Thoracic organ transplantation in the United States, 1994-2003

Mark L. Barr, Robert C. Bourge, Jonathan B. Orens, Kenneth R. McCurry, W. Steves Ring, Tempie E. Hulbert-Shearon, Robert M. Merion

Research output: Contribution to journalReview articlepeer-review

35 Scopus citations


Using OPTN/SRTR data, this article reviews the state of thoracic organ transplantation in 2003 and the previous decade. Time spent on the heart waiting list has increased significantly over the last decade. The percentage of patients awaiting heart transplantation for >2 years increased from 23% in 1994 to 49% by 2003. However, there has been a general decline in heart waiting list death rates over the decade. In 2003, the lung transplant waiting list reached a record high of 3,836 registrants, up slightly from 2002 and more than threefold since 1994. One-year patient survival for those receiving lungs in 2002 was 82%, a statistically significant improvement from 2001 (78%). The number of patients awaiting a heart-lung transplant, declining since 1998, reached 189 in 2003. Adjusted patient survival for heart-lung recipients is consistently worse than the corresponding rate for isolated lung recipients, primarily due to worse outcomes for heart-lung recipients with congenital heart disease. A new lung allocation system, approved in June 2004, derives from the survival benefit of transplantation with consideration of urgency based on waiting list survival, instead of being based solely on waiting time. A goal of the policy is to minimize deaths on the waiting list.

Original languageEnglish (US)
Pages (from-to)934-949
Number of pages16
JournalAmerican Journal of Transplantation
Issue number4 II
StatePublished - Apr 2005


  • Allocation policy
  • Deceased donors
  • Graft survival
  • Heart transplantation
  • Heart-lung transplantation
  • Living donors
  • Lung transplantation
  • Organ donation
  • Patient survival
  • SRTR
  • Waiting list

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)


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