title: Observational study of lung transplant recipients surviving 20 years.
abstract: Lung transplant recipients have reduced long-term survival compared with other solid organ recipients. There is a lack of published data on the characteristics of very long term survivors.
  
  
  
  We describe the demographics, clinical history and post-procedure function of all lung transplant recipients who have survived greater than 20 years at our centre.
  
  
  
  At the time of analysis there were 21 (16.4%) of 128 patients who survived over 20 years. The mean age at transplantation was 31.8 ± 9.9 years. Five of 21 had undergone single-lung, eight double-lung and eight heart-lung transplant procedures. At the last evaluation, mean percentage predicted FEV1 in recipients of single and double lung were 51.3% and 57.9% respectively. By 20 years, 19 (90.5%) patients had developed bronchiolitis obliterans syndrome (BOS) with three (14%) BOS 1, six (29%) BOS 2 and 10 (48%) BOS 3 and two (9.5%) free from BOS. The median time to onset of BOS was 9.7 years (range 1.6-17.9). Of eight patients (38%) who required renal replacement, four (19%) had successfully undergone renal transplantation and four (19%) were on haemodialysis. Only one patient (5%) had symptomatic osteoporosis. Nineteen patients (90%) were treated for hypertension. Five patients (24%) had diabetes, all with an underlying diagnosis of cystic fibrosis and four of them developing diabetes post operatively.
  
  
  
  In our experience, 20-year survivors of lung transplantation had a delayed onset of BOS and morbidities due to immunosuppression that can be appropriately managed leading to long-term survival.
authors: Department of Cardiothoracic Transplantation, Institute of Transplantation, Freeman Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE7 7DN, United Kingdom; Institute of Cellular Medicine, Newcastle Medical School, Newcastle University, Newcastle upon Tyne, NE2 4HH, United Kingdom.
authors: Sasiharan
authors: S
authors: Sithamparanathan
authors: Department of Cardiothoracic Transplantation, Institute of Transplantation, Freeman Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE7 7DN, United Kingdom; Institute of Cellular Medicine, Newcastle Medical School, Newcastle University, Newcastle upon Tyne, NE2 4HH, United Kingdom.
authors: Logan
authors: L
authors: Thirugnanasothy
authors: Department of Cardiothoracic Transplantation, Institute of Transplantation, Freeman Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE7 7DN, United Kingdom.
authors: Stephen
authors: S
authors: Clark
authors: Department of Cardiothoracic Transplantation, Institute of Transplantation, Freeman Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE7 7DN, United Kingdom; Institute of Cellular Medicine, Newcastle Medical School, Newcastle University, Newcastle upon Tyne, NE2 4HH, United Kingdom.
authors: John H
authors: JH
authors: Dark
authors: Department of Cardiothoracic Transplantation, Institute of Transplantation, Freeman Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE7 7DN, United Kingdom; Institute of Cellular Medicine, Newcastle Medical School, Newcastle University, Newcastle upon Tyne, NE2 4HH, United Kingdom.
authors: Andrew J
authors: AJ
authors: Fisher
authors: Department of Microbiology, Freeman Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE7 7DN, United Kingdom.
authors: Kate F
authors: KF
authors: Gould
authors: Department of Cardiothoracic Transplantation, Institute of Transplantation, Freeman Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE7 7DN, United Kingdom.
authors: Asif
authors: A
authors: Hasan
authors: Department of Cardiothoracic Transplantation, Institute of Transplantation, Freeman Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE7 7DN, United Kingdom.
authors: James L
authors: JL
authors: Lordan
authors: Department of Cardiothoracic Transplantation, Institute of Transplantation, Freeman Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE7 7DN, United Kingdom.
authors: Gerard
authors: G
authors: Meachery
authors: Department of Cardiothoracic Transplantation, Institute of Transplantation, Freeman Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE7 7DN, United Kingdom.
authors: Gareth
authors: G
authors: Parry
authors: Department of Cardiothoracic Transplantation, Institute of Transplantation, Freeman Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE7 7DN, United Kingdom; Institute of Cellular Medicine, Newcastle Medical School, Newcastle University, Newcastle upon Tyne, NE2 4HH, United Kingdom. Electronic address: paul.corris@ncl.ac.uk.
authors: Paul A
authors: PA
authors: Corris
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D001989:Bronchiolitis Obliterans / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D003550:Cystic Fibrosis / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D005541:Forced Expiratory Volume / Q000502:physiology; D007165:Immunosuppression Therapy / Q000009:adverse effects; D016040:Lung Transplantation / Q000009:adverse effects / Q000401:mortality / Q000706:statistics & numerical data; D008232:Lymphoproliferative Disorders / Q000150:complications / Q000453:epidemiology; D015995:Prevalence; D015996:Survival Rate / Q000639:trends; D066027:Transplant Recipients / Q000706:statistics & numerical data
keywords: Lung transplantation; Medical complications; Survival