0%
All candidates 71 100.0% 17 100.0%



Table LU 8 Lung transplant waitlist activity among candidates aged 0-11 years
Candidates concurrently listed at more than one center are counted once, from the time of earliest listing to the time of latest removal. Candidates who are listed, undergo transplant, and are relisted are counted more than once. Candidates are not considered to be on the list on the day they are removed; counts on January 1 may differ from counts on December 31 of the prior year. Candidates listed for multi-organ transplants are included.
Waiting list state 2013 2014 2015
Patients at start of year 44 36 29
Patients added during year 38 36 23
Patients removed during year 46 43 32
Patients at end of year 36 29 20



Table LU 9 Removal reason among lung transplant candidates aged 0-11 years
Removal reason as reported to the OPTN. Candidates with death dates that precede removal dates are assumed to have died waiting.
Removal reason 2013 2014 2015
Deceased donor transplant 32 21 17
Living donor transplant 0 0 0
Patient died 4 11 8
Patient refused transplant 1 0 0
Improved, transplant not needed 3 7 2
Too sick for transplant 3 1 2
Other 3 3 3



Table LU 10 Characteristics of lung transplant recipients aged 0-11 years, 2002-2005 and 2012-2015
Lung transplant recipients, including retransplants. ECMO, extracorporeal membrane oxygenation.
Characteristic 2002-05, N 2002-05, Percent 2012-15, N 2012-15, Percent
Age: < 1 year 15 19.5% 12 15.4%
Age: 1-5 years 19 24.7% 25 32.1%
Age: 6-11 years 43 55.8% 41 52.6%
Sex: Female 36 46.8% 44 56.4%
Sex: Male 41 53.2% 34 43.6%
Race/ethnicity: White 51 66.2% 53 67.9%
Race/ethnicity: Black 6 7.8% 7 9.0%
Race/ethnicity: Hispanic 13 16.9% 16 20.5%
Race/ethnicity: Asian 4 5.2% 2 2.6%
Race/ethnicity: Other/unknown 3 3.9% 0 0.0%
Diagnosis: Cystic fibrosis 23 29.9% 20 25.6%
Diagnosis: Pulmonary hypertension 19 24.7% 15 19.2%
Diagnosis: Pulmonary fibrosis 3 3.9% 9 11.5%
Diagnosis: Other vascular 2 2.6% 6 7.7%
Diagnosis: Other/unknown 30 39.0% 28 35.9%
Blood type: A 20 26.0% 28 35.9%
Blood type: B 14 18.2% 12 15.4%
Blood type: AB 6 7.8% 3 3.8%
Blood type: O 37 48.1% 35 44.9%
Wait time: < 31 days 15 19.5% 19 24.4%
Wait time: 31-60 days 9 11.7% 13 16.7%
Wait time: 61-90 days 12 15.6% 14 17.9%
Wait time: 3-< 6 months 13 16.9% 18 23.1%
Wait time: 6-< 12 months 9 11.7% 10 12.8%
Wait time: 1-< 2 years 10 13.0% 2 2.6%
Wait time: 2-< 3 years 2 2.6% 2 2.6%
Wait time: ≥ 3 years 5 6.5% 0 0.0%
Wait time: Unknown 2 2.6% 0 0.0%
Medical condition: Hospitalized in ICU 25 32.5% 31 39.7%
Medical condition: Hospitalized, not ICU 12 15.6% 14 17.9%
Medical condition: Not hospitalized 40 51.9% 33 42.3%
Vent/ECMO at transplant: Vent + ECMO 1 1.3% 5 6.4%
Vent/ECMO at transplant: Vent only 21 27.3% 24 30.8%
Vent/ECMO at transplant: ECMO only 0 0.0% 4 5.1%
Vent/ECMO at transplant: Neither 55 71.4% 45 57.7%
Procedure: Lobar 3 3.9% 0 0.0%
Procedure: Bilateral 74 96.1% 78 100.0%
Donor type: Deceased 74 96.1% 78 100.0%
Donor type: Living 3 3.9% 0 0.0%
Transplant history: First 72 93.5% 71 91.0%
Transplant history: Retransplant 5 6.5% 7 9.0%
Insurance: Private 42 54.5% 41 52.6%
Insurance: Medicaid 31 40.3% 25 32.1%
Insurance: Unknown 4 5.2% 12 15.4%
Tx type: Lung only 69 89.6% 71 91.0%
Tx type: Heart-lung 6 7.8% 6 7.7%
Tx type: Other 2 2.6% 1 1.3%
All recipients 77 100.0% 78 100.0%



Table LU 11 Donor-recipient serology matching among lung transplant recipients aged 0-11 years, 2011-2015
Donor serology is reported on the OPTN Donor Registration Form and recipient serology on the OPTN Translant Recipient Registration Form. There may be multiple fields per serology. Any evidence for a positive serology is treated as positive for that serology. If all fields are unknown, incomplete, or pending, the person is categorized as unknown for that serology; otherwise, serology is assumed negative. CMV, cytomegalovirus; EBV, Epstein-Barr virus.
Donor Recipient CMV EBV
D- R- 37.9% 15.8%
D- R+ 9.5% 21.1%
D- R unk 6.3% 1.1%
D+ R- 20.0% 32.6%
D+ R+ 20.0% 28.4%
D+ R unk 6.3% 1.1%



Table LU 12 Posttransplant events among lung transplant recipients aged 0-11 years
Posttransplant morbidities are recorded on the OPTN Pediatric Transplant Recipient Follow-up Form and are included in the table if they were reported anytime on or before 1-year and 5-year follow-up. One-year events are reported for recipients in 2011-2014 and 5-year events for recipients in 2007-2010. Recipients of more than one transplant are counted separately per transplant. For bronchiolitis obliterans syndrome (BOS), the most severe complication recorded for each transplant is counted.
Event One-year, N One-year, Pct Five-year, N Five-year, Pct
BOS Grade 3 1 1.4% 3 7.1%
BOS Grade 2 1 1.4% 1 2.4%
BOS Grade 1 0 0.0% 2 4.8%
BOS Grade OP 0 0.0% 1 2.4%
BOS Grade unk. 2 2.8% 9 21.4%
No BOS 65 90.3% 26 61.9%
Unknown BOS status 3 4.2% 0 0.0%
Diabetes 2 2.8% 3 7.1%
Malignancy 1 1.4% 1 2.4%
Re-hospitalization 40 55.6% 38 90.5%
Functional status: Fully active 65 90.3% 39 92.9%
Functional status: Min. active 2 2.8% 3 7.1%
Functional status: Bedbound 3 4.2% 0 0.0%
Functional status: Unknown 2 2.8% 0 0.0%
All recipients 72 100.0% 42 100.0%