LUNG TRANSPLANTATION Overall

NUMBER OF LUNG TRANSPLANTS REPORTED BY YEAR AND PROCEDURE TYPE 13 15 47 80 185 408 685 902 1069 1206 1342 1337 1417 1413 1410 1508 1537 This figure includes only the lung transplants that are reported to the ISHLT Transplant Registry. Therefore, these numbers should not be interpreted as the rate of change in lung procedures performed worldwide.

NUMBER OF LUNG TRANSPLANTS REPORTED BY YEAR AND LOCATION This figure includes only the lung transplants that are reported to the ISHLT Transplant Registry. Therefore, these numbers should not be interpreted as the rate of change in lung procedures performed worldwide.

AVERAGE CENTER VOLUME Lung Transplants: January 1, 1998 - June 30, 2002

LUNG TRANSPLANTS: Donor Age by Year of Transplant

AGE DISTRIBUTION OF LUNG TRANSPLANT RECIPIENTS (1/1985-6/2002)

AGE DISTRIBUTION OF LUNG TRANSPLANT RECIPIENTS BY ERA The age distribution of lung transplant recipients was compared between the two eras using a chi-square test. 1985-1996 1/1997-6/2002

LUNG TRANSPLANTATION Actuarial Survival (Transplants: January 1990 - June 2001) Survival was calculated using the Kaplan-Meier method, which incorporates information from all transplants for whom any follow-up has been provided. Since many patients are still alive and some patients have been lost to follow-up, the survival rates are estimates rather than exact rates because the time of death is not know for all patients. The half-life is the estimated time point at which 50% of all of the recipients have died. The conditional half-life is the estimated time point at which 50% of the recipients who survive to at least 1 year have died. Because the decline in survival is greatest during the first year following transplantation, the conditional survival provides a more realistic expectation of survival time for recipients who survive the early post-transplant period. Survival rates were compared using the log-rank test statistic.

LUNG TRANSPLANTATION Adult Recipients

ADULT LUNG TRANSPLANTATION: Indications (1/1995-6/2002) DIAGNOSIS SLT (N = 5,000) BLT (N = 4,488) TOTAL (N = 9,488) COPD/Emphysema 2,698 ( 54.0% ) 1,000 ( 22.0% ) 3,698 ( 39.0% ) IPF 1,186 ( 24.0% ) 403 ( 9.0% ) 1,589 ( 17.0% ) CF 49 ( 1.0% ) 1,447 ( 32.0% ) 1,496 ( 16.0% ) Alpha-1 429 ( 8.6% ) 434 ( 9.7% ) 863 ( 9.1% ) PPH 66 ( 1.3% ) 361 ( 8.0% ) 427 ( 4.5% ) Sarcoidosis 127 ( 2.5% ) 113 ( 2.5% ) 240 ( 2.5% ) Bronchiectasis 11 ( 0.2% ) 192 ( 4.3% ) 203 ( 2.1% ) Congenital Heart Disease 10 ( 0.2% ) 99 ( 2.2% ) 109 ( 1.1% ) LAM 45 ( 0.9% ) 58 ( 1.3% ) 103 ( 1.1% ) Re-TX: OB 47 ( 0.9% ) 47 ( 1.0% ) 94 ( 1.0% ) OB (Non-ReTX) 30 ( 0.6% ) 52 ( 1.2% ) 82 ( 0.9% ) Re-TX: Non-OB 35 ( 0.7% ) 37 ( 0.8% ) 72 ( 0.8% ) Connective Tissue Disorder 21 ( 0.4% ) 22 ( 0.5% ) 43 ( 0.5% ) Cancer 3 ( 0.1% ) 25 ( 0.6% ) 28 ( 0.3% ) Histiocytosis X 8 ( 0.2% ) 19 ( 0.2% ) Other 232 ( 4.6% ) 190 ( 4.2% ) 422 ( 4.4% )

ADULT LUNG TRANSPLANTATION: Indications (Transplants: January 1995 - June 2002) Single Lung Transplants Bilateral/Double Lung Transplants

ADULT LUNG TRANSPLANTATION Indications By Year

ADULT LUNG TRANSPLANTATION Actuarial Survival by Era (Transplants: January 1988 – June 2001) Survival comparisons by era 1988-1992 vs. 1993-1997: p = 0.008 1988-1992 vs. 1998-2001: p < 0.0001 1993-1997 vs. 1998-2001: p = 0.3 Survival was calculated using the Kaplan-Meier method, which incorporates information from all transplants for whom any follow-up has been provided. Since many patients are still alive and some patients have been lost to follow-up, the survival rates are estimates rather than exact rates because the time of death is not know for all patients. Survival rates were compared using the log-rank test statistic.

ADULT LUNG TRANSPLANTATION Actuarial Survival by Age Group (Transplants: January 1990 – June 2001) Survival was calculated using the Kaplan-Meier method, which incorporates information from all transplants for whom any follow-up has been provided. Since many patients are still alive and some patients have been lost to follow-up, the survival rates are estimates rather than exact rates because the time of death is not know for all patients. The half-life is the estimated time point at which 50% of all of the recipients have died. Survival rates were compared using the log-rank test statistic.

ADULT LUNG TRANSPLANTATION Actuarial Survival By Diagnosis (Transplants: January 1990 – June 2001) Survival was calculated using the Kaplan-Meier method, which incorporates information from all transplants for whom any follow-up has been provided. Since many patients are still alive and some patients have been lost to follow-up, the survival rates are estimates rather than exact rates because the time of death is not know for all patients. The half-life is the estimated time point at which 50% of all of the recipients have died. Survival rates were compared using the log-rank test statistic.

ADULT LUNG TRANSPLANTATION Actuarial Survival By Diagnosis Conditional on Survival to 3 Months (Transplants: January 1990 – June 2001) Survival was calculated using the Kaplan-Meier method, which incorporates information from all transplants for whom any follow-up has been provided. Since many patients are still alive and some patients have been lost to follow-up, the survival rates are estimates rather than exact rates because the time of death is not know for all patients. This figure shows survival conditional on survival to 3 months. Therefore, only patients surviving to at least 3 months were included in the calculation. The conditional half-life is the estimated time point at which 50% of the recipients who survive to at least 3 months have died.

ADULT LUNG TRANSPLANTATION Actuarial Survival By Diagnosis Conditional on Survival to 1 Year (Transplants: January 1990 – June 2001) Survival was calculated using the Kaplan-Meier method, which incorporates information from all transplants for whom any follow-up has been provided. Since many patients are still alive and some patients have been lost to follow-up, the survival rates are estimates rather than exact rates because the time of death is not know for all patients. This figure shows survival conditional on survival to 12 months. Therefore, only patients surviving to at least 12 months were included in the calculation. The conditional half-life is the estimated time point at which 50% of the recipients who survive to at least 12 months have died.

ADULT LUNG TRANSPLANTATION Actuarial Survival for Congenital Diagnosis (Transplants: January 1990 – June 2001) Survival was calculated using the Kaplan-Meier method.

ADULT LUNG TRANSPLANTATION Actuarial Survival By Procedure Type (Transplants: January 1990 – June 2001) Diagnosis: Alpha-1 Antitrypsin Deficiency Survival was calculated using the Kaplan-Meier method, which incorporates information from all transplants for whom any follow-up has been provided. Since many patients are still alive and some patients have been lost to follow-up, the survival rates are estimates rather than exact rates because the time of death is not know for all patients. Survival rates were compared using the log-rank test statistic. P = 0.008

ADULT LUNG TRANSPLANTATION Actuarial Survival by Procedure Type (Transplants: January 1990 – June 2001) Diagnosis: Emphysema/COPD Survival was calculated using the Kaplan-Meier method, which incorporates information from all transplants for whom any follow-up has been provided. Since many patients are still alive and some patients have been lost to follow-up, the survival rates are estimates rather than exact rates because the time of death is not know for all patients. Survival rates were compared using the log-rank test statistic. P < 0.0001

ADULT LUNG TRANSPLANTATION Actuarial Survival by Procedure Type (Transplants: January 1990 – June 2001) Diagnosis: IPF Survival was calculated using the Kaplan-Meier method, which incorporates information from all transplants for whom any follow-up has been provided. Since many patients are still alive and some patients have been lost to follow-up, the survival rates are estimates rather than exact rates because the time of death is not know for all patients. Survival rates were compared using the log-rank test statistic. P = 0.2

ADULT LUNG TRANSPLANTATION Actuarial Survival by Procedure Type (Transplants: January 1990 – June 2001) Diagnosis: PPH Survival was calculated using the Kaplan-Meier method, which incorporates information from all transplants for whom any follow-up has been provided. Since many patients are still alive and some patients have been lost to follow-up, the survival rates are estimates rather than exact rates because the time of death is not know for all patients. Survival rates were compared using the log-rank test statistic. P = 0.3

ADULT LUNG TRANSPLANTS (1995-6/2001) Risk Factors for 1 Year Mortality A multivariate logistic regression model was developed to determine factors that were significant predictors of mortality within 1 year of transplant. All transplants with any follow-up were analyzed; those with incomplete follow-up were incorporated using a weight proportional to the amount of time for which follow-up was provided. Continuous factors were modeled using a spline rather than linear and quadratic terms; this allows for a more flexible fit to the data. Risk factors with an odds ratio greater than 1 indicate an increased probability of mortality when compared to the baseline group. Generally, the baseline group is the most common group for categorical risk factors and the mean for continuous factors. An odds ratio less than 1 indicates a decreased probability of mortality. Since the odds ratios for continuous factors may be difficult to summarize, they are provided in figures instead of tabular format. (N=7,262)

ADULT LUNG TRANSPLANTS (1995-6/2001) Risk Factors for 1 Year Mortality A multivariate logistic regression model was developed to determine factors that were significant predictors of mortality within 1 year of transplant. All transplants with any follow-up were analyzed; those with incomplete follow-up were incorporated using a weight proportional to the amount of time for which follow-up was provided. Continuous factors were modeled using a spline rather than linear and quadratic terms; this allows for a more flexible fit to the data. Risk factors with an odds ratio greater than 1 indicate an increased probability of mortality when compared to the baseline group. Generally, the baseline group is the most common group for categorical risk factors and the mean for continuous factors. An odds ratio less than 1 indicates a decreased probability of mortality. Since the odds ratios for continuous factors may be difficult to summarize, they are provided in figures instead of tabular format. (N=7,262)

ADULT LUNG TRANSPLANTS (1/1995-6/2001) Risk Factors for 1 Year Mortality

ADULT LUNG TRANSPLANTS (1/1995-6/2001) Risk Factors for 1 Year Mortality Recipient Age A multivariate logistic regression model was developed to determine factors that were significant predictors of mortality within 1 year of transplant. All transplants with any follow-up were analyzed; those with incomplete follow-up were incorporated using a weight proportional to the amount of time for which follow-up was provided. Continuous factors were modeled using a spline rather than linear and quadratic terms; this allows for a more flexible fit to the data. Risk factors with an odds ratio greater than 1 indicate an increased probability of mortality when compared to the baseline group. Generally, the baseline group is the most common group for categorical risk factors and the mean for continuous factors. An odds ratio less than 1 indicates a decreased probability of mortality. Since the odds ratios for continuous factors may be difficult to summarize, they are provided in figures instead of tabular format.

ADULT LUNG TRANSPLANTS (1/1995-6/2001) Risk Factors for 1 Year Mortality Donor Age A multivariate logistic regression model was developed to determine factors that were significant predictors of mortality within 1 year of transplant. All transplants with any follow-up were analyzed; those with incomplete follow-up were incorporated using a weight proportional to the amount of time for which follow-up was provided. Continuous factors were modeled using a spline rather than linear and quadratic terms; this allows for a more flexible fit to the data. Risk factors with an odds ratio greater than 1 indicate an increased probability of mortality when compared to the baseline group. Generally, the baseline group is the most common group for categorical risk factors and the mean for continuous factors. An odds ratio less than 1 indicates a decreased probability of mortality. Since the odds ratios for continuous factors may be difficult to summarize, they are provided in figures instead of tabular format.

ADULT LUNG TRANSPLANTS (1/1995-6/2001) Risk Factors for 1 Year Mortality BMI Ratio = Donor BMI/Recipient BMI A multivariate logistic regression model was developed to determine factors that were significant predictors of mortality within 1 year of transplant. All transplants with any follow-up were analyzed; those with incomplete follow-up were incorporated using a weight proportional to the amount of time for which follow-up was provided. Continuous factors were modeled using a spline rather than linear and quadratic terms; this allows for a more flexible fit to the data. Risk factors with an odds ratio greater than 1 indicate an increased probability of mortality when compared to the baseline group. Generally, the baseline group is the most common group for categorical risk factors and the mean for continuous factors. An odds ratio less than 1 indicates a decreased probability of mortality. Since the odds ratios for continuous factors may be difficult to summarize, they are provided in figures instead of tabular format.

ADULT LUNG TRANSPLANTS (1/1995-6/2001) Risk Factors for 1 Year Mortality Center volume A multivariate logistic regression model was developed to determine factors that were significant predictors of mortality within 1 year of transplant. All transplants with any follow-up were analyzed; those with incomplete follow-up were incorporated using a weight proportional to the amount of time for which follow-up was provided. Continuous factors were modeled using a spline rather than linear and quadratic terms; this allows for a more flexible fit to the data. Risk factors with an odds ratio greater than 1 indicate an increased probability of mortality when compared to the baseline group. Generally, the baseline group is the most common group for categorical risk factors and the mean for continuous factors. An odds ratio less than 1 indicates a decreased probability of mortality. Since the odds ratios for continuous factors may be difficult to summarize, they are provided in figures instead of tabular format.

ADULT LUNG TRANSPLANTS (1/1995-6/2001) Risk Factors for 1 Year Mortality Ischemia time A multivariate logistic regression model was developed to determine factors that were significant predictors of mortality within 1 year of transplant. All transplants with any follow-up were analyzed; those with incomplete follow-up were incorporated using a weight proportional to the amount of time for which follow-up was provided. Continuous factors were modeled using a spline rather than linear and quadratic terms; this allows for a more flexible fit to the data. Risk factors with an odds ratio greater than 1 indicate an increased probability of mortality when compared to the baseline group. Generally, the baseline group is the most common group for categorical risk factors and the mean for continuous factors. An odds ratio less than 1 indicates a decreased probability of mortality. Since the odds ratios for continuous factors may be difficult to summarize, they are provided in figures instead of tabular format.

ADULT LUNG TRANSPLANTS (1/1995-6/2001) Risk Factors for 1 Year Mortality Creatinine A multivariate logistic regression model was developed to determine factors that were significant predictors of mortality within 1 year of transplant. All transplants with any follow-up were analyzed; those with incomplete follow-up were incorporated using a weight proportional to the amount of time for which follow-up was provided. Continuous factors were modeled using a spline rather than linear and quadratic terms; this allows for a more flexible fit to the data. Risk factors with an odds ratio greater than 1 indicate an increased probability of mortality when compared to the baseline group. Generally, the baseline group is the most common group for categorical risk factors and the mean for continuous factors. An odds ratio less than 1 indicates a decreased probability of mortality. Since the odds ratios for continuous factors may be difficult to summarize, they are provided in figures instead of tabular format.

ADULT LUNG TRANSPLANTS (1/1995-6/2001) Risk Factors for 1 Year Mortality Oxygen required at rest A multivariate logistic regression model was developed to determine factors that were significant predictors of mortality within 1 year of transplant. All transplants with any follow-up were analyzed; those with incomplete follow-up were incorporated using a weight proportional to the amount of time for which follow-up was provided. Continuous factors were modeled using a spline rather than linear and quadratic terms; this allows for a more flexible fit to the data. Risk factors with an odds ratio greater than 1 indicate an increased probability of mortality when compared to the baseline group. Generally, the baseline group is the most common group for categorical risk factors and the mean for continuous factors. An odds ratio less than 1 indicates a decreased probability of mortality. Since the odds ratios for continuous factors may be difficult to summarize, they are provided in figures instead of tabular format.

ADULT LUNG TRANSPLANTS (1/1995-6/2001) Risk Factors for 1 Year Mortality Predicted FeV1% for IPF patients A multivariate logistic regression model was developed to determine factors that were significant predictors of mortality within 1 year of transplant. All transplants with any follow-up were analyzed; those with incomplete follow-up were incorporated using a weight proportional to the amount of time for which follow-up was provided. Continuous factors were modeled using a spline rather than linear and quadratic terms; this allows for a more flexible fit to the data. Risk factors with an odds ratio greater than 1 indicate an increased probability of mortality when compared to the baseline group. Generally, the baseline group is the most common group for categorical risk factors and the mean for continuous factors. An odds ratio less than 1 indicates a decreased probability of mortality. Since the odds ratios for continuous factors may be difficult to summarize, they are provided in figures instead of tabular format.

ADULT LUNG TRANSPLANTS (1/1995-6/2001) Risk Factors for 1 Year Mortality Bilirubin A multivariate logistic regression model was developed to determine factors that were significant predictors of mortality within 1 year of transplant. All transplants with any follow-up were analyzed; those with incomplete follow-up were incorporated using a weight proportional to the amount of time for which follow-up was provided. Continuous factors were modeled using a spline rather than linear and quadratic terms; this allows for a more flexible fit to the data. Risk factors with an odds ratio greater than 1 indicate an increased probability of mortality when compared to the baseline group. Generally, the baseline group is the most common group for categorical risk factors and the mean for continuous factors. An odds ratio less than 1 indicates a decreased probability of mortality. Since the odds ratios for continuous factors may be difficult to summarize, they are provided in figures instead of tabular format.

ADULT LUNG TRANSPLANTS (1995-6/2001) Factors Not Significant for 1 Year Mortality Recipient factors: Hospitalized, pCO2, gender, chronic steroid use, transfusions, history of malignancy, recent infection requiring IV drug therapy Donor factors: Gender, clinical infection, history of hypertension, history of cancer, COD Transplant factors: Procedure type, ABO compatibility, HLA mismatch, year of transplant

ADULT LUNG TRANSPLANTS (1995-6/1997) Risk Factors for 5 Year Mortality A multivariate logistic regression model was developed to determine factors that were significant predictors of mortality within 5 years of transplant. All transplants with any follow-up were analyzed; those with incomplete follow-up were incorporated using a weight proportional to the amount of time for which follow-up was provided. Continuous factors were modeled using a spline rather than linear and quadratic terms; this allows for a more flexible fit to the data. Risk factors with an odds ratio greater than 1 indicate an increased probability of mortality when compared to the baseline group. Generally, the baseline group is the most common group for categorical risk factors and the mean for continuous factors. An odds ratio less than 1 indicates a decreased probability of mortality. Since the odds ratios for continuous factors may be difficult to summarize, they are provided in figures instead of tabular format. (N=2,771)

ADULT LUNG TRANSPLANTS (1/1995-6/1997) Risk Factors for 5 Year Mortality

ADULT LUNG TRANSPLANTS (1/1995-6/1997) Risk Factors for 5 Year Mortality Recipient Age A multivariate logistic regression model was developed to determine factors that were significant predictors of mortality within 5 years of transplant. All transplants with any follow-up were analyzed; those with incomplete follow-up were incorporated using a weight proportional to the amount of time for which follow-up was provided. Continuous factors were modeled using a spline rather than linear and quadratic terms; this allows for a more flexible fit to the data. Risk factors with an odds ratio greater than 1 indicate an increased probability of mortality when compared to the baseline group. Generally, the baseline group is the most common group for categorical risk factors and the mean for continuous factors. An odds ratio less than 1 indicates a decreased probability of mortality. Since the odds ratios for continuous factors may be difficult to summarize, they are provided in figures instead of tabular format.

ADULT LUNG TRANSPLANTS (1/1995-6/1997) Risk Factors for 5 Year Mortality Donor Age A multivariate logistic regression model was developed to determine factors that were significant predictors of mortality within 5 years of transplant. All transplants with any follow-up were analyzed; those with incomplete follow-up were incorporated using a weight proportional to the amount of time for which follow-up was provided. Continuous factors were modeled using a spline rather than linear and quadratic terms; this allows for a more flexible fit to the data. Risk factors with an odds ratio greater than 1 indicate an increased probability of mortality when compared to the baseline group. Generally, the baseline group is the most common group for categorical risk factors and the mean for continuous factors. An odds ratio less than 1 indicates a decreased probability of mortality. Since the odds ratios for continuous factors may be difficult to summarize, they are provided in figures instead of tabular format.

ADULT LUNG TRANSPLANTS (1/1995-6/1997) Risk Factors for 5 Year Mortality Bilirubin A multivariate logistic regression model was developed to determine factors that were significant predictors of mortality within 5 years of transplant. All transplants with any follow-up were analyzed; those with incomplete follow-up were incorporated using a weight proportional to the amount of time for which follow-up was provided. Continuous factors were modeled using a spline rather than linear and quadratic terms; this allows for a more flexible fit to the data. Risk factors with an odds ratio greater than 1 indicate an increased probability of mortality when compared to the baseline group. Generally, the baseline group is the most common group for categorical risk factors and the mean for continuous factors. An odds ratio less than 1 indicates a decreased probability of mortality. Since the odds ratios for continuous factors may be difficult to summarize, they are provided in figures instead of tabular format.

ADULT LUNG TRANSPLANTS (1/1995-6/1997) Risk Factors for 5 Year Mortality PA Systolic A multivariate logistic regression model was developed to determine factors that were significant predictors of mortality within 5 years of transplant. All transplants with any follow-up were analyzed; those with incomplete follow-up were incorporated using a weight proportional to the amount of time for which follow-up was provided. Continuous factors were modeled using a spline rather than linear and quadratic terms; this allows for a more flexible fit to the data. Risk factors with an odds ratio greater than 1 indicate an increased probability of mortality when compared to the baseline group. Generally, the baseline group is the most common group for categorical risk factors and the mean for continuous factors. An odds ratio less than 1 indicates a decreased probability of mortality. Since the odds ratios for continuous factors may be difficult to summarize, they are provided in figures instead of tabular format.

ADULT LUNG TRANSPLANTS (1/1995-6/1997) Risk Factors for 5 Year Mortality pCO2 A multivariate logistic regression model was developed to determine factors that were significant predictors of mortality within 5 years of transplant. All transplants with any follow-up were analyzed; those with incomplete follow-up were incorporated using a weight proportional to the amount of time for which follow-up was provided. Continuous factors were modeled using a spline rather than linear and quadratic terms; this allows for a more flexible fit to the data. Risk factors with an odds ratio greater than 1 indicate an increased probability of mortality when compared to the baseline group. Generally, the baseline group is the most common group for categorical risk factors and the mean for continuous factors. An odds ratio less than 1 indicates a decreased probability of mortality. Since the odds ratios for continuous factors may be difficult to summarize, they are provided in figures instead of tabular format.

ADULT LUNG TRANSPLANTS (1995-6/1997) Factors Not Significant for 5 Year Mortality Recipient factors: Ventilator, inotropes, hospitalized, chronic steroid use, transfusions, history of malignancy, PRA, gender, FeV1, FVC, repeat transplant Donor factors: Gender, clinical infection, history of hypertension, history of cancer, history of diabetes, COD Transplant factors: Procedure type, ABO compatibility, HLA mismatch

ADULT LUNG TRANSPLANTS (1995-6/1997) Risk Factors for 5 Year Mortality Conditional on Survival to 1 Year Because much of the mortality seen within 5 years occurs during the first year following transplant, the risk factors for 5-year mortality are closely related to those seen for 1-year mortality. To determined factors that play a role in the longer term survival, a multivariate logistic regression model was developed to determine factors that were significant predictors of mortality between 1 and 5 years of transplant. All transplants surviving to 1 year with any follow-up after that time were analyzed; those with incomplete follow-up were incorporated using a weight proportional to the amount of time for which follow-up was provided. Continuous factors were modeled using a spline rather than linear and quadratic terms; this allows for a more flexible fit to the data. Risk factors with an odds ratio greater than 1 indicate an increased probability of mortality when compared to the baseline group. Generally, the baseline group is the most common group for categorical risk factors and the mean for continuous factors. An odds ratio less than 1 indicates a decreased probability of mortality. Since the odds ratios for continuous factors may be difficult to summarize, they are provided in figures instead of tabular format. (N=1,899)

ADULT LUNG TRANSPLANTS (1/1995-6/1997) Risk Factors for 5 Year Mortality Conditional on Survival to 1 Year

ADULT LUNG TRANSPLANTS (1/1995-6/1997) Risk Factors for 5 Year Mortality Condtional on Survival to 1 Year Recipient Age Because much of the mortality seen within 5 years occurs during the first year following transplant, the risk factors for 5-year mortality are closely related to those seen for 1-year mortality. To determined factors that play a role in the longer term survival, a multivariate logistic regression model was developed to determine factors that were significant predictors of mortality between 1 and 5 years of transplant. All transplants surviving to 1 year with any follow-up after that time were analyzed; those with incomplete follow-up were incorporated using a weight proportional to the amount of time for which follow-up was provided. Continuous factors were modeled using a spline rather than linear and quadratic terms; this allows for a more flexible fit to the data. Risk factors with an odds ratio greater than 1 indicate an increased probability of mortality when compared to the baseline group. Generally, the baseline group is the most common group for categorical risk factors and the mean for continuous factors. An odds ratio less than 1 indicates a decreased probability of mortality. Since the odds ratios for continuous factors may be difficult to summarize, they are provided in figures instead of tabular format.

ADULT LUNG TRANSPLANTS (1/1995-6/1997) Risk Factors for 5 Year Mortality Conditional on Survival to 1 Year Donor Age Because much of the mortality seen within 5 years occurs during the first year following transplant, the risk factors for 5-year mortality are closely related to those seen for 1-year mortality. To determined factors that play a role in the longer term survival, a multivariate logistic regression model was developed to determine factors that were significant predictors of mortality between 1 and 5 years of transplant. All transplants surviving to 1 year with any follow-up after that time were analyzed; those with incomplete follow-up were incorporated using a weight proportional to the amount of time for which follow-up was provided. Continuous factors were modeled using a spline rather than linear and quadratic terms; this allows for a more flexible fit to the data. Risk factors with an odds ratio greater than 1 indicate an increased probability of mortality when compared to the baseline group. Generally, the baseline group is the most common group for categorical risk factors and the mean for continuous factors. An odds ratio less than 1 indicates a decreased probability of mortality. Since the odds ratios for continuous factors may be difficult to summarize, they are provided in figures instead of tabular format.

ADULT LUNG TRANSPLANTS (1/1995-6/1997) Risk Factors for 5 Year Mortality Conditional on Survival to 1 Year Recipient Height Because much of the mortality seen within 5 years occurs during the first year following transplant, the risk factors for 5-year mortality are closely related to those seen for 1-year mortality. To determined factors that play a role in the longer term survival, a multivariate logistic regression model was developed to determine factors that were significant predictors of mortality between 1 and 5 years of transplant. All transplants surviving to 1 year with any follow-up after that time were analyzed; those with incomplete follow-up were incorporated using a weight proportional to the amount of time for which follow-up was provided. Continuous factors were modeled using a spline rather than linear and quadratic terms; this allows for a more flexible fit to the data. Risk factors with an odds ratio greater than 1 indicate an increased probability of mortality when compared to the baseline group. Generally, the baseline group is the most common group for categorical risk factors and the mean for continuous factors. An odds ratio less than 1 indicates a decreased probability of mortality. Since the odds ratios for continuous factors may be difficult to summarize, they are provided in figures instead of tabular format.

ADULT LUNG TRANSPLANTS (1995-6/1997) Factors Not Significant for Conditional 5 Year Mortality Recipient factors: Diagnosis, ventilator, inotropes, hospitalized, pCO2, gender, chronic steroid use, transfusions, history of malignancy, PRA, repeat transplant, FeV1, FVC Donor factors: Gender, clinical infection, history of hypertension, history of cancer, history of diabetes, COD Transplant factors: ABO compatibility, HLA mismatch, CMV mismatch

ADULT LUNG TRANSPLANTS (1995-6/1997) Factors Not Significant for Conditional 5 Year Mortality Post-transplant factors: Treated for rejection, stroke, dialysis, prolonged graft dysfunction, bronchopleural fistula, airway dehiscence

ADULT LUNG RECIPIENTS Functional Status (Follow-ups: April 1994 – June 2002) This figure shows the functional status reported on the 1-year, 3-year and 5-year annual follow-ups. Because all follow-ups between April 1994 and June 2002 were included, the bars do not include the same patients.

ADULT LUNG RECIPIENTS Employment Status (Follow-ups: April 1994 – June 2002) This figure shows the employment status reported on the 1-year, 3-year and 5-year annual follow-ups. Because all follow-ups between April 1994 and June 2002 were included, the bars do not include the same patients.

ADULT LUNG RECIPIENTS: Rehospitalization Post-transplant (Follow-ups: April 1994 - June 2002) This figure shows the hospitalizations reported on the 1-year, 3-year and 5-year annual follow-ups, representing the hospitalizations between discharge and 1 year, between the 2-year and 3-year follow-up, and between the 4-year and 5-year follow-up, respectively. Because all follow-ups between April 1994 and June 2002 were included, the bars do not include the same patients.

ADULT LUNG RECIPIENTS Induction Immunosuppression (Follow-ups: January 2000 - June 2002)

ADULT LUNG RECIPIENTS Induction Immunosuppression (Follow-ups: January 2000 - June 2002)

ADULT LUNG RECIPIENTS Maintenance Immunosuppression At Any Time During Follow-up Period For follow-ups between January 2000 through June 2002 This figure shows the maintenance immunosuppression reported as being provided at any time during the most recent year on the 1-year and 5-year annual follow-up forms. To provide a snapshot of current practice, only follow-ups occurring between January 2000 and June 2002 were included. Therefore, this figure does not represent changes in practice between the 1-year follow-up and 5-year follow-up on a cohort of patients. The patients in the 1-year tabulation are not the same patients as in the 5-year tabulation. NOTE: Different patients are analyzed in Year 1 and Year 5

ADULT LUNG RECIPIENTS Maintenance Immunosuppression At Time of Follow-up For follow-ups between January 2000 through June 2002 This figure shows the maintenance immunosuppression reported as being provided at the time of the 1-year and 5-year annual follow-up forms. To provide a snapshot of current practice, only follow-ups occurring between January 2000 and June 2002 were included. Therefore, this figure does not represent changes in practice between the 1-year follow-up and 5-year follow-up on a cohort of patients. The patients in the 1-year tabulation are not the same patients as in the 5-year tabulation. NOTE: Different patients are analyzed in Year 1 and Year 5

ADULT LUNG RECIPIENTS Maintenance Immunosuppression at Time of Follow-up For follow-ups between January 2000 through June 2002 This figure shows the maintenance immunosuppression reported as being provided at the time of the 1-year and 5-year annual follow-up forms. To provide a snapshot of current practice, only follow-ups occurring between January 2000 and June 2002 were included. Therefore, this figure does not represent changes in practice between the 1-year follow-up and 5-year follow-up on a cohort of patients. The patients in the 1-year tabulation are not the same patients as in the 5-year tabulation. 1 Year Follow-up (N = 1,501) 5 Year Follow-up (N = 721) NOTE: Different patients are analyzed in Year 1 and Year 5

ADULT LUNG RECIPIENTS Maintenance Immunosuppression Drug Combinations at Time of Follow-up For follow-ups between January 2000 through June 2002 This figure shows the maintenance immunosuppression reported as being provided at the time of the 1-year and 5-year annual follow-up forms. To provide a snapshot of current practice, only follow-ups occurring between January 2000 and June 2002 were included. Therefore, this figure does not represent changes in practice between the 1-year follow-up and 5-year follow-up on a cohort of patients. The patients in the 1-year tabulation are not the same patients as in the 5-year tabulation. NOTE: Different patients are analyzed in Year 1 and Year 5

POST-LUNG TRANSPLANT MORBIDITY FOR ADULTS Cumulative Prevalence in Survivors within 1 Year Post-Transplant (Follow-ups: April 1994-June 2002) This table shows the percentage of patients experiencing various morbidities as reported on the 1-year annual follow-up form. The percentages are based on patients with known responses. Because the outcomes are reported to be unknown at different rates the number with known responses for each outcome are also provided.

POST-LUNG TRANSPLANT MORBIDITY FOR ADULTS Cumulative Prevalence in Survivors within 5 Years Post-Transplant (Follow-ups: April 1994-June 2002) This table shows the percentage of patients experiencing various morbidities as reported within 5 years following transplantation. The percentages are based on patients with known responses. To reduce bias, only patients with responses reported on every follow-up through the 5-year annual follow-up were included. Because the outcomes are reported to be unknown at different rates the number with known responses for each outcome are also provided.

Freedom from Bronchiolitis Obliterans For Adult Lung Recipients (Follow-ups: April 1994-June 2002) Freedom from bronchiolitis obliterans rates were computed using the Kaplan-Meier method. The development of bronchiolitis obliterans is reported on annual follow-ups; a date of diagnosis is not provided. For this figure the date of follow-up was used as the date of occurrence. Patients were included in the analysis until an unknown response for bronchiolitis obliterans was reported. Therefore, the rates seen here may differ from those reported in the cumulative prevalence slide which is based on only those patients with known responses for bronchiolitis obliterans at all follow-up time points.

Freedom from Severe Renal Dysfunction Freedom from Severe Renal Dysfunction* For Adult Lung Recipients (Follow-ups: April 1994-June 2002) * Severe renal dysfunction = Creatinine > 2.5 mg/dl, dialysis or renal transplant Freedom from severe renal dysfunction rates were computed using the Kaplan-Meier method. The development of severe renal dysfunction is reported on annual follow-ups; a date of diagnosis is not provided. For this figure the date of follow-up was used as the date of occurrence. Patients were included in the analysis until an unknown response for severe renal dysfunction was reported. Therefore, the rates seen here may differ from those reported in the cumulative prevalence slide which is based on only those patients with known responses for severe renal dysfunction at all follow-up time points.

MALIGNANCY POST-LUNG TRANSPLANTATION FOR ADULTS Cumulative Prevalence in Survivors (Follow-ups: April 1994 - June 2002) Malignancy/Type 1-Year Survivors 5-Year Survivors No Malignancy 5104 (96.1%) 886 (86.9%) Malignancy (all types combined) 209 (3.9%) 134 (13.1%) Malignancy Type Skin 44 61 Lymph 109 21 Other 35 32 Lymph + Skin 3 Lymph + Other 5 Skin + Other 2 Type Not Reported 10 This table shows the percentage of patients with malignancies reported within 1 and 5 years following transplantation. The percentages are based on patients with known responses. To reduce bias, only patients with responses reported on every follow-up through the 5-year annual follow-up were included in the “5-Year Survivors” column.

Freedom from Malignancy For Adult Lung Recipients (Follow-ups: April 1994-June 2002) Freedom from malignancy rates were computed using the Kaplan-Meier method. The development of malignancy is reported on annual follow-ups; a date of diagnosis is not provided. For this figure the date of follow-up was used as the date of occurrence. Patients were included in the analysis until an unknown response for malignancy was reported. Therefore, the rates seen here may differ from those reported in the cumulative prevalence slide which is based on only those patients with known responses for malignancy at all follow-up time points.

ADULT LUNG TRANSPLANTS (1995-6/1997) Risk Factors for Developing Malignancy within 5 Years A multivariate logistic regression model was developed to determine factors that were significant predictors of developing a malignancy within 5 years of transplant. Since the date of malignancy diagnosis is not collected, the follow-up date on which malignancy was first reported was used as the date of diagnosis. All transplants with any follow-up were analyzed; those with incomplete follow-up were incorporated using a weight proportional to the amount of time for which follow-up was provided. Continuous factors were modeled using a spline rather than linear and quadratic terms; this allows for a more flexible fit to the data. (N=1,514)

ADULT LUNG TRANSPLANTS (1/1995-6/1997) Risk Factors for Developing Malignancy within 5 Years

ADULT LUNG TRANSPLANTS (1/1995-6/1997) Risk Factors for Developing Malignancy within 5 Years Recipient Age A multivariate logistic regression model was developed to determine factors that were significant predictors of developing a malignancy within 5 years of transplant. Since the date of malignancy diagnosis is not collected, the follow-up date on which malignancy was first reported was used as the date of diagnosis. All transplants with any follow-up were analyzed; those with incomplete follow-up were incorporated using a weight proportional to the amount of time for which follow-up was provided. Continuous factors were modeled using a spline rather than linear and quadratic terms; this allows for a more flexible fit to the data.

ADULT LUNG TRANSPLANTS (1/1995-6/1997) Risk Factors for Developing Malignancy within 5 Years Donor Age A multivariate logistic regression model was developed to determine factors that were significant predictors of developing a malignancy within 5 years of transplant. Since the date of malignancy diagnosis is not collected, the follow-up date on which malignancy was first reported was used as the date of diagnosis. All transplants with any follow-up were analyzed; those with incomplete follow-up were incorporated using a weight proportional to the amount of time for which follow-up was provided. Continuous factors were modeled using a spline rather than linear and quadratic terms; this allows for a more flexible fit to the data.

ADULT LUNG TRANSPLANT RECIPIENTS: Cause Of Death (Deaths: January 1992- June 2002) 0-30 Days (N = 937) 31 Days - 1 Year (N = 1,345) >1 Year - 3 Years (N = 1,096) >3 Years - 5 Years (N = 572) >5 Years (N = 456) BRONCHIOLITIS 5 (0.5%) 74 (5.5%) 313 (28.6%) 185 (32.3%) 142 (31.1%) ACUTE REJECTION 46 (4.9%) 27 (2.0%) 21 (1.9%) 4 (0.7%) 2 (0.4%) LYMPHOMA 1 (0.1%) 44 (3.3%) 23 (2.1%) 9 (1.6%) 18 (3.9%) MALIGNANCY, OTHER 52 (4.7%) 43 (7.5%) 40 (8.8%) CMV 56 (4.2%) 17 (1.6%) INFECTION, NON-CMV 220 (23.5%) 521 (38.7%) 284 (25.9%) 113 (19.8%) 79 (17.3%) GRAFT FAILURE 286 (30.5%) 236 (17.5%) 175 (16.0%) 99 (17.3%) 58 (12.7%) CARDIOVASCULAR 108 (11.5%) 58 (4.3%) 36 (3.3%) 24 (4.2%) 21 (4.6%) TECHNICAL 78 (8.3%) 37 (2.8%) 12 (1.1%) 1 (0.2%) OTHER 192 (20.5%) 265 (19.7%) 163 (14.9%) 90 (15.7%) 92 (20.2%)