Ten years of lung transplantation in Switzerland: results of the Swiss Lung Transplant Registry.
OBJECTIVE
Lung transplantation has evolved from an experimental procedure to a viable therapeutic option in many countries. In Switzerland, the first lung transplant was performed in November 1992, more than ten years after the first successful procedure world-wide. Thenceforward, a prospective national lung transplant registry was established, principally to enable quality control.


METHODS
The data of all patients transplanted in the two Swiss Lung Transplant centres Zurich University Hospital and Centre de Romandie (Geneva-Lausanne) were analysed.


RESULTS
In 10 years 242 lung transplants have been performed. Underlying lung diseases were cystic fibrosis including bronchiectasis (32%), emphysema (32%), parenchymal disorders (19%), pulmonary hypertension (11%) and lymphangioleiomyomatosis (3%). There were only 3% redo procedures. The 1, 5 and 9 year survival rates were 77% (95% CI 72-82), 64% (95% CI 57-71) and 56% (95% CI 45-67), respectively. The 5 year survival rate of patients transplanted since 1998 was 72% (95% CI 64-80). Multivariate Cox regression analysis revealed that survival was significantly better in this group compared to those transplanted before 1998 (HR 0.44, 0.26-0.75). Patients aged 60 years and older (HR 5.67, 95% CI 2.50-12.89) and those with pulmonary hypertension (HR 2.01, 95% CI 1.10-3.65) had a significantly worse prognosis The most frequent causes of death were infections (29%), bronchiolitis obliterans syndrome (25%) and multiple organ failure (14%).


CONCLUSIONS
The 10-year Swiss experience of lung transplantation compares favourably with the international data. The best results are obtained in cystic fibrosis, pulmonary emphysema and parenchymal disorders.
Speich
Rudolf
R
Department of Internal Medicine, University Hospital, Raemistrasse 100, CH-8091 Zurich, Switzerland. klinspr@usz.unizh.ch
Nicod
Laurent Pierre
LP
Aubert
John-David
JD
Spiliopoulos
Anastase
A
Wellinger
John
J
Robert
John Henri
JH
Stocker
Reto
R
Zalunardo
Marco
M
Gasche-Soccal
Paola
P
Boehler
Annette
A
Weder
Walter
W
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002423:Cause of Death; D002648:Child; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications; D008171:Lung Diseases / Q000601:surgery; D016040:Lung Transplantation / Q000401:mortality* / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012042:Registries; D012086:Reoperation / Q000706:statistics & numerical data; D015996:Survival Rate; D013557:Switzerland / Q000453:epidemiology