title: Thoracic organ transplants in the United States from October 1987 through December 1991: a report from the UNOS Scientific Registry for Organ Transplants.
abstract: 1. In 1991 there were 2,127 heart, 402 lung, and 51 heart-lung transplants performed in the United States. These numbers reflect increases of 27% for heart, over 1000% for lung, and a decrease of 31% for heart-lung transplants since 1988. 2. The number of programs performing heart transplants has increased by 16% since 1988, whereas the number of programs performing lung transplants has tripled over that time. 3. The most frequent primary indications for thoracic transplantation were: cardiomyopathy (45%) and coronary artery disease (41%) for heart; primary pulmonary hypertension (43%) and congenital/Eisenmenger's for heart-lung; and emphysema/chronic obstructive pulmonary disease (28%) and Alpha-1 antitrypsin deficiency (20%) for lung. 4. Average cold ischemic time increased gradually between 1988 and 1991: 2.7 hours for hearts transplanted in 1991 compared with 3.3 hours for heart-lungs, and 4.3 for lungs. 5. Between 1988 and December 1991, the following percentages increased significantly: pediatric heart and lung transplantations; non-White thoracic transplant recipients and donors; the use of thoracic organs from younger (< or = 5 yrs) as well as older (> or = 45 yrs) donors; and local utilization of thoracic organs. 6. For the entire period covered by this report, 1-year recipient survival rates were: heart 81.6%, heart-lung 55.4%, and lung 67.2%. Patient survival was significantly lower in heart retransplants or when the primary indication for transplantation was the treatment of congenital disease. Between 1988 and 1991, 1-year survival appeared to have increased significantly for heart-lung and lung recipients.
authors.affiliation: United Network for Organ Sharing, Richmond, Virginia.
authors.forename: T J
authors.initials: TJ
authors.lastname: Breen
authors.forename: B
authors.initials: B
authors.lastname: Keck
authors.forename: J D
authors.initials: JD
authors.lastname: Hosenpud
authors.forename: J B
authors.initials: JB
authors.lastname: O'Connell
authors.forename: R
authors.initials: R
authors.lastname: White
authors.forename: O P
authors.initials: OP
authors.lastname: Daily
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006085:Graft Survival; D016027:Heart Transplantation / Q000401:mortality / Q000706:statistics & numerical data*; D016041:Heart-Lung Transplantation / Q000401:mortality / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016040:Lung Transplantation / Q000401:mortality / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012042:Registries; D015996:Survival Rate; D014019:Tissue Donors / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology