OPTN/SRTR 2011 Annual Data Report: Lung

Abstract

Lungs are allocated in part based on the Lung Allocation Score (LAS), which considers risk of death without transplant and posttransplant. Wait-list additions have been increasing steadily after an initial decline following LAS implementation. In 2011, the largest number of adult candidates were added to the waiting list in a single year since 1998; donation and transplant rates have been unable to keep pace with wait-list additions. Candidates aged 65 years or older have been added faster than candidates in other age groups. After an initial decline following LAS implementation, wait-list mortality increased to 15.7 per 100 wait-list years in 2011. Short-and long-term graft survival improved in 2011; 10-year graft failure fell to an all-time low. Since 1998, the number of new pediatric (aged 0-11 years) candidates added yearly to the waiting list has declined. In 2011, 19 pediatric lung transplants were performed, a transplant rate of 34.7 per 100 wait-list years. The percentage of patients hospitalized before transplant has not changed. Both graft and patient survival have continued to improve over the past decade. Posttransplant complications for pediatric lung transplant recipients, similar to complications for adult recipients, include hypertension, renal dysfunction, diabetes, bronchiolitis obliterans syndrome, and malignancy.

The Use of Optical Clearing and Multiphoton Microscopy for Investigation of Three-Dimensional Tissue-Engineered Constructs

“…1 While lung transplant is the only curative solution for end-stage lung disease, it is severely hindered by lack of available tissue and poor outcomes 10 years postoperative. 2 Available vascular interventions suffer from stenosis, occlusion, and infection. 3 Tissue engineering/ regenerative medicine approaches that can reconstruct functional healthy cardiovascular, pulmonary, or other tissues and organs would have a major impact on the health of the population.…”

Enhanced Re-Endothelialization of Decellularized Rat Lungs

“…iven the ever-growing disparity between the increasing demand for transplantable lungs and the limited supply of available donor organs, 1 there is an unmet need for alternatives such as bioengineered lungs. Cadaveric lungs, otherwise unsuitable for transplantation, can serve as biologic scaffolds for lung tissue engineering following decellularization and repopulation of both the airway and vascular compartments with adult or progenitor cells.…”

Coming to terms with tissue engineering and regenerative medicine in the lung

“…By far, the most critical issue is the acute shortage of transplantable donor lungs with unacceptably long wait lists. For example, more than 2,500 patients in the United States alone are on the wait list, with an average wait time of Ͼ1 yr (208), and an unfortunately high rate of mortality during the wait period (approximately 15-20 per 100 waitlisted), and deterioration of the recipient's health status in the interim. A separate critical issue is the condition and transplantable status of donor lungs that often suffer edema, atelectasis, or even pneumonia depending on the donor's comorbidities and approaches to preoperative lung handling.…”