Current status of lung transplantation in Hong Kong

Abstract

The only lung transplant program in Hong Kong, which is jointly led by respiratory physicians in Tuberculosis and Chest Unit of Grantham Hospital (GH) and surgeons in Cardiothoracic Surgical Department of Queen Mary Hospital (QMH), has been running for 25 years. The programme was running initially at low profile and with a low case volume in the first decade. The case load has increased significantly in the last decade. Among 187 potential recipients that had been put on waiting list so far, 77 had received lung transplants and 70 died while on waiting list. Majority of the lung transplant surgeries were bilateral sequential lung transplant. Common underlying diagnoses for lung transplant in Hong Kong included chronic obstructive pulmonary disease (COPD), suppurative lung diseases, pulmonary vascular disease, post haemopoietic stem cell transplant bronchiolitis obliterans syndrome (BOS), interstitial lung diseases (ILDs), and lymphangioleiomyomatosis (LAM). The mean age of recipients at transplant was 47.26 years. The 1-, 3-, 5- and 10-year survival were 84.4%, 74.9%, 64.1% and 50.3% respectively. The rate of acute rejection and chronic lung allograft dysfunction (CLAD) were low compared to international data. With a very low organ donation rate (about 6 per-million-population yearly) in the territory, shortage of donor organs remains the biggest unmet need for lung transplantation in Hong Kong.