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Lung

OPTN/SRTR 2018 Annual Data Report: Lung

Abstract

The primary goal of US lung allocation policy is to ensure that candidates with the highest risk for mortality receive appropriate access to lung transplant. In 2018, 2562 lung transplants were performed in the US, reflecting a 31% increase over the past 5 years. More candidates are being listed for lung transplant, and the number of donors has increased substantially. Despite an increase of 84 lung transplants in 2018, 365 adult candidates died or became too sick to undergo transplant. In 2018, 24 new child (ages 0-11 years) candidates were added to the lung transplant waiting list. Fifteen lung transplants were performed in recipients aged 0-11 years, three in recipients aged younger than 1 year, two in recipients aged 1-5 years, and ten in recipients aged 6-11 years. Of 27 child candidates removed from the waiting list in 2018, 16 (59.3%) were removed due to undergoing transplant, six (22.2%) due to death, one (3.7%) due to improved condition, and one (3.7%) due to becoming too sick to undergo transplant.

Adult lung transplant

Introduction

In 2018, 2562 lung transplants were performed in the US, reflecting a 31% increase over the past 5 years (Figure LU 46). More lung transplants are being performed due to more candidates being listed for lung transplant (Figure LU 1) and a precipitous increase in numbers of donors (Figure LU 37). The number of candidates added to the waiting list increased by 233 in 2018 (Figure LU 1), and the number of donors increased by 80 (Figure LU 37). Despite an increase of 84 lung transplants in 2018, 365 candidates died or became too sick to undergo transplant (Table LU 5).

The primary goal of US lung allocation policy is to ensure that candidates with the highest risk for mortality receive appropriate access to lung transplant. The Organ Procurement and Transplantation Network (OPTN) monitors the status of transplant candidates and recipients and adjusts the system to meet this key objective. Candidates aged 12 years or older access lung transplant based on calculated lung allocation score (LAS), age, geography, and blood type (ABO) compatibility, and, if necessary, waiting time. Candidates aged younger than 12 years access transplant based on illness-based priority status, age, geography, blood type (ABO) compatibility, and waiting time.

The LAS considers waitlist mortality and posttransplant survival in its calculation, with more weight given to waitlist mortality to allow candidates at the highest risk of mortality increased access to transplant. Posttransplant survival is included in the model to minimize allocation of lungs to candidates with poor likelihood of posttransplant survival. In calculating the LAS, pulmonary diseases are categorized into four main groups based on similar survival probability and disease pathophysiology. These are group A, obstructive lung disease; group B, pulmonary vascular disease; group C, cystic fibrosis and immunodeficiency disorders; and group D, restrictive lung disease.

The LAS was implemented in 2005, resulting in candidates who were older and/or sicker being listed for transplant and ultimately undergoing transplant. The LAS was most recently updated in February 2015 with an updated cohort and new variables to more accurately reflect disease severity for the entire transplant population, and in particular group B candidates. Due to the changes in LAS calculation, scores prior to 2015 may not be directly comparable to those after. In March 2017, OPTN implemented a policy to improve transplant access for the pediatric population, with broader geographic sharing of organs for child (age 0-11 years) and adolescent (age 12-17 years) candidates. Additionally, adolescents and adults receive equal preference for adult donor lungs in the LAS system. Finally, in November 2017, a policy was implemented to eliminate donation service area as the first unit of allocation for donor lungs in favor of a more uniform 250-nautical-mile circle from the donor hospital. This policy has now been in effect for 1 year, and some of its impact is reflected in this year’s data report.

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

Waiting list

Characteristics of US candidates waiting for a lung transplant

In 2018, 3134 candidates were added to the lung transplant waiting list, reflecting an 8.0% increase from 2017 (Figure LU 1), and a 42.2% increase over the past decade. Mostly keeping pace with the increasing demand, the number of lung transplants being performed continued to increase annually (Figure LU 46), although the number of candidates remaining on the waiting list at the end of 2018 increased for the first time since the end of 2014 (Figure LU 2).

The proportion of candidates aged 65 years or older continued to increase, comprising 32.0% of the waiting list in 2018 (Figure LU 3). Men outnumbered women and made up 52.7% of the waiting list (Figure LU 4). The percentage of white candidates decreased from 81.9% in 2013 to 75.9% in 2018 (Figure LU 5). The composition of the waiting list continued to change, with an increasing proportion of group D candidates and a decreasing proportion of group A candidates (Figure LU 6). Smaller changes occurred for groups B and C, but the waiting list included a larger proportion of group B candidates and a smaller proportion of group C candidates over the past 5 years. Candidates with type O blood comprised 49.2% of the waiting list, followed by types A, 36.1%; B, 11.1%; and AB, 3.7% (Figure LU 10). The percentage of candidates with lower LAS values at listing continued to decrease; 35.1% of candidates had a LAS of less than 35 at the time of listing, and the proportion of sicker candidates with of LAS 50 or higher continued to increase (Figure LU 8). In 2018, proportions of candidates by LAS values were: <30, 0.4%; 30-<35, 34.7%; 35-<40, 28.7%; 40-<50, 19.0%; and 50-100, 17.1% (Figure LU 8).

Outcome of US candidates listed for lung transplant

Overall lung transplant rates increased from 87.1 per 100 waitlist years in 2009 to 172.3 in 2018 (Figure LU 13). Transplant rates decreased for adolescents aged 12-17 years, although rates fluctuated widely in this age group due to the small number of candidates. From 2017 to 2018, transplant rates decreased slightly for candidates aged older than 50 years, remained similar for those aged 18-34 years, and increased for those aged 35-49 years (Figure LU 11). Candidate time on the waiting list remained stable in 2018; 53.4% of candidates had been listed for less than 90 days (Figure LU 7). The overall median time to transplant was 2.5 months, a decrease of 1.5 months compared with 2013 (Figure LU 19). Waiting time differed by diagnosis group, and was shortest for group D, 1.8 months; followed by group C, 2.7 months; group B, 2.8 months; and group A, 4.6 months (Figure LU 19). The greatest change occurred in group B, with a 41.3% improved waiting time over the past year, likely due to the 2015 LAS revision. As expected, time to transplant was related to LAS values, and was shortest for those with the highest LAS (Figure LU 20). However, waiting times have converged with time, with a 4-month difference in median waiting time between candidates with LAS below 35 and 50-100, due to the increasing transplant rates, allowing lower-LAS candidates to access transplant more readily (Figure LU 20).

Transplant rates differed by age, diagnosis, height, and blood type. By age, rates were highest for candidates aged 65 years or older, 220.1 transplants per 100 waitlist-years (Figure LU 11). By diagnosis, rates were highest for group D, 238.4 transplants per 100 waitlist-years, followed by groups C (205.6), A (109.1), and B (103.5) (Figure LU 13). By height, rates were highest for the tallest candidates, 302.4 transplants per 100 waitlist-years, and lowest for the shortest candidates, 102.7 (Figure LU 15). By blood type, rates were highest for candidates with type AB, 259.3 transplants per 100 waitlist-years, and lowest for candidates with type O, 152.1 (Figure LU 14). Generally, transplant rates did not differ based on distance between candidate residence and transplant program (Figure LU 17). Over the past 5 years, transplant rates for residents of metropolitan regions slowly outpaced rates for residents of non-metropolitan regions (Figure LU 16). Percentages of candidates who underwent lung transplant within one year of listing differed widely by state, from 33.3% to 100% (Figure LU 23).

Waitlist mortality rates generally continued to decrease but varied by age, diagnosis group, LAS, blood type, and sex. By age, waitlist mortality was highest for adolescents, 28.4 deaths per 100 waitlist-years, followed by ages 65 years or older (26.0), 35-49 years (18.2) 50-64 years (17.5), and 18-34 years (14.4) (Figure LU 24). By diagnosis, waitlist mortality was highest for group-D candidates, 29.7 deaths per 100 waitlist-years, and lowest for group-A candidates, 9.4 (Figure LU 27). By blood type, waitlist mortality was higher for candidates with type AB (Figure LU 29). By LAS, waitlist mortality was substantially higher for candidates with an LAS of 50 or higher (121.8 deaths per 100 waitlist-years), and ranged from 6.6 for candidates with LAS 30-<35 to 28.7 for candidates with LAS 40-<50 (Figure LU 28). Waitlist mortality was higher for men in this unadjusted analysis (Figure LU 26). Of candidates removed from the waiting list, 22.6% died within 6 months, but this varied by age and LAS (Figure LU 35, Figure LU 36).

Pretransplant use of extra-corporeal membrane oxygenation (ECMO) and mechanical ventilation continued, with 8% of candidates bridged using one or both of these modalities, although this population has decreased from 9.6% in 2013 (Table LU 7). A quarter of candidates were hospitalized prior to transplant, and 13.6% required an intensive care unit stay (Table LU 7).

Donors

Of 2407 deceased lung donors in 2018, 1.3% were aged younger than 12 years, 6.9% 12-17 years, 46.2% 18-34 years, 26.7% 35-49 years, and 18.9% 50 years or older (Figure LU 38); 39.2% of donors were female (Figure LU 39), 18.2% black, and 15.5% Hispanic (Figure LU 40). Discard rates differed by donor age; discard rates were highest for donors aged 35 years or older, but did not meaningfully differ between increased risk and standard infectious risk donors (Figure LU 42, Figure LU 43). The proportion of donors with a smoking history of 20 pack-years or longer decreased slightly over time and was 7.9% in 2018 (Figure LU 44). Use of organs from donation after circulatory death donors increased over the past 5 years, 4.8% in 2018 compared with 1.8% in 2013 (Table LU 8). The percentage of donors with anoxia as a cause of death increased over time from 10.8% in 2007 to 32.8% in 2018 (Figure LU 45). Head trauma and stroke continued to decline as causes of death among deceased lung donors.

Transplant

Characteristics of US lung transplant recipients

In 2018, 2562 lung transplants were performed, 75% bilateral (Figure LU 46); 97.4% were first lung transplants and only 2.6% were re-transplants (Table LU 8). Recipients aged 65 years or older underwent 886 transplants; 18-64 years, 1636 transplants; and younger than 18 years, 40 transplants (Figure LU 47). Men continued to undergo more transplants than women, and most recipients were of white race (Figure LU 48, Figure LU 49). Group D recipients underwent 60.0% of transplants, group A 23.8%, group C 10.3%, and group B 5.9% (Table LU 7). The median LAS at transplant was 42.3, an increase of two points from the previous year (Figure LU 53); LAS distribution was: 21.9%, <35; 21.3%, 35-<40; 23.0%, 40-<50; 10.3%, 50-<60; and 23.4%, 60-100 (Table LU 7). Notably, median LAS at transplant differed by primary diagnosis, and was highest for recipients in group B (49.0) and lowest for those in group A (33.6) (Figure LU 54).

In 2018, 67 programs in the US performed lung transplants in adults; a median of 27 transplants were performed at a program (Figure LU 59). Programs in the 25th percentile performed 2-17 transplants per year, and those in the 75th percentile 28-50 (Figure LU 59). The annual transplant volume for programs in the 95th percentile was 104, a value that ranged from 87 to 104 over the past 5 years (Figure LU 59); three programs accounted for nearly 20% of total volume of lung transplants performed in the US (Figure LU 60). Most lung transplants in the US were performed at programs performing 41-100 transplants per year (49.0%), followed by those performing 11-40 (30.5%), more than 100 (18.9%), and 1-10 (1.6%) (Figure LU 60).

In 2018, most transplant recipients lived in metropolitan regions, and only 15.2% in non-metropolitan regions (Table LU 6). Most recipients lived near their transplant programs, 51.3% within less than 50 miles and 16.7% within 50 to less than 100 miles (Table LU 6). The proportion of recipients with private insurance declined to 41.0%, compared with 50.6% in 2013, with a corresponding increase in the proportion with public insurance, likely due to increasing age of the lung transplant population (Table LU 6).

Outcomes of US lung transplant recipients

In 2018, over 15,000 individuals were living with a lung transplant, 426 who underwent transplant at age 17 or younger, 14,585 who underwent transplant as adults (Figure LU 70). Survival improved slightly at all time-points; 89.4% of recipients survived to 1 year, 73.5% to 3 years, and 59.4% to 5 years (Figure LU 69). Induction agents were used commonly; 68.9% of recipients received an IL-2 receptor antagonist and 9.1% T-cell depleting agents (Figure LU 56). Rates of acute rejection were only slightly lower (15.7%-15.9%) in recipients who received induction than in those who did not (18.0%) (Figure LU 72), and choice of induction did not seem to make a difference in incidence of rejection. Tacrolimus, mycophenolate, and steroids remained the most common immunosuppression regimen, used in 85.5% of transplant recipients (Figure LU 57). Half of recipients received a matched serology donor for cytomegalovirus (CMV) and 82.2% for Epstein Barr virus (EBV) (Table LU 9).

Infection and cardiovascular and cerebrovascular causes remained common causes of death in the first year posttransplant (Figure LU 75), with infection the most prevalent, and graft failure predominating by 3 years posttransplant (Figure LU 76). Programs reported development of bronchiolitis obliterans syndrome in 6.4% of recipients by 1 year and in 41.8% by 5 years (Table LU 10). Malignancy remained a common complication; 23.7% of recipients were diagnosed with malignancy by 5 years posttransplant (Table LU 10). Chronic kidney disease affected 12.9% of recipients by 5 years, with 2.7% requiring dialysis, but only 20 individuals underwent renal transplant within 5 years of lung transplant (Table LU 10). Despite these complications, nearly 81.4% of recipients were at normal functional status and did not require assistance to complete activities of daily living.

Lung transplant in children

Waiting list

In 2018, 24 new child (ages 0-11 years) candidates were added to the lung transplant waiting list; one was inactive at the time of listing (Figure LU 77). 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 107 in 2007 to 22 in 2018 (Figure LU 78). The largest age group of child candidates on the waiting list in 2018 was 6-11 years; these candidates made up 65.0%, followed by candidates aged 1-5 years, 22.5%, and younger than 1 year, 12.5% (Figure LU 79). Most child lung transplant candidates were white (57.5%), followed by Hispanic (20.0%), other or unknown race (12.5%), and black (10.0%) (Figure LU 80).

Of 27 candidates removed from the waiting list in 2018, 16 (59.3%) were removed due to undergoing transplant, six (22.2%) due to death, one (3.7%) due to improved condition, and one (3.7%) due to becoming too sick to undergo transplant (Table LU 14, Table LU 15). Regarding 3-year outcomes for child lung transplant candidates listed in 2015, 73.9% underwent deceased donor transplant, 8.7% died waiting, 13.0% were removed from the list for reasons other than transplant or death, and 4.4% were still waiting (Figure LU 83). The overall child lung transplant rate rose dramatically in 2013 and has remained steady since, with a rate of 68.3 per 100 waitlist-years in 2018 (Figure LU 84). In general, pretransplant mortality has increased over the decade; the rate was 31.1 deaths per 100 waitlist-years among candidates aged 0-11 years in 2017-2018, compared with 11.7 in 2007-2008 (Figure LU 86).

Transplant

In 2018, a total of 15 lung transplants were performed in recipients aged 0-11 years, three in recipients aged younger than 1 year, two in recipients aged 1-5 years, and ten in recipients aged 6-11 years (Figure LU 88). In 2018, seven programs were characterized as pediatric, compared with 55 adult-only programs (Figure LU 89). Cystic fibrosis and pulmonary hypertension were the leading known causes of disease, but almost 50% of causes were identified as other or unknown (Table LU 17). Half of child lung transplant recipients in 2016-2018 were not hospitalized at the time of transplant, with 77.3% as priority 1. Ventilator support and ECMO use remained stable over the past decade. In 2016-2018, lung-only transplants increased to 93.2% from 82.3% in 2006-2008 (Table LU 18).

Pediatric Immunosuppression and Outcomes

Induction therapy has changed over time, with increased use of T-cell-depleting agents to 60.0% of patients in 2017-2018 and continued decreased use of interleukin-2 receptor antagonists to 30.0% (Figure LU 90). The most common initial immunosuppression agent regimen was tacrolimus, mycophenolate, and steroids, used in 92.9% of child recipients (Figure LU 91). The incidence of posttransplant lymphoproliferative disorder among EBV-negative recipients who underwent transplant in 2006-2016 was 5.7% at 5 years posttransplant, compared with 1.1% among EBV-positive recipients (Figure LU 93). Incidence of death was 17.2% at 6 months and 24.1% at 1 year for transplants in 2016-2017, 41.7% at 3 years for transplants in 2014-2015, 33.3% at 5 years for transplants in 2012-2013, and 45.7% at 10 years for transplants in 2008-2009 (Figure LU 94). For children who underwent transplant in 2006-2013, overall 1-, 3-, and 5-year patient survival was 85.0%, 68.8%, and 60.6%, respectively (Figure LU 95). By age, patient survival rates were highest for recipients aged 6-11 years at all time-points. Among children, cystic fibrosis was associated with higher survival rates than pulmonary hypertension or other diagnoses (Figure LU 96). Leading causes of death at 1 year posttransplant were respiratory- and infection-related, and at 5 years graft failure and respiratory-related (Figure LU 97, Figure LU 98). The incidence of acute rejection among child lung transplant recipients in 2012-2017 was 7.1%.

Among child lung transplant recipients in 2016-2018, the combination of a CMV-positive donor and CMV-negative recipient occurred in 27.3% of transplants; this combination for EBV occurred in 43.2% of transplants (Table LU 19).

Complication rates in child lung transplant recipients increased with time posttransplant, including bronchiolitis obliterans syndrome (4.1% at 1 year and 26.0% at 5 years) (Table LU 20). For most surviving child lung transplant recipients (94.0%), functional status was reported as fully active at 5 years posttransplant.

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 listed for lung transplant on December 31 of each year
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 sex
Figure LU 5. Distribution of candidates aged 12 years or older actively waiting for lung transplant by race
Figure LU 6. Distribution of candidates aged 12 years or older actively waiting for lung transplant by diagnosis group
Figure LU 7. Distribution of candidates aged 12 years or older actively waiting for lung transplant by waiting time
Figure LU 8. Distribution of candidates aged 12 years or older actively waiting for lung transplant by LAS at listing
Figure LU 9. Distribution of candidates aged 12 years or older actively waiting for lung transplant by height
Figure LU 10. Distribution of candidates aged 12 years or older actively waiting for lung transplant by blood type
Figure LU 11. Deceased donor lung transplant rates among waitlist candidates aged 12 years or older by age
Figure LU 12. Deceased donor lung transplant rates among waitlist candidates aged 12 years or older by race
Figure LU 13. Deceased donor lung transplant rates among waitlist candidates aged 12 years or older by diagnosis group
Figure LU 14. Deceased donor lung transplant rates among waitlist candidates aged 12 years or older by blood type
Figure LU 15. Deceased donor lung transplant rates among waitlist candidates aged 12 years or older by height
Figure LU 16. Deceased donor lung transplant rates among waitlist candidates aged 12 years or older by metropolitan vs. non-metropolitan residence
Figure LU 17. Deceased donor lung transplant rates among waitlist candidates aged 12 years or older by distance from listing center
Figure LU 18. Three-year outcomes for candidates aged 12 years or older waiting for lung transplant, new listings in 2015
Figure LU 19. Median months to lung transplant for waitlisted candidates aged 12 years or older, by diagnosis group
Figure LU 20. Median months to lung transplant for waitlisted candidates aged 12 years or older, by LAS at listing
Figure LU 21. Percentage of candidates aged 12 years or older who underwent deceased donor lung transplant within a given time period of listing
Figure LU 22. Percentage of candidates aged 12 years or older who underwent deceased donor lung transplant within 1 year of listing in 2017 by DSA
Figure LU 23. Percentage of candidates aged 12 years or older who underwent deceased donor lung transplant within 1 year of listing in 2017 by state
Figure LU 24. Pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant by age
Figure LU 25. Pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant by race
Figure LU 26. Pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant by sex
Figure LU 27. Pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant by diagnosis group
Figure LU 28. Pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant by LAS
Figure LU 29. Pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant by blood type
Figure LU 30. Pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant by height
Figure LU 31. Pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant by metropolitan vs. non-metropolitan residence
Figure LU 32. Pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant by distance from listing center
Figure LU 33. Pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung, by active/inactive status
Figure LU 34. Pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant in 2016-2018, by DSA
Figure LU 35. Deaths within six months after removal among lung waitlist candidates aged 12 years or older, by diagnosis
Figure LU 36. Deaths within six months after removal among lung waitlist candidates aged 12 years or older, by age at removal

Deceased donation

Figure LU 37. Deceased lung donor count by age
Figure LU 38. Distribution of deceased lung donors by age
Figure LU 39. Distribution of deceased lung donors by sex
Figure LU 40. Distribution of deceased lung donors by race
Figure LU 41. Percent of pediatric donor lungs allocated to adult recipients, by DSA of donor hospital, 2014-2018
Figure LU 42. Rates of lungs recovered for transplant and not transplanted by donor age
Figure LU 43. Rates of lungs recovered for transplant and not transplanted, by donor risk of disease transmission
Figure LU 44. Lung donors with a smoking history of 20 pack-years or more
Figure LU 45. Cause of death among deceased lung donors

Transplant

Figure LU 46. Total lung transplants
Figure LU 47. Total lung transplants by age
Figure LU 48. Total lung transplants by sex
Figure LU 49. Total lung transplants by race
Figure LU 50. Total lung transplants by diagnosis group
Figure LU 51. Total lung transplants by LAS
Figure LU 52. Total lung transplants by CPRA
Figure LU 53. Median LAS at transplant
Figure LU 54. Median LAS at transplant by diagnosis group
Figure LU 55. Percentage of transplants that were bilateral among lung recipients aged 12 years or older by diagnosis
Figure LU 56. Induction agent use in lung transplant recipients aged 12 years or older
Figure LU 57. Immunosuppression regimen use in transplant recipients aged 12 years or older
Figure LU 58. Total HLA A, B, and DR mismatches among deceased donor lung transplant recipients aged 12 years or older, 2014-2018
Figure LU 59. Annual adult lung transplant center volumes, by percentile
Figure LU 60. Distribution of adult lung transplants by annual center volume

Outcomes

Figure LU 61. Patient survival among lung transplant recipients aged 12 years or older, 2011-2013, by age
Figure LU 62. Patient survival among lung transplant recipients aged 12 years or older, 2011-2013, by race
Figure LU 63. Patient survival among lung transplant recipients aged 12 years or older, 2011-2013, by LAS
Figure LU 64. Patient survival among lung transplant recipients aged 12 years or older, 2011-2013, by transplant type
Figure LU 65. Patient survival among lung transplant recipients aged 12 years or older, 2011-2013, by diagnosis group
Figure LU 66. Patient survival among lung transplant recipients aged 12 years or older, 2011-2013, by diagnosis and transplant type
Figure LU 67. Patient survival among lung transplant recipients aged 12 years or older, 2011-2013, by metropolitan vs. non-metropolitan recipient residence
Figure LU 68. Patient survival among lung transplant recipients aged 12 years or older, 2011-2013, by recipients' distance from transplant center
Figure LU 69. Patient death among lung transplant recipients aged 12 years or older
Figure LU 70. Recipients alive with a functioning lung graft on June 30 of the year, by age at transplant
Figure LU 71. Incidence of acute rejection by 1 year posttransplant among lung transplant recipients aged 12 years or older by age, 2016-2017
Figure LU 72. Incidence of acute rejection by 1 year posttransplant among lung transplant recipients aged 12 years or older by induction agent 2016-2017
Figure LU 73. Incidence of acute rejection by 1 year posttransplant among lung transplant recipients aged 12 years or older by diagnosis group, 2016-2017
Figure LU 74. Incidence of PTLD among lung transplant recipients aged 12 years or older by recipient EBV status at transplant, 2012-2016
Figure LU 75. One-year cumulative incidence of death by cause among lung recipients aged 12 years or older, 2016-2017
Figure LU 76. Five-year cumulative incidence of death by cause among lung recipients aged 12 years or older, 2012-2013

Pediatric transplant

Figure LU 77. New candidates aged 0-11 years added to the lung transplant waiting list
Figure LU 78. Candidates aged 0-11 years waiting for lung transplant
Figure LU 79. Distribution of candidates aged 0-11 years actively waiting for lung transplant, by age
Figure LU 80. Distribution of candidates aged 0-11 years actively waiting for lung transplant by race
Figure LU 81. Distribution of candidates aged 0-11 years actively waiting for lung transplant by sex
Figure LU 82. Distribution of candidates aged 0-11 years actively waiting for lung transplant by waiting time
Figure LU 83. Three-year outcomes for newly listed candidates aged 0-11 years waiting for lung transplant, 2015
Figure LU 84. Deceased donor lung transplant rates among waitlist candidates aged 0-11 years, by age
Figure LU 85. Deceased donor lung transplant rates among waitlist candidates aged 0-11 years, by race
Figure LU 86. Pretransplant mortality rates among candidates aged 0-11 years waitlisted for lung transplant by age
Figure LU 87. Pretransplant mortality rates among candidates aged 0-11 years waitlisted for lung transplant by distance from listing center
Figure LU 88. Lung transplants, recipients aged 0-11 years by age
Figure LU 89. Number of centers performing pediatric and adult lung transplants by center's age mix
Figure LU 90. Induction agent use in lung transplant recipients aged 0-11 years
Figure LU 91. Immunosuppression regimen use in transplant recipients aged 0-11 years
Figure LU 92. Total HLA A, B, and DR mismatches among deceased donor lung transplant recipients aged 0-11 years, 2014-2018
Figure LU 93. Incidence of PTLD among lung transplant recipients aged 0-11 years by recipient EBV status at transplant, 2006-2016
Figure LU 94. Patient death among lung transplant recipients aged 0-11 years
Figure LU 95. Patient survival among lung transplant recipients aged 0-11 years, 2006-2013, by age
Figure LU 96. Patient survival among lung transplant recipients aged 0-11 years, 2006-2013, by diagnosis
Figure LU 97. One-year cumulative incidence of death by cause among lung transplant recipients aged 0-11 years, 2008-2017
Figure LU 98. Five-year cumulative incidence of death by cause among lung transplant recipients aged 0-11 years, 2008-2013

Table List

Waiting list

Table LU 1. Demographic characteristics of candidates aged 12 years or older on the lung transplant waiting list on December 31, 2013, and December 31, 2018
Table LU 2. Clinical characteristics of candidates aged 12 years or older on the lung transplant waiting list on December 31, 2013, and December 31, 2018
Table LU 3. Listing characteristics of candidates aged 12 years or older on the lung transplant waiting list on December 31, 2013, and December 31, 2018
Table LU 4. Lung transplant waitlist activity among candidates aged 12 years or older
Table LU 5. Removal reason among lung transplant candidats aged 12 years or older

Transplant

Table LU 6. Demographic characteristics of lung transplant recipients aged 12 years or older, 2013 and 2018
Table LU 7. Clinical characteristics of lung transplant recipients aged 12 years or older, 2013 and 2018
Table LU 8. Transplant characteristics of lung transplant recipients aged 12 years or older, 2013 and 2018
Table LU 9. Donor-recipient serology matching among lung transplant recipients aged 12 years or older, 2016-2018

Outcomes

Table LU 10. Posttransplant events among lung transplant recipients aged 12 years or older

Pediatric transplant

Table LU 11. Demographic characteristics of candidates aged 0-11 years on the lung transplant waiting list on December 31, 2008 and December 31, 2018
Table LU 12. Clinical characteristics of candidates aged 0-11 years on the lung transplant waiting list on December 31, 2008 and December 31, 2018
Table LU 13. Listing characteristics of candidates aged 0-11 years on the lung transplant waiting list on December 31, 2008 and December 31, 2018
Table LU 14. Lung transplant waitlist activity among candidates aged 0-11 years
Table LU 15. Removal reason among lung transplant candidates aged 0-11 years
Table LU 16. Demographic characteristics of lung transplant recipients aged 0-11 years, 2006-2008 and 2016-2018
Table LU 17. Clinical characteristics of lung transplant recipients aged 0-11 years, 2006-2008 and 2016-2018
Table LU 18. Transplant characteristics of lung transplant recipients aged 0-11 years, 2006-2008 and 2016-2018
Table LU 19. Donor-recipient serology matching among lung transplant recipients aged 0-11 years, 2016-2018
Table LU 20. 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 90.0% from 1611 candidates at 2007 to 3061 candidates at 2018; the inactive category decreases by 72.9% from 269 candidates at 2007 to 73 candidates at 2018; and the all category increases by 66.7% from 1880 candidates at 2007 to 3134 candidates at 2018.

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 listed for lung transplant on december 31 of each year; the active category increases by 21.3% from 994 candidates at 2007 to 1206 candidates at 2018; the inactive category decreases by 81.8% from 1173 candidates at 2007 to 213 candidates at 2018; and the all category decreases by 34.5% from 2167 candidates at 2007 to 1419 candidates at 2018.

Figure LU 2. Candidates aged 12 years or older listed for lung transplant on December 31 of each year
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 51.8% from 2.1 percent at 2007 to 1 percent at 2018; the 18 to 34 category decreases by 37.8% from 13.9 percent at 2007 to 8.7 percent at 2018; the 35 to 49 category decreases by 30.1% from 18.6 percent at 2007 to 13 percent at 2018; the 50 to 64 category decreases by 16.4% from 54.1 percent at 2007 to 45.2 percent at 2018; and the greater than or equal to 65 category increases by 186.9% from 11.2 percent at 2007 to 32 percent at 2018.

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 sex; the male category is 48.4 percent at 2007 and remains relatively constant with a value of 52.7 percent at 2018; and the female category is 51.6 percent at 2007 and remains relatively constant with a value of 47.3 percent at 2018.

Figure LU 4. Distribution of candidates aged 12 years or older actively waiting for lung transplant by sex
Candidates waiting for transplant at any time in the given year. Candidates listed concurrently at multiple centers are counted once. Active and inactive patients 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 83.3 percent at 2007 and remains relatively constant with a value of 75.9 percent at 2018; the black category increases by 21.9% from 8.7 percent at 2007 to 10.6 percent at 2018; the hispanic category increases by 58.5% from 6.3 percent at 2007 to 9.9 percent at 2018; the asian category increases by 159.3% from 1.1 percent at 2007 to 2.8 percent at 2018; and the other/unknown category is 0.7 percent at 2007 and remains relatively constant with a value of 0.8 percent at 2018.

Figure LU 5. 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 28.9% from 41.4 percent at 2007 to 29.4 percent at 2018; the b category is 6.8 percent at 2007 and remains relatively constant with a value of 7.1 percent at 2018; the c category decreases by 32.4% from 14.8 percent at 2007 to 10 percent at 2018; and the d category increases by 44.3% from 37.1 percent at 2007 to 53.5 percent at 2018.

Figure LU 6. 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 47.4% from 20.9 percent at 2007 to 30.8 percent at 2018; the 31 to less than 90 days category increases by 15.6% from 19.5 percent at 2007 to 22.6 percent at 2018; the 3 to less than 6 months category is 16 percent at 2007 and remains relatively constant with a value of 16.2 percent at 2018; the 6 to less than 12 months category is 13.8 percent at 2007 and remains relatively constant with a value of 14.1 percent at 2018; the 1 to less than 2 years category decreases by 14.9% from 11.7 percent at 2007 to 9.9 percent at 2018; and the greater than or equal to 2 years category decreases by 64.5% from 18.1 percent at 2007 to 6.4 percent at 2018.

Figure LU 7. 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 at listing; the less than 30 category decreases by 90.0% from 4.1 percent at 2007 to 0.4 percent at 2018; the 30 to less than 35 category decreases by 26.6% from 47.3 percent at 2007 to 34.7 percent at 2018; the 35 to less than 40 category increases by 36.0% from 21.1 percent at 2007 to 28.7 percent at 2018; the 40 to less than 50 category increases by 27.7% from 14.9 percent at 2007 to 19 percent at 2018; the greater than or equal to 50 category increases by 93.0% from 8.9 percent at 2007 to 17.1 percent at 2018; and the no las category decreases by 100.0% from 3.7 percent at 2007 to 0 percent at 2018.

Figure LU 8. Distribution of candidates aged 12 years or older actively waiting for lung transplant by LAS at listing
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. LAS, lung allocation score.


A line plot for distribution of candidates aged 12 years or older actively waiting for lung transplant by height; the less than 160 cm category is 22.2 percent at 2007 and remains relatively constant with a value of 21.3 percent at 2018; the 160 to less than 168 category is 32 percent at 2007 and remains relatively constant with a value of 29.8 percent at 2018; the 168 to less than 175 category is 17.7 percent at 2007 and remains relatively constant with a value of 18.6 percent at 2018; the 175 to less than 183 category is 21.9 percent at 2007 and remains relatively constant with a value of 23.9 percent at 2018; and the greater than or equal to 183 category is 6.2 percent at 2007 and remains relatively constant with a value of 6.4 percent at 2018.

Figure LU 9. Distribution of candidates aged 12 years or older actively waiting for lung transplant by height
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 blood type; the a category is 39.1 percent at 2007 and remains relatively constant with a value of 36.1 percent at 2018; the b category increases by 10.8% from 10 percent at 2007 to 11.1 percent at 2018; the ab category is 3.8 percent at 2007 and remains relatively constant with a value of 3.7 percent at 2018; and the o category is 47.1 percent at 2007 and remains relatively constant with a value of 49.2 percent at 2018.

Figure LU 10. 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 waitlist candidates aged 12 years or older by age; the 12 to 17 category increases by 197.9% from 54.5 transplants per 100 waitlist years at 2007 to 162.2 transplants per 100 waitlist years at 2018; the 18 to 34 category increases by 271.4% from 48.3 transplants per 100 waitlist years at 2007 to 179.5 transplants per 100 waitlist years at 2018; the 35 to 49 category increases by 299.8% from 35.6 transplants per 100 waitlist years at 2007 to 142.4 transplants per 100 waitlist years at 2018; the 50 to 64 category increases by 140.9% from 64 transplants per 100 waitlist years at 2007 to 154.3 transplants per 100 waitlist years at 2018; and the greater than or equal to 65 category increases by 68.1% from 130.9 transplants per 100 waitlist years at 2007 to 220.1 transplants per 100 waitlist years at 2018.

Figure LU 11. Deceased donor lung transplant rates among 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 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 or fewer than 20 candidates at risk are not shown.


A line plot for deceased donor lung transplant rates among waitlist candidates aged 12 years or older by race; the white category increases by 218.7% from 59 transplants per 100 waitlist years at 2007 to 188 transplants per 100 waitlist years at 2018; the black category increases by 154.8% from 51.8 transplants per 100 waitlist years at 2007 to 131.9 transplants per 100 waitlist years at 2018; the hispanic category increases by 134.4% from 59.5 transplants per 100 waitlist years at 2007 to 139.4 transplants per 100 waitlist years at 2018; and the other category increases by 161.2% from 42.7 transplants per 100 waitlist years at 2007 to 111.6 transplants per 100 waitlist years at 2018.

Figure LU 12. Deceased donor lung transplant rates among waitlist candidates aged 12 years or older by race
Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of wait time in a given year. Individual listings are counted separately. Rates with less than 10 patient-years of exposure or fewer than 20 candidates at risk are not shown.


A line plot for deceased donor lung transplant rates among waitlist candidates aged 12 years or older by diagnosis group; the a category increases by 129.4% from 47.5 transplants per 100 waitlist years at 2007 to 109.1 transplants per 100 waitlist years at 2018; the b category increases by 567.1% from 15.5 transplants per 100 waitlist years at 2007 to 103.5 transplants per 100 waitlist years at 2018; the c category increases by 291.4% from 52.5 transplants per 100 waitlist years at 2007 to 205.6 transplants per 100 waitlist years at 2018; the d category increases by 133.0% from 102.3 transplants per 100 waitlist years at 2007 to 238.4 transplants per 100 waitlist years at 2018; and the all category increases by 197.3% from 58 transplants per 100 waitlist years at 2007 to 172.3 transplants per 100 waitlist years at 2018.

Figure LU 13. Deceased donor lung transplant rates among 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 wait time in a given year. Individual listings are counted separately. Rates with less than 10 patient-years of exposure or fewer than 20 candidates at risk are not shown.


A line plot for deceased donor lung transplant rates among waitlist candidates aged 12 years or older by blood type; the a category increases by 243.5% from 58.2 transplants per 100 waitlist years at 2007 to 200 transplants per 100 waitlist years at 2018; the b category increases by 164.3% from 62.7 transplants per 100 waitlist years at 2007 to 165.6 transplants per 100 waitlist years at 2018; the ab category increases by 240.9% from 76.1 transplants per 100 waitlist years at 2007 to 259.3 transplants per 100 waitlist years at 2018; and the o category increases by 175.0% from 55.3 transplants per 100 waitlist years at 2007 to 152.1 transplants per 100 waitlist years at 2018.

Figure LU 14. Deceased donor lung transplant rates among 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 wait time in a given year. Individual listings are counted separately. Rates with less than 10 patient-years of exposure or fewer than 20 candidates at risk are not shown.


A line plot for deceased donor lung transplant rates among waitlist candidates aged 12 years or older by height; the less than 160 cm category increases by 183.7% from 36.2 transplants per 100 waitlist years at 2007 to 102.7 transplants per 100 waitlist years at 2018; the 160 to less than 168 category increases by 193.8% from 49.8 transplants per 100 waitlist years at 2007 to 146.2 transplants per 100 waitlist years at 2018; the 168 to less than 175 category increases by 185.1% from 70.2 transplants per 100 waitlist years at 2007 to 200.2 transplants per 100 waitlist years at 2018; the 175 to less than 183 category increases by 204.5% from 88.8 transplants per 100 waitlist years at 2007 to 270.4 transplants per 100 waitlist years at 2018; and the greater than or equal to 183 category increases by 281.6% from 79.2 transplants per 100 waitlist years at 2007 to 302.4 transplants per 100 waitlist years at 2018.

Figure LU 15. Deceased donor lung transplant rates among 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 wait time in a given year. Individual listings are counted separately. Rates with less than 10 patient-years of exposure or fewer than 20 candidates at risk are not shown.


A line plot for deceased donor lung transplant rates among waitlist candidates aged 12 years or older by metropolitan vs. non-metropolitan residence; the metropolitan category increases by 199.0% from 58.7 transplants per 100 waitlist years at 2007 to 175.4 transplants per 100 waitlist years at 2018; and the non to metropolitan category increases by 177.2% from 54.9 transplants per 100 waitlist years at 2007 to 152.3 transplants per 100 waitlist years at 2018.

Figure LU 16. Deceased donor lung transplant rates among waitlist candidates aged 12 years or older by metropolitan vs. non-metropolitan residence
Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of wait time in a given year. Individual listings are counted separately. Urban/rural determination is made using the RUCA (Rural-Urban Commuting Area) designation of the candidate's permanent zip code. Rates with less than 10 patient-years of exposure or fewer than 20 candidates at risk are not shown.


A line plot for deceased donor lung transplant rates among waitlist candidates aged 12 years or older by distance from listing center; the 0 to less than 50 nm category increases by 179.9% from 59.1 transplants per 100 waitlist years at 2007 to 165.6 transplants per 100 waitlist years at 2018; the 50 to less than 100 category increases by 220.5% from 53.3 transplants per 100 waitlist years at 2007 to 170.7 transplants per 100 waitlist years at 2018; the 100 to less than 250 category increases by 195.9% from 62.7 transplants per 100 waitlist years at 2007 to 185.4 transplants per 100 waitlist years at 2018; and the greater than or equal to 250 category increases by 233.0% from 54.5 transplants per 100 waitlist years at 2007 to 181.6 transplants per 100 waitlist years at 2018.

Figure LU 17. Deceased donor lung transplant rates among waitlist candidates aged 12 years or older by distance from listing center
Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of wait time in a given year. Individual listings are counted separately. Distance is nautical miles (NM) between the zip code centroids of the candidate's listing center and candidate's permanent zip code. Rates with less than 10 patient-years of exposure or fewer than 20 candidates at risk are not shown.


A line plot for three-year outcomes for candidates aged 12 years or older waiting for lung transplant, new listings in 2015; the still waiting category decreases by 97.2% from 100 percent at 0 Months postlisting to 2.8 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 18. Three-year outcomes for candidates aged 12 years or older waiting for lung transplant, new listings in 2015
Candidates aged 12 years or older waiting for lung transplant and first listed in 2015. 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, by diagnosis group; the a category decreases by 22.1% from 5.9 months at 2007 to 4.6 months at 2018; the b category decreases by 76.4% from 11.7 months at 2007 to 2.8 months at 2018; the c category decreases by 52.9% from 5.7 months at 2007 to 2.7 months at 2018; the d category decreases by 39.1% from 3 months at 2007 to 1.8 months at 2018; and the all category decreases by 46.4% from 4.6 months at 2007 to 2.5 months at 2018.

Figure LU 19. Median months to lung transplant for waitlisted candidates aged 12 years or older, by diagnosis group
Observations censored on December 31, 2018; 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 median months to lung transplant for waitlisted candidates aged 12 years or older, by las at listing; the less than 35 category decreases by 47.5% from 9.2 months at 2007 to 4.8 months at 2018; the 35 to less than 40 category decreases by 29.0% from 4.1 months at 2007 to 2.9 months at 2018; the 40 to less than 50 category is 1.9 months at 2007 and remains relatively constant with a value of 1.8 months at 2018; and the 50 to 100 category decreases by 48.9% from 1.5 months at 2007 to 0.8 months at 2018.

Figure LU 20. Median months to lung transplant for waitlisted candidates aged 12 years or older, by LAS at listing
Observations censored on December 31, 2018; 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 candidates aged 12 years or older who underwent deceased donor lung transplant within a given time period of listing; the 3 to month category increases by 27.1% from 42.2 percent at 2007 to 53.6 percent at 2017; the 6 to month category increases by 21.1% from 54.6 percent at 2007 to 66.1 percent at 2017; the 1 to year category increases by 14.9% from 65.1 percent at 2007 to 74.8 percent at 2017; the 3 to year category is 73.9 percent at 2007 and remains relatively constant with a value of 80.3 percent at 2015; the 5 to year category is 75.3 percent at 2007 and remains relatively constant with a value of 78.8 percent at 2013; and the 10 to year category is 76 percent at 2007 and remains relatively constant with a value of 77 percent at 2008.

Figure LU 21. Percentage of candidates aged 12 years or older 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 2017 by dsa, the values range from 18.75 to 96.49.

Figure LU 22. Percentage of candidates aged 12 years or older who underwent deceased donor lung transplant within 1 year of listing in 2017 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 map of percentage of candidates aged 12 years or older who underwent deceased donor lung transplant within 1 year of listing in 2017 by state, the values range from 33.33 to 100.00.

Figure LU 23. Percentage of candidates aged 12 years or older who underwent deceased donor lung transplant within 1 year of listing in 2017 by state
Candidates concurrently listed at more than one center are counted once, from the time of earliest listing to the time of latest removal.


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 66.2% from 17.1 deaths per 100 waitlist years at 2007-2008 to 28.4 deaths per 100 waitlist years at 2017-2018; the 18 to 34 category decreases by 13.9% from 16.7 deaths per 100 waitlist years at 2007-2008 to 14.4 deaths per 100 waitlist years at 2017-2018; the 35 to 49 category increases by 70.0% from 10.7 deaths per 100 waitlist years at 2007-2008 to 18.2 deaths per 100 waitlist years at 2017-2018; the 50 to 64 category increases by 19.3% from 14.7 deaths per 100 waitlist years at 2007-2008 to 17.5 deaths per 100 waitlist years at 2017-2018; and the greater than or equal to 65 category increases by 13.7% from 22.8 deaths per 100 waitlist years at 2007-2008 to 26 deaths per 100 waitlist years at 2017-2018.

Figure LU 24. 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. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Rates with less than 10 patient-years of exposure or fewer than 20 candidates at risk 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 27.6% from 14.2 deaths per 100 waitlist years at 2007-2008 to 18.2 deaths per 100 waitlist years at 2017-2018; the black category increases by 51.0% from 14.5 deaths per 100 waitlist years at 2007-2008 to 21.8 deaths per 100 waitlist years at 2017-2018; the hispanic category increases by 20.6% from 19.6 deaths per 100 waitlist years at 2007-2008 to 23.7 deaths per 100 waitlist years at 2017-2018; the other category increases by 95.3% from 11.5 deaths per 100 waitlist years at 2007-2008 to 22.5 deaths per 100 waitlist years at 2017-2018; and the all category increases by 33.3% from 14.5 deaths per 100 waitlist years at 2007-2008 to 19.3 deaths per 100 waitlist years at 2017-2018.

Figure LU 25. 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. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Rates with less than 10 patient-years of exposure or fewer than 20 candidates at risk 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 43.0% from 16.1 deaths per 100 waitlist years at 2007-2008 to 23 deaths per 100 waitlist years at 2017-2018; and the female category increases by 25.2% from 13.5 deaths per 100 waitlist years at 2007-2008 to 16.9 deaths per 100 waitlist years at 2017-2018.

Figure LU 26. 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. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Rates with less than 10 patient-years of exposure or fewer than 20 candidates at risk 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 increases by 15.2% from 8.1 deaths per 100 waitlist years at 2007-2008 to 9.4 deaths per 100 waitlist years at 2017-2018; the b category increases by 54.9% from 12.4 deaths per 100 waitlist years at 2007-2008 to 19.2 deaths per 100 waitlist years at 2017-2018; the c category decreases by 16.4% from 16.1 deaths per 100 waitlist years at 2007-2008 to 13.5 deaths per 100 waitlist years at 2017-2018; and the d category increases by 19.8% from 24.8 deaths per 100 waitlist years at 2007-2008 to 29.7 deaths per 100 waitlist years at 2017-2018.

Figure LU 27. 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. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Rates with less than 10 patient-years of exposure or fewer than 20 candidates at risk 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 9.5 deaths per 100 waitlist years at 2007-2008 and remains relatively constant with a value of 10.1 deaths per 100 waitlist years at 2017-2018; the 30 to less than 35 category decreases by 20.8% from 8.4 deaths per 100 waitlist years at 2007-2008 to 6.6 deaths per 100 waitlist years at 2017-2018; the 35 to less than 40 category decreases by 52.9% from 23.9 deaths per 100 waitlist years at 2007-2008 to 11.3 deaths per 100 waitlist years at 2017-2018; the 40 to less than 50 category decreases by 35.0% from 44.1 deaths per 100 waitlist years at 2007-2008 to 28.7 deaths per 100 waitlist years at 2017-2018; and the greater than or equal to 50 category decreases by 43.3% from 214.9 deaths per 100 waitlist years at 2007-2008 to 121.8 deaths per 100 waitlist years at 2017-2018.

Figure LU 28. 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. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Rates with less than 10 patient-years of exposure or fewer than 20 candidates at risk 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 26.9% from 14.4 deaths per 100 waitlist years at 2007-2008 to 18.3 deaths per 100 waitlist years at 2017-2018; the b category increases by 15.7% from 16.1 deaths per 100 waitlist years at 2007-2008 to 18.7 deaths per 100 waitlist years at 2017-2018; the ab category increases by 67.2% from 15.1 deaths per 100 waitlist years at 2007-2008 to 25.2 deaths per 100 waitlist years at 2017-2018; and the o category increases by 39.8% from 14.2 deaths per 100 waitlist years at 2007-2008 to 19.9 deaths per 100 waitlist years at 2017-2018.

Figure LU 29. 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. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Rates with less than 10 patient-years of exposure or fewer than 20 candidates at risk are not shown.


A line plot for pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant by height; the less than 160 cm category increases by 14.7% from 16.8 deaths per 100 waitlist years at 2007-2008 to 19.2 deaths per 100 waitlist years at 2017-2018; the 160 to less than 168 category increases by 35.4% from 12.6 deaths per 100 waitlist years at 2007-2008 to 17 deaths per 100 waitlist years at 2017-2018; the 168 to less than 175 category increases by 29.7% from 15.2 deaths per 100 waitlist years at 2007-2008 to 19.7 deaths per 100 waitlist years at 2017-2018; the 175 to less than 183 category increases by 70.9% from 14.1 deaths per 100 waitlist years at 2007-2008 to 24 deaths per 100 waitlist years at 2017-2018; and the greater than or equal to 183 category is 16.5 deaths per 100 waitlist years at 2007-2008 and remains relatively constant with a value of 17.4 deaths per 100 waitlist years at 2017-2018.

Figure LU 30. Pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant by height
Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Rates with less than 10 patient-years of exposure or fewer than 20 candidates at risk are not shown.


A line plot for pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant by metropolitan vs. non-metropolitan residence; the metropolitan category increases by 33.4% from 14.4 deaths per 100 waitlist years at 2007-2008 to 19.2 deaths per 100 waitlist years at 2017-2018; and the non to metropolitan category increases by 29.2% from 15.2 deaths per 100 waitlist years at 2007-2008 to 19.7 deaths per 100 waitlist years at 2017-2018.

Figure LU 31. Pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant by metropolitan vs. non-metropolitan residence
Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Rates with less than 10 patient-years of exposure or fewer than 20 candidates at risk are not shown. Urban/rural determination is made using the RUCA (Rural-Urban Commuting Area) designation of the candidate's permanent zip code.


A line plot for pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant by distance from listing center; the 0 to less than 50 nm category increases by 28.7% from 14.8 deaths per 100 waitlist years at 2007-2008 to 19.1 deaths per 100 waitlist years at 2017-2018; the 50 to less than 100 category increases by 54.9% from 13.7 deaths per 100 waitlist years at 2007-2008 to 21.3 deaths per 100 waitlist years at 2017-2018; the 100 to less than 250 category is 16.6 deaths per 100 waitlist years at 2007-2008 and remains relatively constant with a value of 17.6 deaths per 100 waitlist years at 2017-2018; and the greater than or equal to 250 category increases by 75.7% from 11.6 deaths per 100 waitlist years at 2007-2008 to 20.4 deaths per 100 waitlist years at 2017-2018.

Figure LU 32. Pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant by distance from listing center
Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Rates with less than 10 patient-years of exposure or fewer than 20 candidates at risk are not shown. Distance is nautical miles (NM) between the zip code centroids of the candidate's listing center and candidate's permanent zip code.


A line plot for pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung, by active/inactive status; the active category decreases by 10.9% from 22.5 deaths per 100 waitlist years at 2007-2008 to 20 deaths per 100 waitlist years at 2017-2018; and the inactive category increases by 70.8% from 8.2 deaths per 100 waitlist years at 2007-2008 to 14 deaths per 100 waitlist years at 2017-2018.

Figure LU 33. Pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung, by active/inactive status
Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Rates with less than 10 patient-years of exposure or fewer than 20 candidates at risk are not shown. Status (active/inactive) is assessed on the later of January 1 of the given year and listing date.


A map of pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant in 2016-2018, by dsa, the values range from 2.32 to 58.07.

Figure LU 34. Pretransplant mortality rates among candidates aged 12 years or older waitlisted for lung transplant in 2016-2018, by DSA
Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the DSA. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. 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 lung waitlist candidates aged 12 years or older, by diagnosis; the a category increases by 265.6% from 7.2 percent at 2007 to 26.2 percent at 2018; the b category is 8.2 percent at 2007 and remains relatively constant with a value of 7.4 percent at 2018; the c category decreases by 25.7% from 19.2 percent at 2007 to 14.3 percent at 2018; the d category increases by 17.2% from 22.4 percent at 2007 to 26.2 percent at 2018; and the all category increases by 79.1% from 12.6 percent at 2007 to 22.6 percent at 2018.

Figure LU 35. Deaths within six months after removal among lung waitlist candidates aged 12 years or older, by diagnosis
Denominator includes only candidates removed from the waiting list for reasons other than transplant or death while on the list.


A line plot for deaths within six months after removal among lung waitlist candidates aged 12 years or older, by age at removal; the 18 to 34 category decreases by 45.5% from 10.2 percent at 2007 to 5.6 percent at 2018; the 35 to 49 category increases by 121.7% from 6.2 percent at 2007 to 13.8 percent at 2018; the 50 to 64 category increases by 34.0% from 16 percent at 2007 to 21.4 percent at 2018; and the greater than or equal to 65 category increases by 131.8% from 15.5 percent at 2007 to 35.8 percent at 2018.

Figure LU 36. Deaths within six months after removal among lung waitlist candidates aged 12 years or older, by age at removal
Denominator includes only candidates removed from the waiting list for reasons other than transplant or death while on the list. Data for candidates aged 12-17 years are not shown due to insufficient patient counts.


A line plot for deceased lung donor count by age; the all category increases by 77.4% from 1357 count at 2007 to 2407 count at 2018; the less than 12 category increases by 25.0% from 24 count at 2007 to 30 count at 2018; the 12 to 17 category is 163 count at 2007 and remains relatively constant with a value of 166 count at 2018; the 18 to 34 category increases by 91.2% from 579 count at 2007 to 1107 count at 2018; the 35 to 49 category increases by 83.6% from 348 count at 2007 to 639 count at 2018; and the greater than or equal to 50 category increases by 98.3% from 229 count at 2007 to 454 count at 2018.

Figure LU 37. Deceased lung donor count by age
Count of deceased donors with at least one lung recovered for transplant, by age at donation. Donors are counted once, regardless of number of lungs recovered.


A line plot for distribution of deceased lung donors by age; the less than 12 category decreases by 29.9% from 1.8 percent at 2007 to 1.3 percent at 2018; the 12 to 17 category decreases by 42.9% from 12.1 percent at 2007 to 6.9 percent at 2018; the 18 to 34 category is 43.1 percent at 2007 and remains relatively constant with a value of 46.2 percent at 2018; the 35 to 49 category is 25.9 percent at 2007 and remains relatively constant with a value of 26.7 percent at 2018; and the greater than or equal to 50 category increases by 11.1% from 17.1 percent at 2007 to 18.9 percent at 2018.

Figure LU 38. Distribution of deceased lung donors by age
Deceased donors with at least one lung recovered for transplant. Donors who donated more than one lung are counted once.


A line plot for distribution of deceased lung donors by sex; the male category is 59 percent at 2007 and remains relatively constant with a value of 60.8 percent at 2018; and the female category is 41 percent at 2007 and remains relatively constant with a value of 39.2 percent at 2018.

Figure LU 39. Distribution of deceased lung donors by sex
Deceased donors with at least one lung recovered for transplant. Donors who donated more than one lung are counted once.


A line plot for distribution of deceased lung donors by race; the white category is 61.3 percent at 2007 and remains relatively constant with a value of 61.9 percent at 2018; the black category is 18.6 percent at 2007 and remains relatively constant with a value of 18.2 percent at 2018; the hispanic category is 16 percent at 2007 and remains relatively constant with a value of 15.5 percent at 2018; and the other/unknown category is 4.1 percent at 2007 and remains relatively constant with a value of 4.4 percent at 2018.

Figure LU 40. Distribution of deceased lung donors by race
Deceased donors with at least one lung recovered for transplant. Donors who donated more than one lung are counted once.


A map of percent of pediatric donor lungs allocated to adult recipients, by dsa of donor hospital, 2014-2018, the values range from 0.00 to 100.00.

Figure LU 41. Percent of pediatric donor lungs allocated to adult recipients, by DSA of donor hospital, 2014-2018
Numerator: pediatric donor lungs donors allocated to adult recipients. Denominator: total pediatric donor lungs. When lungs are transplanted individually, we count them separately. When they are transplanted as a block, the are considered one lung.


A line plot for rates of lungs recovered for transplant and not transplanted, by donor risk of disease transmission; the phs increased risk category increases by 180.5% from 2.8 percent at 2007-2008 to 7.7 percent at 2017-2018; and the not increased risk category increases by 56.3% from 4.5 percent at 2007-2008 to 7.1 percent at 2017-2018.

Figure LU 43. Rates of lungs recovered for transplant and not transplanted, by donor risk of disease transmission
"Increased risk" is defined by criteria from the US Public Health Service Guidelines for increased risk for HIV, hepatitis B and hepatitis C transmission.


A line plot for lung donors with a smoking history of 20 pack-years or more; the percent category decreases by 41.1% from 13.4 percent at 2007 to 7.9 percent at 2018.

Figure LU 44. 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 202.6% from 10.8 percent at 2007 to 32.8 percent at 2018; the cva/stroke category decreases by 26.9% from 35.4 percent at 2007 to 25.8 percent at 2018; the head trauma category decreases by 23.6% from 50.8 percent at 2007 to 38.8 percent at 2018; the cns tumor category decreases by 32.3% from 0.7 percent at 2007 to 0.5 percent at 2018; and the other category is 2.3 percent at 2007 and remains relatively constant with a value of 2.1 percent at 2018.

Figure LU 45. 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 22.4% from 523 transplants at 2007 to 640 transplants at 2018; the bilateral category increases by 96.9% from 976 transplants at 2007 to 1922 transplants at 2018; and the all category increases by 70.9% from 1499 transplants at 2007 to 2562 transplants at 2018.

Figure LU 46. 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 16.7% from 18 transplants at 2007 to 15 transplants at 2018; the 12 to 17 category decreases by 32.4% from 37 transplants at 2007 to 25 transplants at 2018; the 18 to 34 category increases by 20.1% from 194 transplants at 2007 to 233 transplants at 2018; the 35 to 49 category increases by 33.6% from 232 transplants at 2007 to 310 transplants at 2018; the 50 to 64 category increases by 37.5% from 795 transplants at 2007 to 1093 transplants at 2018; and the greater than or equal to 65 category increases by 297.3% from 223 transplants at 2007 to 886 transplants at 2018.

Figure LU 47. 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 78.0% from 860 transplants at 2007 to 1531 transplants at 2018; and the female category increases by 61.3% from 639 transplants at 2007 to 1031 transplants at 2018.

Figure LU 48. 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 60.8% from 1254 transplants at 2007 to 2017 transplants at 2018; the black category increases by 92.8% from 125 transplants at 2007 to 241 transplants at 2018; the hispanic category increases by 145.7% from 92 transplants at 2007 to 226 transplants at 2018; the asian category increases by 229.4% from 17 transplants at 2007 to 56 transplants at 2018; and the other/unknown category increases by 100.0% from 11 transplants at 2007 to 22 transplants at 2018.

Figure LU 49. 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 increases by 21.8% from 500 transplants at 2007 to 609 transplants at 2018; the b category increases by 132.8% from 67 transplants at 2007 to 156 transplants at 2018; the c category increases by 32.0% from 200 transplants at 2007 to 264 transplants at 2018; the d category increases by 109.7% from 731 transplants at 2007 to 1533 transplants at 2018; and the other/unknown category decreases by 100.0% from 1 transplants at 2007 to 0 transplants at 2018.

Figure LU 50. 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 increases by 26.9% from 438 transplants at 2007 to 556 transplants at 2018; the 35 to less than 40 category increases by 42.9% from 380 transplants at 2007 to 543 transplants at 2018; the 40 to less than 50 category increases by 64.4% from 357 transplants at 2007 to 587 transplants at 2018; the 50 to less than 60 category increases by 143.5% from 108 transplants at 2007 to 263 transplants at 2018; and the 60 to 100 category increases by 206.2% from 195 transplants at 2007 to 597 transplants at 2018.

Figure LU 51. 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 32.0% from 1059 transplants at 2007 to 1398 transplants at 2018; the 1 to less than 20% category is 249 transplants at 2007 and remains relatively constant with a value of 245 transplants at 2018; the 20 to less than 80% category increases by 350.8% from 63 transplants at 2007 to 284 transplants at 2018; the 80 to 100% category increases by 281.8% from 11 transplants at 2007 to 42 transplants at 2018; and the unknown category increases by 406.8% from 117 transplants at 2007 to 593 transplants at 2018.

Figure LU 52. 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 21.1% from 47.5 las at 2007 to 57.6 las at 2018; the median las category is 38.9 las at 2007 and remains relatively constant with a value of 42.3 las at 2018; and the 25th percentile category is 34.4 las at 2007 and remains relatively constant with a value of 35.7 las at 2018.

Figure LU 53. 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 33.6 las at 2007 and remains relatively constant with a value of 33.6 las at 2018; the b category increases by 34.0% from 36.6 las at 2007 to 49 las at 2018; the c category increases by 12.1% from 38.8 las at 2007 to 43.4 las at 2018; and the d category is 45.1 las at 2007 and remains relatively constant with a value of 46.8 las at 2018.

Figure LU 54. Median LAS at transplant by diagnosis group
Recipients aged 12 years or older; last LAS before transplant.


A line plot for percentage of transplants that were bilateral among lung recipients aged 12 years or older by diagnosis; the alpha to 1 category is 85.4 percent at 2007 and remains relatively constant with a value of 89.8 percent at 2018; the copd category increases by 20.9% from 57.8 percent at 2007 to 70 percent at 2018; the ipf category increases by 30.0% from 48.1 percent at 2007 to 62.5 percent at 2018; and the other category is 83.5 percent at 2007 and remains relatively constant with a value of 86.4 percent at 2018.

Figure LU 55. Percentage of transplants that were bilateral 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 68.7% from 40.8 percent at 2007 to 68.9 percent at 2018; the t to cell depleting category decreases by 57.2% from 21.3 percent at 2007 to 9.1 percent at 2018; and the none category decreases by 40.9% from 38.4 percent at 2007 to 22.7 percent at 2018.

Figure LU 56. 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 immunosuppression regimen use in transplant recipients aged 12 years or older; the tac mmf steroid category increases by 54.5% from 55.3 percent at 2007 to 85.5 percent at 2018; the tac mmf category increases by 59.7% from 1.5 percent at 2007 to 2.3 percent at 2018; the tac steroid category decreases by 71.2% from 5 percent at 2007 to 1.4 percent at 2018; the other category decreases by 70.5% from 36.4 percent at 2007 to 10.7 percent at 2018; and the none reported category decreases by 100.0% from 1.8 percent at 2007 to 0 percent at 2018.

Figure LU 57. Immunosuppression regimen use in transplant recipients aged 12 years or older
Immunosuppression regimen at transplant reported to the OPTN. Tac, tacrolimus. MMF, mycophenolate mofetil.


A bar plot for total hla a, b, and dr mismatches among deceased donor lung transplant recipients aged 12 years or older, 2014-2018, the 0 group is 0.08 percent; the 1 group is 0.53 percent; the 2 group is 3.08 percent; the 3 group is 10.79 percent; the 4 group is 23.72 percent; the 5 group is 33.05 percent; the 6 group is 21.01 percent; and the unk. group is 7.73 percent.

Figure LU 58. Total HLA A, B, and DR mismatches among deceased donor lung transplant recipients aged 12 years or older, 2014-2018
Donor and recipient antigen matching is based on OPTN antigen values and split equivalences policy as of 2018.


A line plot for annual adult lung transplant center volumes, by percentile; the 5th category is 1 transplants per center at 2007 and remains relatively constant with a value of 1 transplants per center at 2018; the 25th category increases by 100.0% from 8.5 transplants per center at 2007 to 17 transplants per center at 2018; the median category increases by 58.8% from 17 transplants per center at 2007 to 27 transplants per center at 2018; the 75th category increases by 40.8% from 35.5 transplants per center at 2007 to 50 transplants per center at 2018; and the 95th category increases by 77.8% from 58.5 transplants per center at 2007 to 104 transplants per center at 2018.

Figure LU 59. Annual adult lung transplant center volumes, by percentile
Annual volume data are limited to recipients aged 18 or older.


A line plot for distribution of adult lung transplants by annual center volume; the 1 to 10 category decreases by 77.6% from 7.3 percent of transplants at 2007 to 1.6 percent of transplants at 2018; the 11 to 40 category decreases by 35.7% from 47.4 percent of transplants at 2007 to 30.5 percent of transplants at 2018; the 41 to 100 category increases by 33.8% from 36.6 percent of transplants at 2007 to 49 percent of transplants at 2018; and the greater than or equal to 101 category increases by 116.8% from 8.7 percent of transplants at 2007 to 18.9 percent of transplants at 2018.

Figure LU 60. Distribution of adult lung transplants by annual center volume
Based on annual volume data among recipients aged 18 or older.


A line plot for patient survival among lung transplant recipients aged 12 years or older, 2011-2013, by age; the 12 to 17 category decreases by 50.6% from 100 percent at 0 Months posttransplant to 49.4 percent at 60 Months posttransplant; the 18 to 34 category decreases by 41.0% from 100 percent at 0 Months posttransplant to 59 percent at 60 Months posttransplant; the 35 to 49 category decreases by 30.3% from 100 percent at 0 Months posttransplant to 69.7 percent at 60 Months posttransplant; the 50 to 64 category decreases by 39.0% from 100 percent at 0 Months posttransplant to 61 percent at 60 Months posttransplant; the greater than or equal to 65 category decreases by 52.3% from 100 percent at 0 Months posttransplant to 47.7 percent at 60 Months posttransplant; and the all category decreases by 42.1% from 100 percent at 0 Months posttransplant to 57.9 percent at 60 Months posttransplant.

Figure LU 61. Patient survival among lung transplant recipients aged 12 years or older, 2011-2013, 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, 2011-2013, by race; the white category decreases by 41.8% from 100 percent at 0 Months posttransplant to 58.2 percent at 60 Months posttransplant; the black category decreases by 44.8% from 100 percent at 0 Months posttransplant to 55.2 percent at 60 Months posttransplant; the hispanic category decreases by 42.4% from 100 percent at 0 Months posttransplant to 57.6 percent at 60 Months posttransplant; the asian category decreases by 37.7% from 100 percent at 0 Months posttransplant to 62.3 percent at 60 Months posttransplant; and the other/unknown category decreases by 42.9% from 100 percent at 0 Months posttransplant to 57.1 percent at 60 Months posttransplant.

Figure LU 62. Patient survival among lung transplant recipients aged 12 years or older, 2011-2013, 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, 2011-2013, by las; the less than 35 category decreases by 41.2% from 100 percent at 0 Months posttransplant to 58.8 percent at 60 Months posttransplant; the 35 to less than 40 category decreases by 41.0% from 100 percent at 0 Months posttransplant to 59 percent at 60 Months posttransplant; the 40 to less than 50 category decreases by 40.2% from 100 percent at 0 Months posttransplant to 59.8 percent at 60 Months posttransplant; the 50 to less than 60 category decreases by 46.0% from 100 percent at 0 Months posttransplant to 54 percent at 60 Months posttransplant; and the greater than or equal to 60 category decreases by 44.4% from 100 percent at 0 Months posttransplant to 55.6 percent at 60 Months posttransplant.

Figure LU 63. Patient survival among lung transplant recipients aged 12 years or older, 2011-2013, 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, 2011-2013, by transplant type; the single left category decreases by 49.3% from 100 percent at 0 Months posttransplant to 50.7 percent at 60 Months posttransplant; the single right category decreases by 48.0% from 100 percent at 0 Months posttransplant to 52 percent at 60 Months posttransplant; and the bilateral category decreases by 39.1% from 100 percent at 0 Months posttransplant to 60.9 percent at 60 Months posttransplant.

Figure LU 64. Patient survival among lung transplant recipients aged 12 years or older, 2011-2013, 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, 2011-2013, by diagnosis group; the a category decreases by 41.8% from 100 percent at 0 Months posttransplant to 58.2 percent at 60 Months posttransplant; the b category decreases by 43.1% from 100 percent at 0 Months posttransplant to 56.9 percent at 60 Months posttransplant; the c category decreases by 35.4% from 100 percent at 0 Months posttransplant to 64.6 percent at 60 Months posttransplant; and the d category decreases by 43.7% from 100 percent at 0 Months posttransplant to 56.3 percent at 60 Months posttransplant.

Figure LU 65. Patient survival among lung transplant recipients aged 12 years or older, 2011-2013, 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, 2011-2013, by diagnosis and transplant type; the alpha to 1 single category decreases by 45.0% from 100 percent at 0 Months posttransplant to 55 percent at 60 Months posttransplant; the alpha to 1 bilateral category decreases by 40.7% from 100 percent at 0 Months posttransplant to 59.3 percent at 60 Months posttransplant; the ipf single category decreases by 49.6% from 100 percent at 0 Months posttransplant to 50.4 percent at 60 Months posttransplant; the ipf bilateral category decreases by 39.8% from 100 percent at 0 Months posttransplant to 60.2 percent at 60 Months posttransplant; the copd single category decreases by 46.5% from 100 percent at 0 Months posttransplant to 53.5 percent at 60 Months posttransplant; and the copd bilateral category decreases by 39.8% from 100 percent at 0 Months posttransplant to 60.2 percent at 60 Months posttransplant.

Figure LU 66. Patient survival among lung transplant recipients aged 12 years or older, 2011-2013, 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 survival among lung transplant recipients aged 12 years or older, 2011-2013, by metropolitan vs. non-metropolitan recipient residence; the metropolitan category decreases by 42.5% from 100 percent at 0 Months posttransplant to 57.5 percent at 60 Months posttransplant; and the non to metropolitan category decreases by 40.4% from 100 percent at 0 Months posttransplant to 59.6 percent at 60 Months posttransplant.

Figure LU 67. Patient survival among lung transplant recipients aged 12 years or older, 2011-2013, by metropolitan vs. non-metropolitan recipient residence
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, 2011-2013, by recipients

Figure LU 68. Patient survival among lung transplant recipients aged 12 years or older, 2011-2013, by recipients' distance from transplant center
Patient survival estimated using unadjusted Kaplan-Meier methods. For recipients of more than one transplant during the period, only the first is considered. Distance is between the zipcode centroids of the TX center and the recipient's permanent residence, measured in nautical miles (NM).


A line plot for patient death among lung transplant recipients aged 12 years or older; the 6 to month category decreases by 58.1% from 15.3 percent at 2001 to 6.4 percent at 2017; the 1 to year category decreases by 52.5% from 22.4 percent at 2001 to 10.6 percent at 2017; the 3 to year category decreases by 32.1% from 39 percent at 2001 to 26.5 percent at 2015; the 5 to year category decreases by 21.8% from 51.9 percent at 2001 to 40.6 percent at 2013; and the 10 to year category is 72.2 percent at 2001 and remains relatively constant with a value of 69.6 percent at 2008.

Figure LU 69. 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, 2018.


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 21.7% from 0.4 patients (in thousands) at 2007 to 0.4 patients (in thousands) at 2018; the 18 to 49 category increases by 52.4% from 2.8 patients (in thousands) at 2007 to 4.3 patients (in thousands) at 2018; the greater than or equal to 50 category increases by 150.3% from 4.1 patients (in thousands) at 2007 to 10.3 patients (in thousands) at 2018; and the all category increases by 106.1% from 7.3 patients (in thousands) at 2007 to 15 patients (in thousands) at 2018.

Figure LU 70. 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, 2016-2017, the 12-17 group is 14.55 percent; the 18-34 group is 20.49 percent; the 35-49 group is 17.13 percent; the 50-64 group is 15.49 percent; the >= 65 group is 15.78 percent; and the all group is 16.27 percent.

Figure LU 71. Incidence of acute rejection by 1 year posttransplant among lung transplant recipients aged 12 years or older by age, 2016-2017
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 bar plot for incidence of acute rejection by 1 year posttransplant among lung transplant recipients aged 12 years or older by induction agent 2016-2017, the il2-ra group is 15.88 percent; the tcd group is 15.69 percent; and the no agents group is 18.01 percent.

Figure LU 72. Incidence of acute rejection by 1 year posttransplant among lung transplant recipients aged 12 years or older by induction agent 2016-2017
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. If a recipient used both IL-2-RA and TCD agents, s/he will contribute to both of those cumulative incidence estimates.


A bar plot for incidence of acute rejection by 1 year posttransplant among lung transplant recipients aged 12 years or older by diagnosis group, 2016-2017, the a group is 15.60 percent; the b group is 20.64 percent; the c group is 17.13 percent; and the d group is 16.07 percent.

Figure LU 73. Incidence of acute rejection by 1 year posttransplant among lung transplant recipients aged 12 years or older by diagnosis group, 2016-2017
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, 2012-2016; 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 74. Incidence of PTLD among lung transplant recipients aged 12 years or older by recipient EBV status at transplant, 2012-2016
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's 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, 2016-2017; 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 75. One-year cumulative incidence of death by cause among lung recipients aged 12 years or older, 2016-2017
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, 2012-2013; 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 76. Five-year cumulative incidence of death by cause among lung recipients aged 12 years or older, 2012-2013
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 52.1% from 48 candidates at 2007 to 23 candidates at 2018; the inactive category decreases by 50.0% from 2 candidates at 2007 to 1 candidates at 2018; and the all category decreases by 52.0% from 50 candidates at 2007 to 24 candidates at 2018.

Figure LU 77. 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 59.5% from 37 candidates at 2007 to 15 candidates at 2018; the inactive category decreases by 90.0% from 70 candidates at 2007 to 7 candidates at 2018; and the all category decreases by 79.4% from 107 candidates at 2007 to 22 candidates at 2018.

Figure LU 78. 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 decreases by 13.5% from 14.5 percent at 2007 to 12.5 percent at 2018; the 1 to 5 category decreases by 11.1% from 25.3 percent at 2007 to 22.5 percent at 2018; and the 6 to 11 category is 60.2 percent at 2007 and remains relatively constant with a value of 65 percent at 2018.

Figure LU 79. 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 decreases by 14.8% from 67.5 percent at 2007 to 57.5 percent at 2018; the black category is 9.6 percent at 2007 and remains relatively constant with a value of 10 percent at 2018; the hispanic category increases by 38.3% from 14.5 percent at 2007 to 20 percent at 2018; and the other/unknown category increases by 48.2% from 8.4 percent at 2007 to 12.5 percent at 2018.

Figure LU 80. 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 29.7% from 38.6 percent at 2007 to 50 percent at 2018; and the female category decreases by 18.6% from 61.4 percent at 2007 to 50 percent at 2018.

Figure LU 81. 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 6 months category increases by 31.1% from 45.8 percent at 2007 to 60 percent at 2018; the 6 months to less than 2 years category increases by 17.3% from 27.7 percent at 2007 to 32.5 percent at 2018; and the greater than or equal to 2 years category decreases by 71.7% from 26.5 percent at 2007 to 7.5 percent at 2018.

Figure LU 82. 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, 2015; the still waiting category decreases by 95.7% from 100 percent at 0 Months postlisting to 4.3 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 83. Three-year outcomes for newly listed candidates aged 0-11 years waiting for lung transplant, 2015
Candidates aged 0-11 who joined the waitlist in 2015. 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 deceased donor lung transplant rates among waitlist candidates aged 0-11 years, by age; the less than 6 category decreases by 28.9% from 86.7 transplants per 100 waitlist years at 2007 to 61.6 transplants per 100 waitlist years at 2018; the 6 to 11 category increases by 680.1% from 9.2 transplants per 100 waitlist years at 2007 to 71.9 transplants per 100 waitlist years at 2018; and the overall category increases by 262.8% from 18.8 transplants per 100 waitlist years at 2007 to 68.3 transplants per 100 waitlist years at 2018.

Figure LU 84. Deceased donor lung transplant rates among waitlist candidates aged 0-11 years, by age
Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting 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 or fewer than 20 candidates at risk are not shown.


A line plot for deceased donor lung transplant rates among waitlist candidates aged 0-11 years, by race; the white category increases by 217.1% from 18.5 transplants per 100 waitlist years at 2007 to 58.8 transplants per 100 waitlist years at 2018; and the non to white category increases by 377.8% from 19.6 transplants per 100 waitlist years at 2007 to 93.7 transplants per 100 waitlist years at 2018.

Figure LU 85. Deceased donor lung transplant rates among waitlist candidates aged 0-11 years, by race
Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting 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 or fewer than 20 candidates at risk 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 165.5% from 11.7 deaths per 100 waitlist years at 2007-2008 to 31.1 deaths per 100 waitlist years at 2017-2018; the less than 6 category is 36 deaths per 100 waitlist years at 2007-2008 and remains relatively constant with a value of 36.3 deaths per 100 waitlist years at 2017-2018; and the 6 to 11 category increases by 301.2% from 6.8 deaths per 100 waitlist years at 2007-2008 to 27.2 deaths per 100 waitlist years at 2017-2018.

Figure LU 86. 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. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Age is determined at the later of listing date or January 1 of the given year. Individual listings are counted separately. Rates with less than 10 patient-years of exposure or fewer than 20 candidates at risk are not shown.


A line plot for pretransplant mortality rates among candidates aged 0-11 years waitlisted for lung transplant by distance from listing center; the 0 to less than 100 nm category increases by 287.5% from 9.6 deaths per 100 waitlist years at 2007-2008 to 37 deaths per 100 waitlist years at 2017-2018; and the greater than or equal to 100 category increases by 112.2% from 11.8 deaths per 100 waitlist years at 2007-2008 to 25 deaths per 100 waitlist years at 2017-2018.

Figure LU 87. Pretransplant mortality rates among candidates aged 0-11 years waitlisted for lung transplant by distance from listing center
Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Rates with less than 10 patient-years of exposure or fewer than 20 candidates at risk are not shown. Distance is between the zipcode centroids of the TX center and the recipient's permanent residence, measured in nautical miles (NM).


A line plot for lung transplants, recipients aged 0-11 years by age; the less than 1 category decreases by 40.0% from 5 transplants at 2007 to 3 transplants at 2018; the 1 to 5 category decreases by 71.4% from 7 transplants at 2007 to 2 transplants at 2018; the 6 to 11 category increases by 66.7% from 6 transplants at 2007 to 10 transplants at 2018; and the all category decreases by 16.7% from 18 transplants at 2007 to 15 transplants at 2018.

Figure LU 88. 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 89. 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 recipients 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 is 32.4 percent at 2007-2008 and remains relatively constant with a value of 30 percent at 2017-2018; the t to cell depleting category increases by 410.0% from 11.8 percent at 2007-2008 to 60 percent at 2017-2018; and the none category decreases by 76.1% from 55.9 percent at 2007-2008 to 13.3 percent at 2017-2018.

Figure LU 90. 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 immunosuppression regimen use in transplant recipients aged 0-11 years; the tac mmf steroid category increases by 34.6% from 69 percent at 2007-2008 to 92.9 percent at 2017-2018; the tac mmf category is 0 percent at 2007-2008 and is percent at 2017-2018; the tac steroid category is 0 percent at 2007-2008 and is percent at 2017-2018; the other category decreases by 100.0% from 13.8 percent at 2007-2008 to 0 percent at 2017-2018; and the none reported category decreases by 100.0% from 17.2 percent at 2007-2008 to 0 percent at 2017-2018.

Figure LU 91. Immunosuppression regimen use in transplant recipients aged 0-11 years
Immunosuppression regimen at transplant reported to the OPTN. Tac, tacrolimus. MMF, mycophenolate mofetil.


A bar plot for total hla a, b, and dr mismatches among deceased donor lung transplant recipients aged 0-11 years, 2014-2018, the 0 group is 0.00 percent; the 1 group is 0.00 percent; the 2 group is 1.25 percent; the 3 group is 3.75 percent; the 4 group is 15.00 percent; the 5 group is 25.00 percent; the 6 group is 18.75 percent; and the unk. group is 36.25 percent.

Figure LU 92. Total HLA A, B, and DR mismatches among deceased donor lung transplant recipients aged 0-11 years, 2014-2018
Donor and recipient antigen matching is based on OPTN antigen values and split equivalences policy as of 2018.


A line plot for incidence of ptld among lung transplant recipients aged 0-11 years by recipient ebv status at transplant, 2006-2016; 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 93. Incidence of PTLD among lung transplant recipients aged 0-11 years by recipient EBV status at transplant, 2006-2016
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's disease. Only the earliest date of PTLD diagnosis is considered. EBV, Epstein-Barr virus.


A line plot for patient survival among lung transplant recipients aged 0-11 years, 2006-2013, by age; the less than 1 category decreases by 48.6% from 100 percent at 0 Months post-transplant to 51.4 percent at 60 Months post-transplant; the 1 to 5 category decreases by 40.4% from 100 percent at 0 Months post-transplant to 59.6 percent at 60 Months post-transplant; the 6 to 11 category decreases by 34.6% from 100 percent at 0 Months post-transplant to 65.4 percent at 60 Months post-transplant; and the all category decreases by 39.4% from 100 percent at 0 Months post-transplant to 60.6 percent at 60 Months post-transplant.

Figure LU 95. Patient survival among lung transplant recipients aged 0-11 years, 2006-2013, by age
Recipient survival estimated using unadjusted Kaplan-Meier methods.


A line plot for patient survival among lung transplant recipients aged 0-11 years, 2006-2013, by diagnosis; the cystic fibrosis category decreases by 29.7% from 100 percent at 0 Months post-transplant to 70.3 percent at 60 Months post-transplant; the ph category decreases by 58.6% from 100 percent at 0 Months post-transplant to 41.4 percent at 60 Months post-transplant; and the other category decreases by 37.2% from 100 percent at 0 Months post-transplant to 62.8 percent at 60 Months post-transplant.

Figure LU 96. Patient survival among lung transplant recipients aged 0-11 years, 2006-2013, 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, 2008-2017; 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 97. One-year cumulative incidence of death by cause among lung transplant recipients aged 0-11 years, 2008-2017
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, 2008-2013; 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 98. Five-year cumulative incidence of death by cause among lung transplant recipients aged 0-11 years, 2008-2013
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. Demographic characteristics of candidates aged 12 years or older on the lung transplant waiting list on December 31, 2013, and December 31, 2018
Candidates waiting for transplant on December 31 of the given year, regardless of first listing date; multiple listings are collapsed. Distance is computed from candidate's home zip code to the transplant center.
Characteristic 2013, N 2013, Percent 2018, N 2018, Percent
Age: 12-17 years 20 1.3% 13 0.9%
Age: 18-34 years 175 11.0% 112 7.9%
Age: 35-49 years 240 15.2% 199 14.0%
Age: 50-64 years 813 51.3% 673 47.4%
Age: ≥ 65 years 336 21.2% 422 29.7%
Sex: Female 944 59.6% 825 58.1%
Sex: Male 640 40.4% 594 41.9%
Race/ethnicity: White 1280 80.8% 1041 73.4%
Race/ethnicity: Black 158 10.0% 162 11.4%
Race/ethnicity: Hispanic 99 6.2% 159 11.2%
Race/ethnicity: Asian 40 2.5% 49 3.5%
Race/ethnicity: Other/unknown 7 0.4% 8 0.6%
Geography: Metropolitan 1286 81.2% 1193 84.1%
Geography: Non-metro 298 18.8% 226 15.9%
Distance: < 50 miles 728 46.0% 760 53.6%
Distance: 50-<100 miles 294 18.6% 249 17.5%
Distance: 100-<150 miles 153 9.7% 134 9.4%
Distance: 150-<250 miles 205 12.9% 146 10.3%
Distance: ≥ 250 miles 191 12.1% 125 8.8%
Distance: Unknown 13 0.8% 5 0.4%
Height: < 150 cm 69 4.4% 63 4.4%
Height: 150-< 160 cm 325 20.5% 336 23.7%
Height: 160-< 170 cm 589 37.2% 483 34.0%
Height: 170-< 180 cm 428 27.0% 366 25.8%
Height: ≥ 180 cm 171 10.8% 170 12.0%
Height: Unknown 2 0.1% 1 0.1%
All candidates 1584 100.0% 1419 100.0%



Table LU 2. Clinical characteristics of candidates aged 12 years or older on the lung transplant waiting list on December 31, 2013, and December 31, 2018
Candidates waiting for transplant on December 31 of the given year, regardless of first listing date; multiple listings are collapsed. All candidates with unknown LAS in are inactive.
Characteristic 2013, N 2013, Percent 2018, N 2018, Percent
Diagnosis group: A 724 45.7% 572 40.3%
Diagnosis group: B 113 7.1% 134 9.4%
Diagnosis group: C 189 11.9% 119 8.4%
Diagnosis group: D 558 35.2% 594 41.9%
LAS: < 30 33 2.1% 74 5.2%
LAS: 30-< 35 741 46.8% 558 39.3%
LAS: 35-< 40 370 23.4% 428 30.2%
LAS: 40-< 50 266 16.8% 246 17.3%
LAS: 50-< 60 78 4.9% 52 3.7%
LAS: ≥ 60 74 4.7% 61 4.3%
LAS: Unknown 22 1.4% 0 0.0%
Blood type: A 621 39.2% 498 35.1%
Blood type: B 155 9.8% 155 10.9%
Blood type: AB 47 3.0% 28 2.0%
Blood type: O 761 48.0% 738 52.0%
All candidates 1584 100.0% 1419 100.0%



Table LU 3. Listing characteristics of candidates aged 12 years or older on the lung transplant waiting list on December 31, 2013, and December 31, 2018
Candidates waiting for transplant on December 31 of the given year, regardless of first listing date; multiple listings are collapsed.
Characteristic 2013, N 2013, Percent 2018, N 2018, Percent
Wait time: < 31 days 143 9.0% 188 13.2%
Wait time: 31-60 days 104 6.6% 119 8.4%
Wait time: 61-90 days 99 6.2% 118 8.3%
Wait time: 3-< 6 months 234 14.8% 243 17.1%
Wait time: 6-< 12 months 311 19.6% 292 20.6%
Wait time: 1-< 2 years 272 17.2% 251 17.7%
Wait time: 2-< 3 years 145 9.2% 86 6.1%
Wait time: ≥ 3 years 276 17.4% 122 8.6%
Waitlist status: Active 1281 80.9% 1194 84.1%
Waitlist status: Inactive 303 19.1% 213 15.0%
Waitlist status: Unknown 0 0.0% 12 0.8%
Transplant history: First 1534 96.8% 1387 97.7%
Transplant history: Retransplant 50 3.2% 32 2.3%
Tx type: Lung only 1522 96.1% 1356 95.6%
Tx type: Heart-lung 45 2.8% 42 3.0%
Tx type: Other 17 1.1% 21 1.5%
All candidates 1584 100.0% 1419 100.0%



Table LU 4. 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 2016 2017 2018
Patients at start of year 1518 1387 1354
Patients added during year 2692 2901 3134
Patients removed during year 2816 2928 3069
Patients at end of year 1394 1360 1419



Table LU 5. 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 2016 2017 2018
Deceased donor transplant 2322 2449 2541
Living donor transplant 0 0 0
Patient died 202 214 238
Patient refused transplant 16 12 21
Improved, transplant not needed 29 38 47
Too sick for transplant 136 112 127
Other 111 103 95



Table LU 6. Demographic characteristics of lung transplant recipients aged 12 years or older, 2013 and 2018
Lung transplant recipients, including retransplants. Distance is computed from recipient's home zip code to the transplant center.
Characteristic 2013, N 2013, Percent 2018, N 2018, Percent
Age: 12-17 years 39 2.0% 25 1.0%
Age: 18-34 years 193 10.1% 233 9.1%
Age: 35-49 years 224 11.7% 310 12.2%
Age: 50-64 years 910 47.5% 1093 42.9%
Age: ≥ 65 years 550 28.7% 886 34.8%
Sex: Female 755 39.4% 1022 40.1%
Sex: Male 1161 60.6% 1525 59.9%
Race/ethnicity: White 1591 83.0% 2007 78.8%
Race/ethnicity: Black 167 8.7% 240 9.4%
Race/ethnicity: Hispanic 125 6.5% 224 8.8%
Race/ethnicity: Asian 19 1.0% 56 2.2%
Race/ethnicity: Other/unknown 14 0.7% 20 0.8%
Height: < 150 cm 44 2.3% 57 2.2%
Height: 150-< 160 cm 233 12.2% 360 14.1%
Height: 160-< 170 cm 596 31.1% 763 30.0%
Height: 170-< 180 cm 666 34.8% 873 34.3%
Height: ≥ 180 cm 374 19.5% 492 19.3%
Height: Unknown 3 0.2% 2 0.1%
Insurance: Private 969 50.6% 1044 41.0%
Insurance: Medicare 753 39.3% 1146 45.0%
Insurance: Other government 173 9.0% 296 11.6%
Insurance: Unknown 21 1.1% 61 2.4%
Geography: Metropolitan 1586 82.8% 2159 84.8%
Geography: Non-metro 330 17.2% 388 15.2%
Distance: < 50 miles 889 46.4% 1306 51.3%
Distance: 50-<100 miles 325 17.0% 425 16.7%
Distance: 100-<150 miles 229 12.0% 265 10.4%
Distance: 150-<250 miles 232 12.1% 250 9.8%
Distance: ≥ 250 miles 225 11.7% 237 9.3%
Distance: Unknown 16 0.8% 64 2.5%
All recipients 1916 100.0% 2547 100.0%



Table LU 7. Clinical characteristics of lung transplant recipients aged 12 years or older, 2013 and 2018
Lung transplant recipients, including retransplants. ECMO, extracorporeal membrane oxygenation.
Characteristic 2013, N 2013, Percent 2018, N 2018, Percent
Diagnosis group: A 504 26.3% 607 23.8%
Diagnosis group: B 70 3.7% 150 5.9%
Diagnosis group: C 240 12.5% 262 10.3%
Diagnosis group: D 1102 57.5% 1528 60.0%
Blood type: A 745 38.9% 956 37.5%
Blood type: B 184 9.6% 285 11.2%
Blood type: AB 73 3.8% 113 4.4%
Blood type: O 914 47.7% 1193 46.8%
Medical condition: Hospitalized in ICU 290 15.1% 347 13.6%
Medical condition: Hospitalized, not ICU 165 8.6% 293 11.5%
Medical condition: Not hospitalized 1461 76.3% 1874 73.6%
Medical condition: Hospitalization unknown 0 0.0% 33 1.3%
LAS: < 30 4 0.2% 3 0.1%
LAS: 30-< 35 405 21.1% 554 21.8%
LAS: 35-< 40 373 19.5% 543 21.3%
LAS: 40-< 50 461 24.1% 587 23.0%
LAS: 50-< 60 216 11.3% 263 10.3%
LAS: ≥ 60 457 23.9% 597 23.4%
Vent/ECMO at transplant: Vent + ECMO 61 3.2% 79 3.1%
Vent/ECMO at transplant: Vent only 91 4.7% 41 1.6%
Vent/ECMO at transplant: ECMO only 32 1.7% 84 3.3%
Vent/ECMO at transplant: Neither 1732 90.4% 2343 92.0%
All recipients 1916 100.0% 2547 100.0%



Table LU 8. Transplant characteristics of lung transplant recipients aged 12 years or older, 2013 and 2018
Lung transplant recipients, including retransplants. DBD, donation after brain death; DCD, donation after circulatory death.
Characteristic 2013, N 2013, Percent 2018, N 2018, Percent
Wait time: < 31 days 665 34.7% 1020 40.0%
Wait time: 31-60 days 279 14.6% 434 17.0%
Wait time: 61-90 days 130 6.8% 256 10.1%
Wait time: 3-< 6 months 314 16.4% 399 15.7%
Wait time: 6-< 12 months 252 13.2% 246 9.7%
Wait time: ≥ 1 year 276 14.4% 192 7.5%
Procedure: Lobar 2 0.1% 0 0.0%
Procedure: Single 619 32.3% 640 25.1%
Procedure: Bilateral 1295 67.6% 1907 74.9%
Donor type: DBD 1880 98.1% 2426 95.2%
Donor type: DCD 35 1.8% 121 4.8%
Donor type: Living 1 0.1% 0 0.0%
Transplant history: First 1838 95.9% 2481 97.4%
Transplant history: Retransplant 78 4.1% 66 2.6%
Tx type: Lung only 1884 98.3% 2493 97.9%
Tx type: Heart-lung 19 1.0% 28 1.1%
Tx type: Other 13 0.7% 26 1.0%
All recipients 1916 100.0% 2547 100.0%



Table LU 9. Donor-recipient serology matching among lung transplant recipients aged 12 years or older, 2016-2018
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. CMV, cytomegalovirus; EBV, Epstein-Barr virus.
Donor Recipient CMV EBV
D- R- 18.1% 0.7%
D- R+ 19.8% 7.5%
D- R unk 0.3% 0.2%
D+ R- 27.7% 7.8%
D+ R+ 33.0% 81.6%
D+ R unk 0.5% 2.2%
D unk R- 0.2% 0.0%
D unk R+ 0.3% 0.1%
D unk R unk 0.0% 0.0%



Table LU 10. 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 2015-2017 and 5-year events for recipients in 2011-2013. Recipients of more than one transplant are counted separately per transplant.
Event One-year, N One-year, Pct Five-year, N Five-year, Pct
BOS: None reported 5449 90.6% 1757 58.1%
BOS: Reported 382 6.4% 1262 41.8%
BOS: Unknown 184 3.1% 3 0.1%
Creatinine > 2.5 mg/dl 251 4.2% 390 12.9%
Chronic dialysis 95 1.6% 82 2.7%
Renal transplant 5 0.1% 20 0.7%
Diabetes 483 8.0% 568 18.8%
Malignancy 218 3.6% 717 23.7%
Re-hospitalization 2889 48.0% 2366 78.3%
Functional status: No assistance needed 4828 80.3% 2459 81.4%
Functional status: Some assistance needed 428 7.1% 212 7.0%
Functional status: Total assistance needed 126 2.1% 74 2.4%
Functional status: Unknown 632 10.5% 277 9.2%
All recipients 6015 100.0% 3022 100.0%



Table LU 11. Demographic characteristics of candidates aged 0-11 years on the lung transplant waiting list on December 31, 2008 and December 31, 2018
Candidates aged 0-11 years waiting for transplant on December 31 of the given year, regardless of first listing date; multiple listings are collapsed. Age calculated at snapshot. Candidates listed as before age 12 who turned 12 before the cohort date are excluded. Distance is computed from candidate's home zip code to the transplant center.
Characteristic 2008, N 2008, Percent 2018, N 2018, Percent
Age: < 1 year 4 7.7% 0 0.0%
Age: 1-5 years 12 23.1% 7 41.2%
Age: 6-11 years 36 69.2% 10 58.8%
Sex: Female 28 53.8% 7 41.2%
Sex: Male 24 46.2% 10 58.8%
Race/ethnicity: White 38 73.1% 12 70.6%
Race/ethnicity: Black 5 9.6% 1 5.9%
Race/ethnicity: Hispanic 9 17.3% 4 23.5%
Geography: Metropolitan 41 78.8% 13 76.5%
Geography: Non-metro 11 21.2% 4 23.5%
Distance: < 50 miles 12 23.1% 6 35.3%
Distance: 50-<100 miles 7 13.5% 1 5.9%
Distance: 100-<150 miles 3 5.8% 2 11.8%
Distance: 150-<250 miles 6 11.5% 2 11.8%
Distance: ≥ 250 miles 24 46.2% 5 29.4%
Distance: Unknown 0 0.0% 1 5.9%
Height: < 70 cm 9 17.3% 2 11.8%
Height: 70-< 90 cm 15 28.8% 2 11.8%
Height: 90-< 110 cm 11 21.2% 4 23.5%
Height: 110-< 130 cm 15 28.8% 8 47.1%
Height: ≥ 130 cm 2 3.8% 1 5.9%
All candidates 52 100.0% 17 100.0%



Table LU 12. Clinical characteristics of candidates aged 0-11 years on the lung transplant waiting list on December 31, 2008 and December 31, 2018
Candidates aged 0-11 years waiting for transplant on December 31, 2008, and December 31, 2018, regardless of first listing date; multiple listings are collapsed. Candidates listed as before age 12 who turned 12 before the cohort date are excluded.
Characteristic 2008, N 2008, Percent 2018, N 2018, Percent
Diagnosis: Cystic fibrosis 7 13.5% 4 23.5%
Diagnosis: Pulmonary hypertension 21 40.4% 2 11.8%
Diagnosis: Pulmonary fibrosis 8 15.4% 0 0.0%
Diagnosis: Other vascular 3 5.8% 2 11.8%
Diagnosis: Other/unknown 13 25.0% 9 52.9%
Blood type: A 22 42.3% 6 35.3%
Blood type: B 8 15.4% 0 0.0%
Blood type: AB 2 3.8% 2 11.8%
Blood type: O 20 38.5% 9 52.9%
All candidates 52 100.0% 17 100.0%



Table LU 13. Listing characteristics of candidates aged 0-11 years on the lung transplant waiting list on December 31, 2008 and December 31, 2018
Candidates aged 0-11 years waiting for transplant on December 31, 2008, and December 31, 2018, regardless of first listing date; multiple listings are collapsed. Candidates listed as before age 12 who turned 12 before the cohort date are excluded.
Characteristic 2008, N 2008, Percent 2018, N 2018, Percent
Wait time: < 31 days 3 5.8% 0 0.0%
Wait time: 31-60 days 0 0.0% 2 11.8%
Wait time: 61-90 days 1 1.9% 4 23.5%
Wait time: 3-< 6 months 7 13.5% 1 5.9%
Wait time: 6-< 12 months 4 7.7% 3 17.6%
Wait time: 1-< 2 years 11 21.2% 4 23.5%
Wait time: 2-< 3 years 6 11.5% 2 11.8%
Wait time: ≥ 3 years 20 38.5% 1 5.9%
Waitlist status: Active 15 28.8% 12 70.6%
Waitlist status: Inactive 37 71.2% 5 29.4%
Transplant history: First 52 100.0% 17 100.0%
Tx type: Lung only 44 84.6% 14 82.4%
Tx type: Heart-lung 7 13.5% 2 11.8%
Tx type: Other 1 1.9% 1 5.9%
All candidates 52 100.0% 17 100.0%



Table LU 14. 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 2016 2017 2018
Patients at start of year 20 22 25
Patients added during year 23 30 24
Patients removed during year 21 27 27
Patients at end of year 22 25 22



Table LU 15. 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 2016 2017 2018
Deceased donor transplant 15 16 16
Living donor transplant 0 0 0
Patient died 4 8 6
Patient refused transplant 0 0 0
Improved, transplant not needed 2 2 1
Too sick for transplant 0 1 1
Other 0 0 3



Table LU 16. Demographic characteristics of lung transplant recipients aged 0-11 years, 2006-2008 and 2016-2018
Lung transplant recipients aged 0-11 years, including retransplants. Distance is computed from recipient's home zip code to the transplant center.
Characteristic 2006-08, N 2006-08, Percent 2016-18, N 2016-18, Percent
Age: < 1 year 15 24.2% 9 20.5%
Age: 1-5 years 19 30.6% 11 25.0%
Age: 6-11 years 28 45.2% 24 54.5%
Sex: Female 33 53.2% 25 56.8%
Sex: Male 29 46.8% 19 43.2%
Race/ethnicity: White 39 62.9% 25 56.8%
Race/ethnicity: Black 7 11.3% 4 9.1%
Race/ethnicity: Hispanic 11 17.7% 11 25.0%
Race/ethnicity: Asian 5 8.1% 2 4.5%
Race/ethnicity: Other/unknown 0 0.0% 2 4.5%
Height: < 70 cm 17 27.4% 11 25.0%
Height: 70-< 90 cm 10 16.1% 7 15.9%
Height: 90-< 110 cm 10 16.1% 4 9.1%
Height: 110-< 130 cm 15 24.2% 16 36.4%
Height: ≥ 130 cm 10 16.1% 6 13.6%
Insurance: Private 31 50.0% 14 31.8%
Insurance: Medicaid 30 48.4% 24 54.5%
Insurance: Unknown 1 1.6% 6 13.6%
Geography: Metropolitan 50 80.6% 34 77.3%
Geography: Non-metro 12 19.4% 10 22.7%
Distance: < 50 miles 16 25.8% 11 25.0%
Distance: 50-<100 miles 5 8.1% 6 13.6%
Distance: 100-<150 miles 5 8.1% 0 0.0%
Distance: 150-<250 miles 4 6.5% 6 13.6%
Distance: ≥ 250 miles 32 51.6% 17 38.6%
Distance: Unknown 0 0.0% 4 9.1%
All recipients 62 100.0% 44 100.0%



Table LU 17. Clinical characteristics of lung transplant recipients aged 0-11 years, 2006-2008 and 2016-2018
Lung transplant recipients, including retransplants. Pediatric priority was reported in 2012 and later. ECMO, extracorporeal membrane oxygenation.
Characteristic 2006-08, N 2006-08, Percent 2016-18, N 2016-18, Percent
Diagnosis: Cystic fibrosis 12 19.4% 10 22.7%
Diagnosis: Pulmonary hypertension 12 19.4% 10 22.7%
Diagnosis: Pulmonary fibrosis 6 9.7% 2 4.5%
Diagnosis: Other vascular 2 3.2% 2 4.5%
Diagnosis: Other/unknown 30 48.4% 20 45.5%
Blood type: A 25 40.3% 13 29.5%
Blood type: B 5 8.1% 8 18.2%
Blood type: AB 7 11.3% 2 4.5%
Blood type: O 25 40.3% 21 47.7%
Medical condition: Hospitalized in ICU 21 33.9% 17 38.6%
Medical condition: Hospitalized, not ICU 16 25.8% 5 11.4%
Medical condition: Not hospitalized 25 40.3% 22 50.0%
Medical urgency: priority 1 34 77.3%
Medical urgency: priority 2 10 22.7%
Vent/ECMO at transplant: Vent + ECMO 2 3.2% 2 4.5%
Vent/ECMO at transplant: Vent only 21 33.9% 12 27.3%
Vent/ECMO at transplant: ECMO only 0 0.0% 1 2.3%
Vent/ECMO at transplant: Neither 39 62.9% 29 65.9%
All recipients 62 100.0% 44 100.0%



Table LU 18. Transplant characteristics of lung transplant recipients aged 0-11 years, 2006-2008 and 2016-2018
Lung transplant recipients, including retransplants.
Characteristic 2006-08, N 2006-08, Percent 2016-18, N 2016-18, Percent
Wait time: < 31 days 18 29.0% 5 11.4%
Wait time: 31-60 days 13 21.0% 11 25.0%
Wait time: 61-90 days 8 12.9% 7 15.9%
Wait time: 3-< 6 months 10 16.1% 7 15.9%
Wait time: 6-< 12 months 10 16.1% 10 22.7%
Wait time: ≥ 1 year 3 4.8% 4 9.1%
Bilateral procedure 62 100.0% 44 100.0%
Transplant history: First 59 95.2% 44 100.0%
Transplant history: Retransplant 3 4.8% 0 0.0%
Tx type: Lung only 51 82.3% 41 93.2%
Tx type: Heart-lung 11 17.7% 2 4.5%
Tx type: Other 0 0.0% 1 2.3%
All recipients 62 100.0% 44 100.0%



Table LU 19. Donor-recipient serology matching among lung transplant recipients aged 0-11 years, 2016-2018
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. CMV, cytomegalovirus; EBV, Epstein-Barr virus.
Donor Recipient CMV EBV
D- R- 36.4% 20.5%
D- R+ 15.9% 15.9%
D- R unk 2.3% 0.0%
D+ R- 27.3% 43.2%
D+ R+ 18.2% 20.5%
D+ R unk 0.0% 0.0%



Table LU 20. 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 2014-2017 and 5-year events for recipients in 2010-2013. Recipients of more than one transplant are counted separately per transplant.
Event One-year, N One-year, Pct Five-year, N Five-year, Pct
BOS: None reported 44 89.8% 37 74.0%
BOS: Reported 2 4.1% 13 26.0%
BOS: Unknown 3 6.1% 0 0.0%
Diabetes 0 0.0% 4 8.0%
Malignancy 1 2.0% 1 2.0%
Re-hospitalization 22 44.9% 43 86.0%
Functional status: Fully active 45 91.8% 47 94.0%
Functional status: Min. active 1 2.0% 1 2.0%
Functional status: Bedbound 1 2.0% 0 0.0%
Functional status: Unknown 2 4.1% 2 4.0%
All recipients 49 100.0% 50 100.0%