Lung transplantation in Australia, 1986–2018: more than 30 years in the making

Abstract

Lung transplantation in Australia is 32 years old in 2018. From its early infancy in 1986, it continues to evolve and is internationally recognised as demonstrating world's best practices in organ donation, utilisation and transplantation procedures. Over the past decade, transplant numbers have increased substantially due to innovations in donor procurement, such as donation after circulatory death, the use of ex vivo lung perfusion, extended criteria and organ utilisation, with more than 200 lung transplants undertaken in Australia annually. Parallel to this, lung transplant outcomes have continued to improve. While the management of lung transplant recipients is heavily dependent on a tertiary care paradigm, this model is well developed and has been extremely successful, with Australian outcomes exceeding those of the International Society for Heart and Lung Transplantation Registry at all time points.

Diagnosis and treatment of lung disease associated with alpha one‐antitrypsin deficiency: A position statement from the Thoracic Society of Australia and New Zealand*

“…However, the non‐transplanted group had slightly better lung function (26.3% vs 23.1%), and the early post‐transplant survival described in this study is significantly worse than that reported in the International Thoracic Organ Transplant Registry, especially for AATD where post‐transplant survival is superior to all other diagnoses (including cigarette smoking‐related emphysema) except cystic fibrosis . The reported post‐transplant survival is also significantly worse than that reported by Australian transplant programmes (90%, 74% and 68% at 1, 3 and 5 years, respectively) …”

Pulmonary Type B Niemann-Pick Disease Successfully Treated with Lung Transplantation

“…Since the first successful lung transplant in 1963, there has been a steady increase in the need for lung transplantation worldwide [16]. Australia has improved its donor rates from being one of the lowest per year to 18 donors per million of the population [17]. This is due in part to the increased rates of donation from deaths which occur after circulatory death (DCD) and Ex Vivo Lung Perfusion (EVLP) increasing the donation rate by 25% overall.…”

<p>Trends and hospital outcomes of lung transplantation among patients with and without chronic obstructive pulmonary disease in Spain: a national population-based study (2001&ndash;2015)</p>

“…Since completion of the first successful LTx in the 1980s, thousands of procedures have been performed worldwide 3–5. This therapeutic modality has been recommended for several respiratory diseases, including patients suffering advanced COPD 6.…”