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Lung transplant numbers, survival rates up: report

Since the first successful lung transplant was performed in Toronto 25 years ago, the number of lung transplants performed in Canada has grown substantially, according to a new report. Lung transplants grew by 84 per cent between 1997 and 2006.
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Since the first successful lung transplant was performed in Toronto 25 years ago, the number of lung transplants performed in Canada has grown substantially, according to a report released on Thursday.

 Organ transplant facts
  • As of December 2006, there were just over 20,000 Canadians living with an organ transplant — enough to fill a major league sports arena.
  • 1,222 lung transplants were performed in Canada between 1997 and 2006.
  • Canada's lung transplant rate is 5.3 per million population (PMP), compared to 4.7 PMP in the United States and 2.9 PMP in France.
  • Canada has lower transplantation rates than both the U.S. 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).
  • The total number of solid organ transplants in Canada increased from 1,620 in 1997, to 2,087 in 2006.
  • There were an estimated 33,832 people with end-stage renal disease or kidney failure in Canada at the end of 2006, an increase of 70 per cent since 1997.
  • In 2006, there were 87 Canadians waiting for a heart transplant, with 13 deaths occurring while people were on the waiting list.
  • Between 1997 and 2006, the number of patients awaiting heart transplants decreased 10 per cent, while the number of deaths on the waiting list decreased by more than half.
  • There were 603 pancreatic transplants performed in Canada in the last decade, two-thirds of which were simultaneous pancreas-kidney transplants.
 Source: CIHI

 

The Canadian Institute for Health Information reported that lung transplants grew by 84 per cent between 1997 and 2006, up from 93 the first year to 171 in 2006. 

Over a similar time period, the three-year survival rate for lung transplant patients improved from 60 per cent to 80 per cent.

"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," said Margaret Keresteci, CIHI’s manager of clinical registries.

"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."

Trevor Umlah of Halifax has cystic fibrosis, a multi-organ disease that mainly affects the lung and causes severe breathing problems.

"Sitting down I was fine," Umlah recalled. "If I got up to do anything, like go to the bathroom or go the fridge, it was just like running a marathon."

Umlah received a double lung transplant last year. He is on medication for life and has to get blood work every three weeks, but Unlaw said he is lucky to be alive, and he believes that a donation from a stranger helped to save his life.  

The rate of increase in lung transplants outpaced transplants of other solid organs such as kidneys, hearts or livers, which grew 29 per cent over the same period, the report's authors found.

More people waiting

Advances in suppressing the immune system, better organ preservation techniques and advances in managing lung transplant recipients help account for the increase, said Dr. Shaf Keshavjee, director of the Toronto lung transplant program at Toronto General Hospital.

The world's first successful lung transplant was performed in Canada in 1983, followed by the first bilateral or double-lung transplant in 1986.

But as advances in treatment have made lung transplants possible for more patients, more people are waiting for the organs.

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.

Canadian Blood Services has taken over the national registry program for organ transplants to try to raise awareness and improve the rate of organ donation.

There are missed opportunities with families declining to donate organs because they don't know the intentions of their loved ones, said Dr. Peter Nickerson of Canadian Blood Services in Ottawa.

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