Lung transplantation in Europe: access and equity
Lung transplantation can be a life-saving option for people with severe lung disease when other treatments are no longer effective. This page looks at lung transplantation from a European perspective. It highlights how access differs between countries and the barriers that people may face in receiving this treatment. The information here aims to support greater awareness and advocacy for fair and timely access to lung transplantation across Europe.
You can also access more information about organ donation and about lung transplantation, including personal experiences.
Content Table
Lung transplantation in Europe
Lung transplantation offers a life-saving treatment for people living with advanced lung conditions. However, access varies across Europe. Where someone lives can determine who receives a transplant and who does not.
Understanding these differences and why they happen is essential to improving outcomes and equity across healthcare systems, ensuring that patients receive timely transplantation, regardless of where they live.
The current landscape of lung transplantation
As part of the Chair’s Campaign, ELF conducted two surveys to map lung transplantation across Europe: one gathering perspectives from people with lived experience of lung disease and their carers and another collecting data from transplant centres on capacity, services, and practices. You can scroll through the results below.
For an overview of transplant centre locations and activities across Europe, the interactive map from the European Society for Organ Transplantation (ESOT) provides detailed information on transplant services by country.
Insights from patients and carers across Europe
Insights from lung transplant centres across Europe
Perspectives on lung transplantation
This video brings together perspectives from across the lung health community, featuring insights from the European Lung Foundation Chair, Dimitris Kontopidis, Lena Polychroni, a person with lived experience of transplantation and Professor Michael Perch, a healthcare professional working in the field.
Together, they discuss the current state of lung transplantation in Europe, the barriers that persist and what must change to ensure equitable access for all who need it.
Inequalities and barriers to access
In healthcare, inequities mean that some people receive worse care or have poorer health outcomes not because of their medical needs, but because of where they live, their income, or other circumstances beyond their control.
There are many factors, relating to a country's healthcare systems and structure, that contribute to unequal access to lung transplantation across Europe. These include:
Lack of national transplant programmes
Several European countries have no established lung transplant services, which means some people miss out on the option of transplantation or they have to seek care abroad.
Referrals
There are different referral pathways in different countries, and some countries face significant delays for accessing specialist care, meaning that people are not evaluated in a timely or consistent way.
Distance to centres
People in rural regions face significant travel burdens, affecting their first assessment and ongoing post-transplant follow-up.
Organ donation rates
There is wide variation in national donation rates and opt-in versus opt-out systems directly impacts organ availability and waiting times.
Funding issues
Differences in healthcare costs create barriers for people seeking cross-border care.
Workforce and infrastructure shortages
There are limited transplant surgeons, lung specialists (pulmonologists) and intensive care capacity, which can delay programme expansion in many regions.
Cross-border access challenges
Issues with policies, administration and language can complicate the process of finding transplantation options in other countries, despite EU policies designed to help cross-border healthcare.
Improving lung transplantation in Europe
There are multiple actions that are needed to improve this variation in lung transplantation. These include:
Strengthening national transplant programmes
Setting up or expanding transplant services, ensuring good staffing and long-term sustainability.
Expanding training programmes
Programmes could build on successful models like the Medical University of Vienna’s lung transplant academy, which offers twice-yearly training programmes and 6- to 12-month scholarships. This approach has helped establish independent transplant programmes in countries including Czech Republic, Hungary, Estonia, Slovenia, Croatia, Greece, and Ukraine, demonstrating how specialised training centres can strengthen transplantation capacity across Europe. This work was pioneered by Walter Klepetko, who earned the ELF Award in 2024 for this initiative.
Improving organ donation systems
Using evidence-based approaches, such as opt-out systems and public awareness campaigns.
Better referral and shared care
Developing clear referral guidelines and improving access to transplantation.
European collaboration and data sharing
Improving records of lung transplantation (registries), sharing knowledge between transplant centres and better support for cross-border care.
Policy and funding priorities
Ensuring EU and national policies are prioritising transplantation.
Call to action
Healthcare systems, policymakers, patient organisations and professional societies must work together to ensure equitable access to lung transplantation across Europe so that all people have equal access to lung transplantation, based on their need rather than their geographic location.
Further resources
- Learn about organ donation
- Learn about lung transplantation for patients
