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Lung Transplantation In California

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David Weill, MD
ISHLT Pulmonary Transplantation Council Chair
Stanford University Medical Center
Stanford, California, USA

Like so much else, organ transplantation in California benefits from an abundance of riches. With great beaches and weather, vibrant cities, the movie industry, and a bountiful agricultural climate (especially for grapes), California is certainly a land of plenty. And did I mention the food? Any type of food is available from the chic restaurants in Los Angeles to the culinary creativity of San Francisco (which many consider the second best dining city in the country—do you even need to ask? New Orleans). So with all this going in its favor, and with a population of nearly 40 million people to support a robust organ donor and patient referral base, there are not surprisingly several active lung transplant programs.

From our 4 active Organ Procurement Organizations (OPOs), in 2012 there were a total of 386 lungs procured in California. Just for perspective, in the same year, there were around 3200 lungs procured in the entire United States. Let's see: California has a little more than 10% of the total US population and a bit more than 10% of all procured lungs. And the California economy represents 13% of the US Gross Domestic Product ... well, you get the point.

But the biggest beneficiary of the California lung transplant environment is the patients. From NorCal to SoCal, there are a several excellent transplant programs from which to choose, meaning that a patient that lives in Southern California can have his or her pick of several different programs such as UCLA, UCSD, USC, and Cedars-Sinai. All of these Programs have significant transplant experience and have leaders in the field working within the Centers. UCLA, the busiest lung transplant program in California, has consistently achieved patient outcomes that surpass national and local benchmarks.

In the Northland (remember: ideally situated near the wineries), UCSF and Stanford both have active transplant programs, transplanting nearly 100 lungs per year between the two programs. UCSF has been a leader in transplanting sick patients with Interstitial Lung Diseases of all sorts and has consistently delivered excellent outcomes. Stanford has also been in the lung transplant business for a long time, with Dr. Bruce Reitz performing the first heart-lung transplant in 1981. As I remind Dr. Reitz frequently, I was a junior in high school at the time. He has since retired, doubtlessly in no small part due to such conversations. But we still benefit from his wisdom.

As a result of having several good, active programs, a large population base, and excellent donor networks, there were 192 lung transplants performed in California in 2012. Yeah, you guessed it ... a little over 10% of all lung transplants occurring in the US that year. My personal opinion is that even a greater number of lung transplants could be performed in the state, given the quality and number of the organ donors available within California. For example, just consider the California Transplant Donor Network (CTDN) operating in Northern California: 150 to 160 lungs are procured by CTDN each year, 20% of which are exported out of the region to Centers as far away as Duke and Toronto. With all due respect to my exceptional colleagues at these two Programs, I would like to see them coming to California less for our donor lungs and more for social reasons!

The California lung transplant community welcomes the ISHLT back to San Diego in 2014, where the intellectual vigor and community vibrancy is as bright as a day at the beach in Coronado. We hope everyone enjoys the meeting and takes the time to enjoy all that California has to offer. See you there.

Disclosure Statement: The author has no conflicts of interest to disclose.

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