ISHLT registry

LT is the best therapeutic option for patients with IPF with life-threatening disease (208-210). Since no medical therapies have been proven to influence survival in IPF, IPF patients should be referred to LT centers at the time of diagnosis (provided no contraindications exist). The decision to list for LT is best made by the local transplant team members, who are familiar with local waiting times. Either single (SLT) or bilateral sequential lung transplantation (BSLT) can be performed (208,209,211). Data from the International Society for Heart and Lung Transplantation (ISHLT) Registry reported that 19% of >17,000 LTs... 

In the recent ISHLT registry report, the one-, three-, and five-year prevalence rates of OB in adult lung transplant recipients (LTRs) followed-up between April 1994 and June 2005 were 10%, 30%, and 44%, respectively (1), whereas the one-, three- and five-year mortality rates from BOS were 5%, 26%, and 29%, respectively (1). OB/BOS is the single most important factor responsible for late mortality after lung transplantation, and affects 33% of LTRs who survive more than five years (1). 

Currently, MMF is approved for use in kidney, liver, and heart transplants. A recent analysis of 5599 patients in the Joint International Society for Heart and Lung Transplantation (ISHLT) and UNOS Thoracic Registry showed a statistically signihcant survival advantage for MMF compared with azathioprine (1 year, 96% versus 93% 3 years, 91% versus 86%). Efficacy has been demonstrated in combination with both CSA and TAC. 

Hosenpud JD, Bennett LE. Mycophenolate mofetil compared to azathio-prine improves survival in patients surviving the initial cardiac transplant hospitalization An analyisis of the joint ISHLT/UNOS Thoracic Registry. J Heart Lung Transplant 2000 19 72. 

The prevalence of angiographic CAV increases 10% with each year of post-transplant follow-up. Data from the ISHLT Transplantation Registry show a prevalence of 7.8% and 20.8% at 1 and 5 years of follow-up, respectively (Segovia 2002). Average survival after diagnosis of significant CAV ranges between 2 and 4.2 years (Cantin et al. 2002). 

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