Lung Transplant Stats
Reported last year in
THE CANADIAN PRESS
Twenty-five years after the world's first successful lung transplant was performed in Toronto, a new report shows that the number of lung transplants in Canada has risen dramatically.
The study by the Canadian Institute for Health Information, released Thursday, also shows that survival rates have improved, and more young people with cystic fibrosis are benefiting from the operation.
"It's actually a tremendous Canadian success story in that they've shown that we're now doing 84 per cent more lung transplants in the country than we were doing 10 years ago," said Dr. Shaf Keshavjee, director of the lung transplant program at Toronto General Hospital.
"And also, that the outcomes have gotten better and better over the time."
The number of lung transplants increased from 93 in 1997 to 171 in 2006, and the three-year survival rate has improved from 60 per cent in 1997 to 80 per cent in 2003.
The world's first successful lung transplant was performed in 1983 at Toronto General Hospital by Dr. Joel Cooper. The patient led an active life for another six years before dying of kidney failure at age 64.
Keshavjee said there are patients now who are alive more than 20 years after receiving a lung transplant who otherwise would have died in six months.
However, not everyone who needs new lungs receives them. The data show that 299 people died while on the waiting list between 1997 and 2006.
"One of the biggest challenges and one of the limiting factors is certainly the availability of organs," said Margaret Keresteci, the institute's manager of clinical registries.
An exciting development in recent years, Keresteci said, is that a single healthy lobe – part of a lung – from a living donor can be used for transplants.
And she noted that younger people are getting lung transplants – specifically people with the disease cystic fibrosis, in which mucus builds up and can cause repeated infections in the lungs.
In total, 1,222 lung transplants were performed from 1997 to 2006, and double-lung transplants accounted for 75 per cent of the surgeries in 2006.
"Thirty-one per cent of the double-lung transplants are people with cystic fibrosis," Keresteci said.
Britta Watts, now 32, was born with cystic fibrosis, and was active and healthy growing up. But when she turned 19, "it started going downhill pretty quickly," she said in an interview from her home in Steveston, B.C.
A cold turned into pneumonia, and one hospital admission per year quickly turned into two or three, she said.
"Eventually I was basically living in hospital where I was doing sort of a five-week in, and coming home for a few days, and then having to go back again. It became very, very difficult."
Her lung function dropped below 19 per cent, she said. "I was on full-time oxygen at that point."
Watts had her double-lung transplant in April 2005 at the age of 28.
"I do remember going in, and it was very surreal, but it was a good day. It was a very good day."
The first year of healing was "rather difficult" as she faced some infection and rejection.
"After that first year was over, I just kept getting stronger and stronger," she said. "I'm a very lucky girl."
Watts is a beneficiary of decades of research and experience.
Keshavjee said transplants were a high-risk operation in the 1980s and about 50 per cent of patients died in surgery. Last year at Toronto General, 100 operations were performed and he said ``operative mortality" was six per cent.
"A lot of this has come from innovations that we've been working on in trying to preserve lungs so that we can transport them further, preserve them so that they can be used safely and more predictably in patients," he said.
Lung transplants are performed in hospitals in Vancouver, Edmonton, Winnipeg, Toronto and Montreal.
Keshavjee, a professor and chair of thoracic surgery at the University of Toronto, said surgeries are being done on higher risk patients, older patients and patients with other problems, who might need a combined transplant – for instance, lung and heart.
An operation costs about $100,000 but that's less than the tally for lengthy hospital stays and years of antibiotics, he noted.
He said the waiting list a decade ago at his hospital was two years, and now it's three to six months.
"Now the focus on outcomes from transplantation is not just survival – that they're alive, which is of course fantastic – but it's that they're getting back to meaningful lives," Keshavjee said.
Life for Watts has changed enormously, and she now paddles at various festivals on a dragonboat team made up primarily of transplant recipients.
"We're there just to promote organ donation and to remind people that it does work, and there is such a good outcome of signing that organ donation card," she said.
"We do really, really well and we're very grateful.
[ Posted on Thursday August 27 - 7:31 pm ]
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