Trends in survival and CLAD rates after lung transplantation in Europe

<bold>Background:</bold> Outcomes after Lung transplantation (LTx) are modest in comparison to other solid organ Tx. We aimed at reviewing trends on survival and chronic lung allograft dysfunction with special focus on bronchiolitis obliterans syndrome (CLAD-BOS) in Europe. <bold>Methods:</bold> Currently there is no dedicated European LTx registry. We used accessible data from other existing registries including ISHLT, European reports and literature. <bold>Results:</bold> Survival rate for LTx at 1, 3, and 5 years reaches 71% - 83%, 55% - 71%, and 50% - 63% respectively, with variations due to parameters like period considered, patient age, transplant type, and diagnosis. French data shows improvement in 5-year survival over several time periods. Freedom from CLAD-BOS reaches 95%, 76%, and 62% at year 1, 3 and 5 in the Spanish registry. Monocentric studies show 5-year rates of 57% to 73%. CLAD-BOS represents the leading CLAD phenotype accounting for 65% to 75%. A French study based on 3 time periods from 1988-2004, 2004-2011, and 2011-2014 including 139, 166, and 176 patients, found an increase in 5-year freedom from CLAD with 47%, 64% and, 73%. CLAD-BOS still represents the leading cause of death. <bold>Conclusion:</bold> In Europe, 5-year post-LTx survival is in the range of 55% to 63% and 5-year freedom from CLAD-BOS ranges from 57% to 73%. CLAD remains the most prevalent and fatal complication with CLAD-BOS being the most frequent phenotype. This emphasizes the urgent need for new treatments. <fig><object-id>erj;64/suppl_68/PA579/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>