Lung transplantation program LMU Klinikum Munich 1990 – 2019: Advances in postoperative outcome and survival over three decades

Background Lung transplantation (LuTX) can be the last resort regarding treatment for chronic pulmonary diseases. Lately, groundbreaking improvements were achieved throughout the entire process, from organ donation to implantation, itself a medical and logistical challenge. This retrospective study aims to illustrate the evolution of the LuTX-program at the LMU Klinikum since its launch in 1990 by depicting and comparing postoperative survival and outcome.

Methods We analyzed all LuTX performed from 1990 to 2019. Data was collected on TX-indication, date, type/technique and postoperative survival. Logistical regression, multivariate analysis and survival curves were used to identify factors that are detrimental to post-TX outcome and are subsequently reducing survival chances.

Results Overall, 1054 LuTX were performed over 30 years, comprising a total of 1024 patients (30 retransplantations). Each year, 33.3±11.3 donor lungs were transplanted on average, with a range from one (1991) to 103 LuTX (2018). Patients with interstitial lung disease (ILD) represented the largest group (33.9%; n=357 patients). The best results regarding five-year survival rates (Five-YSR) were observed in patients with hypersensitivity pneumonitis (HP)/lymphangioleiomyomatosis (LAM) (Five-YSR: 75.5%; n=92). We could show that among other factors, the technique and side of the transplanted lung played a crucial role in post-TX survival, depicting double superior to single LuTX (5-YSR: left=42.4%; right=55.4%; double=64.5%). Multivariate cox regression identified indication and time/year of TX as the most influential parameters.

Conclusions Data analysis of the underlying study sample shows that the field of LuTX has undergone enormous progress regarding postoperative survival and outcome. Furthermore, improvements in immunosuppressive medication and management of rejection reactions have drastically reduced the rate of lung transplant rejections.

Publication History

Article published online:
09 March 2023