December 18, 2008—Since the world’s first successful lung transplant was performed in
Canada 25 years ago, the number of lung transplants performed annually has grown significantly. A new report released today by the Canadian Institute for Health Information (CIHI) shows that lung transplants in Canada increased from 93 in 1997, to 171 in 2006, rising at a faster rate than solid organ transplants in general (up 29% over the same period).
The report, Treatment of End-Stage Organ Failure in Canada, 1997 to 2006, draws on data from CIHI’s Canadian Organ Replacement Register (CORR) to examine dialysis, transplantation and organ donation characteristics and trends in Canada over a 10-year period. In total, 1,222 lung transplants were performed in this country between 1997 and 2006. Patients receiving double-lung transplants accounted for 75% of the procedures performed in 2006, a number that more than doubled since 1997 (from 52 to 129).
“The lung transplant landscape has evolved a great deal in a short span of time, offering a new lease on life to a growing number of Canadians with lung disease,” says Margaret Keresteci, CIHI’s manager of Clinical Registries. “Although these transplants are technically very difficult to perform, outcomes have improved significantly. Just a decade ago, the likelihood that a child with cystic fibrosis would live to see his or her 18th birthday was doubtful, but transplantation has changed this reality. While the numbers remain relatively small, lung transplants have increased at a rate greater than kidney, heart or liver transplants.”
Survival rates continue to improve
Over a similar time frame, the three-year survival rate for lung transplant recipients increased from 60% in 1997, to 80% in 2003.
“There are several reasons why outcomes for lung transplant recipients have continued to improve,” says Dr. Shaf Keshavjee, Director of the Toronto Lung Transplant Program at Toronto General Hospital. “In addition to advances in immunosuppression, better organ preservation techniques have been developed and there continue to be advancements in the management and monitoring of lung transplant recipients.”
Canada a world leader
The world’s first successful lung transplant was performed in Canada in 1983, followed by the first bilateral (or double-lung) transplant in 1986. Canada’s lung transplant experience is highly regarded internationally, and the country’s lung transplantation rate is 5.3 per million population (PMP), compared to 4.7 PMP in the United States and 2.9 PMP in France. Canada’s success in lung transplantation is in part due to the increase in living donors. Today in Canada, there are six lung transplant programs in five provinces, two of which perform living donations.
Canada has lower transplantation rates than both the United States and France for other types of organs, such as heart transplants (5.4 PMP in Canada, versus 7.3 in the U.S. and 5.8 in France) and liver transplants (14.2 PMP in Canada, versus 22.2 in the U.S. and 16.7 in France).
Waiting times for transplants grow
Advances in treatment opened up lung transplants as a possibility for more patients, which led to a corresponding growth in the number of people waiting for transplantation. Over 10 years, the number of people waiting for a lung transplant more than doubled, with 252 Canadians waiting to receive a transplant in 2006, compared to 119 in 1997. Between 1997 and 2006, 299 people died while waiting for a lung transplant in Canada.
“End-stage organ failure continues to present complex issues and challenges for Canadian clinicians, the health care system and patients,” says Keresteci. “Treatment options are evolving, but only through the systematic collection of data can sound information be produced. It is the intent of this report to provide such information in an effort to improve the health of Canadians with end-stage organ failure.”
Other highlights from Treatment of End-Stage Organ Failure in Canada, 1997 to 2006:
The Canadian Institute for Health Information (CIHI) collects and analyzes information on health and health care in Canada and makes it publicly available. Canada’s federal, provincial and territorial governments created CIHI as a not-for-profit, independent organization dedicated to forging a common approach to Canadian health information. CIHI’s goal: to provide timely, accurate and comparable information. CIHI’s data and reports inform health policies, support the effective delivery of health services and raise awareness among Canadians of the factors that contribute to good health.
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Information about: 2008 CORR Report - 2008 CORR Report—Treatment of End-Stage Organ Failure in Canada 1997 to 2006