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THE AUSTRALIA AND NEW ZEALAND CARDIOTHORACIC ORGAN TRANSPLANT REGISTRY EIGHTEENTH ANNUAL REPORT 1984 – 2013 ANZCOTR 2013
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NUMBER OF ALL TRANSPLANT TYPES BY YEAR 1984 - 2013 ANZCOTR 2013
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NUMBER OF ALL TRANSPLANTS* 1984 - 2013 ANZCOTR 2013 *Includes domino, heterotopic and retransplants
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ALL HEART TRANSPLANTS BY HOSPITAL 1984 - 2013
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HEART LUNG TRANSPLANTS BY HOSPITAL 1986 - 2013 ANZCOTR 2013 Prince Charles 2005 figure includes one retransplant
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SINGLE LUNG TRANSPLANTS BY HOSPITAL 1990 - 2013 ANZCOTR 2013
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BILATERAL LUNG TRANSPLANTS BY HOSPITAL 1992 - 2013 ANZCOTR 2013 Includes retransplants
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COMBINED WAITING LIST ACTIVITY 2013 ANZCOTR 2013 *Contains complete calendar year activity from all Registry Participant Centres. nb lungs column includes heart/lung procedures HEARTS TOTALLUNGS TOTAL Active as at 1 January 201378107 New Additions during 2013105227 From on hold to Active Jan 2013 Removals from Waiting List (Permanent) W1 - Transplant Performed86188 W2 - Patients condition Improved52 W3 - Too ill, new dev of contraindications etc1210 W4 - Patient declined11 W5 - Transferred to another interstate list10 W6 - Died waiting1514 W7-Removed - unspecified 01 TOTAL at Year end - (Active) 31 December 201358108 Total at month end inactive - (On HOLD)910
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PRE TRANSPLANT DIAGNOSIS HEART 1984 - 2013 ISCHAEMIC HEART DISEASE 34% IDIOPATHIC DILATED CARDIOMYOPATHY 40% Viral CM / Myocarditis 3% Congenital HD 6% Other 13% Retransplant 1% Peripartum CM 1% ANZCOTR 2013 Familial CM 2%
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PRE TRANSPLANT DIAGNOSIS 1984 - 2013 n = 2384 ANZCOTR 2013
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PRE-TRANSPLANT STATUS HEARTS 1996 -2013 ANZCOTR 2013
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PRE-TRANSPLANT STATUS HEARTS 1993 - 2013 ANZCOTR 2013 STATUS - Year96979899012345678910111213 n=10310582757080828876897968907176 8486 NYHA III %705557606164506750433444593860284935 NYHA IV %172426202920321627 28218 78137 Inotropic support %9131215610121153 108949217 Intra-aortic Balloon Pump %111100215100000101 Ventricular Assist Device %3744464513262725 3228293540 Total Artificial Heart %000000000000001110
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DONOR / RECIPIENT STATE OF ORIGIN HEARTS 1984 - 2013 Number ANZCOTR 2013
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DONOR / RECIPIENT STATE OF ORIGIN HEARTS 1984 - 2013 ANZCOTR 2013
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Mean Waiting Time to Transplant HEARTS 1984 - 2013 DAYS YEAR ANZCOTR 2013
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WAITING DAYS TO HEART TRANSPLANT 1984-2013 ANZCOTR 2013
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Mean Recipient Age at Transplant HEARTS 1984 -2013 Year Age(yrs) ANZCOTR 2013
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RECIPIENT AGE AT HEART TRANSPLANT YEARS 1984 - 2013 ANZCOTR 2013
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Hearts Mean Donor Age 1984 - 2013 Year Age in years ANZCOTR 2013
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DONOR AGE HEARTS - YEARS 1984-2013 ANZCOTR 2013
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HEARTS - Mean Ischaemic Time 1984 - 2013 Minutes Year ANZCOTR 2013
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MEAN HEART ISCHAEMIC TIME - MINUTES 1984-2013 ANZCOTR 2013
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ACTUARIAL SURVIVAL - HEART TRANSPLANT 1984 - 2013 n* = Number alive at start of year ANZCOTR 2013
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ACTUARIAL SURVIVAL - HEART TRANSPLANT 1984 - 2013 Percent Survival YEAR ANZCOTR 2013 Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
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ACTUARIAL SURVIVAL – ORTHOTOPIC v HETEROTOPIC v DOMINO TRANSPLANTS 1984 - 2013 ANZCOTR 2013
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Actuarial Survival Orthotopic v Heterotopic v Domino Hearts 1984 - 2013 Percent Survival ANZCOTR 2013 Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
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ACTUARIAL SURVIVAL ALL HEARTS PERIOD COMPARISON 1984 – 2013 ANZCOTR 2013 Percent Survival p<0.001 Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
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ACTUARIAL SURVIVAL HEARTS PERIOD COMPARISON 1984 - 2013 ANZCOTR 2013 *N = NUMBER ALIVE AT START OF YEAR
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ACTUARIAL SURVIVAL PRE TRANSPLANT DIAGNOSIS 1984 - 2013 Percent ANZCOTR 2013 IDCM v IHD p<0.005 IHD v Others p<0.005 Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
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ACTUARIAL SURVIVAL PRE TRANSPLANT DIAGNOSIS HEARTS 1984 – 2013 ANZCOTR 2013
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ACTUARIAL SURVIVAL PRE-TRANSPLANT STATUS HEARTS 1984 - 2013 ANZCOTR 2013 Percent Survival Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel p=ns
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ACTUARIAL SURVIVAL PRE-TRANSPLANT STATUS HEARTS 1984 - 2013 ANZCOTR 2013
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ACTUARIAL SURVIVAL RECIPIENT AGE BY GENDER HEARTS 1984 - 2013 ANZCOTR 2013 *N= NUMBER ALIVE AT START OF YEAR
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ACTUARIAL SURVIVAL BY RECIPIENT AGE AND GENDER HEARTS 1984 - 2013 ANZCOTR 2013 Percent Survival MALES 0-39 yrsv MALES>39yrs p<0.005 MALES>39yrs v FEMALES>39yrs p <0.05 Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
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ACTUARIAL SURVIVAL DONOR AGE HEARTS 1984 - 2013 ANZCOTR 2013 * * 2 OF THE 16 CASES IN THE GREATER THAN 59 YEARS CATEGORY ARE HETEROTOPIC HEART TRANSPLANTS
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ACTUARIAL SURVIVAL DONOR AGE HEARTS 1984 - 2013 YEAR Percent Survival ANZCOTR 2013 2 OF THE 11 CASES IN THE GREATER THAN 59 YEARS CATEGORY ARE HETEROTOPIC HEART TRANSPLANTS Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel 0-16yrs v 40-49yrs p<0.001 0-16yrs v 50-59yrs p<0.005 17-39yrs v 40-49yrs p<0.001 17-39yrs v 50-59yrs p<0.009
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ACTUARIAL SURVIVAL DONOR GENDER HEARTS 1984 - 2013 ANZCOTR 2013
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ACTUARIAL SURVIVAL DONOR GENDER HEARTS 1984 - 2013 Year Percent Survival ANZCOTR 2013 p=ns Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
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ACTUARIAL SURVIVAL RECIPIENT GENDER HEARTS 1984 - 2013 ANZCOTR 2013
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ACTUARIAL SURVIVAL RECIPIENT GENDER HEARTS 1984 - 2013 Year Percent Survival ANZCOTR 2013 p=ns Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
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ACTUARIAL SURVIVAL ISCHAEMIC TIME HEARTS 1984 - 2013 ANZCOTR 2013
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ACTUARIAL SURVIVAL ISCHAEMIC TIME HEARTS 1984 - 2013 ANZCOTR 2013 p=ns Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
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ACTUARIAL SURVIVAL CROSSMATCH HEARTS 1984 - 2013 ANZCOTR 2013
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ACTUARIAL SURVIVAL CROSSMATCH HEARTS 1984 - 2013 Year Percent Survival ANZCOTR 2013 p < 0.01 Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
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ACTUARIAL SURVIVAL PEAK PANEL REACTIVE ANTIBODIES ALL HEARTS 1984 - 2013 ANZCOTR 2013
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ACTUARIAL SURVIVAL PEAK PRA ALL HEARTS 1984 - 2013 Year Percent Survival ANZCOTR 2013 p=ns Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
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ACTUARIAL SURVIVAL CMV STATUS HEARTS 1984 - 2013 ANZCOTR 2013
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ACTUARIAL SURVIVAL CMV STATUS HEARTS 1984 - 2013 Year Percent Survival ANZCOTR 2013 p=ns R+ve = R+veD+ve or R+veD-ve Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
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ACTUARIAL SURVIVAL HLA MISMATCH HEARTS 1984 - 2013 ANZCOTR 2013
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ACTUARIAL SURVIVAL HLA MISMATCH HEARTS 1984 - 2013 Year Percent Survival ANZCOTR 2013 p<0.05 Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
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ACTUARIAL SURVIVAL HLA DR LOCUS MISMATCH HEARTS 1984 - 2013 ANZCOTR 2013
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ACTUARIAL SURVIVAL HLA DR LOCUS MISMATCH HEARTS 1984 - 2013 Year Percent Survival ANZCOTR 2013 p= ns Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
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ACTUARIAL SURVIVAL MALIGNANCIES HEART 1984 - 2013 ANZCOTR 2013 *Survival of the group who were defined by having developed a malignancy
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ACTUARIAL SURVIVAL MALIGNANCIES HEARTS 1984 - 2013 Year Percent Survival ANZCOTR 2013 ptld v other mal p=<0.005 Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
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RECIPIENT CAUSE OF DEATH - HEARTS 1984 - 2013 n = 1114 TxCADMisc InfectionAcute Rejection Other Malignancies PTLDCVAHemorrhage No of Deaths ANZCOTR 2013 18% 27% 14% 10% 15% 4% 1% NSGF 7%
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CAUSE OF DEATH HEARTS 1984 - 2013 ANZCOTR 2013
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CAUSE OF DEATH ALL HEARTS <5 YEARS AFTER TX 1984-2013 ANZCOTR 2013 No% Infection10822 Misc (incl 4 no data8717 Rejection8617 Non Specific Graft Failure6714 Graft Atherosclerosis (TxCAD)5611 Non Lymphoid Malignancy306 Lymphoproliferative Disease133 CVA204 Haemorrhage122 Graft Atherosclerosis & Rejection92 Pulmonary Failure61 Pulmonary Hypertension21 Totals495100.0
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CAUSE OF DEATH ALL HEARTS ≥5 YEARS AFTER TX 1984-2013 No % Misc (incl data pending)17829 Graft Atherosclerosis (TxCAD)14523 Non Lymphoid Malignancy14123 Infection457 Lymphoproliferative Disease325 Rejection203 CVA224 Non Specific Graft Failure163 Pulmonary Failure61 Haemorrhage30.5 Graft Atherosclerosis & Rejection71 Pulmonary Hypertension10.5 Totals619100.0 ANZCOTR 2013
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MALIGNANCIES* - HEART n = 596 1984 - 2013 PTLD 16 % Other 84 % ANZCOTR 2013 *the count of initial diagnosis only
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MALIGNANCIES - HEART N=596 1984 - 2013 ANZCOTR 2013
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Reason for Transplant Heart Lung 1986 - 2013 PPH 26% Eisenmenger’s 21% Other PH 3% AAT deficiency 7% Emphysema 3% Congenital Heart Disease 14% Cystic Fibrosis 14% CFA 3% Bronchiectasis 2% Misc 7% ANZCOTR 2013
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REASON FOR TRANSPLANT HEART LUNG n = 182 1986 - 2013 ANZCOTR 2013 Primary Pulmonary Hypertension 47 Eisenmenger's Syndrome 37 Congenital Heart Disease 26 Cystic Fibrosis 25 Alpha-1-Antitrypsin Deficiency 13 Emphysema 6 Cryptogenic Fibrosing Alveolitis 5 Other Pulmonary Hypertension 6 Bronchiectasis 4 Miscellaneous 13 Total 182
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Reason for Transplant Single Lung 1990 - 2013 AAT 16% Emphysema 51% IPF 25% Misc 6% Bronchiectasis 1% Other PH / Eisenmengers / CF 1% ANZCOTR 2013
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REASON FOR TRANSPLANT SINGLE LUNG 1990 - 2013 n = 476 ANZCOTR 2013
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Reason for Transplant Bilateral Lung 1992 – 2013 n =1704 Cystic Fibrosis 33% Emphysema 27% IPF 10% Bronchiectasis 8% Misc 9% AAT 7% Other PH 1% PPH 4% ANZCOTR 2013 Eisenmengers 1%
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REASON FOR TRANSPLANT BILATERAL LUNG 1992 - 2013 n = 1704 ANZCOTR 2013
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Donor / Recipient State of Origin All Lungs 1986 - 2013 ANZCOTR 2013 Number *Retransplants and unknown state of origins are not included
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DONOR / RECIPIENT STATE OF ORIGIN ALL LUNGS 1986 - 2013 ANZCOTR 2013 *Retransplants and unknown state of origins are not included
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Mean Wait to Transplant All Lungs 1990 - 2013 Days Year ANZCOTR 2013
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MEAN WAITING TIME TO LUNG TRANSPLANT – DAYS 1990 - 2013 ANZCOTR 2013
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Mean Recipient Age at Transplant LUNGS 1989 - 2013 ANZCOTR 2013 Age in Years
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MEAN RECIPIENT AGE AT LUNG TRANSPLANT 1989 - 2013 ANZCOTR 2013
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Mean Donor Age at Transplant ALL LUNGS 1989 - 2013 ANZCOTR 2013 Years of Age
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MEAN DONOR AGE AT TRANSPLANT LUNGS 1989 - 2013 ANZCOTR 2013
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LUNGS MEAN ISCHAEMIC TIME 1989 - 2013 ANZCOTR 2013 Minutes
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LUNGS - MEAN ISCHAEMIC TIME 1989 - 2013 MINUTES ANZCOTR 2013
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Recipient Gender % Lung Transplants 1986 - 2013 % ANZCOTR 2013
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Recipient Gender Lung Transplants 1986 - 2013 ANZCOTR 2013
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ACTUARIAL SURVIVAL ALL LUNGS 1986 - 2013 ANZCOTR 2013
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ACTUARIAL SURVIVAL ALL LUNG TRANSPLANTS 1986 - 2013 Year Percent Survival ANZCOTR 2013 SL v HL p<0.005 SL v BL p<0.005 Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
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ACTUARIAL SURVIVAL DCD DONORS V DBD DONORS 2006 - 2013 Year Percent Survival ANZCOTR 2013 p=ns Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
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ACTUARIAL SURVIVAL DCD DONORS v DBD DONORS 2006 - 2013 ANZCOTR 2013
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ACTUARIAL SURVIVAL DONOR AGE ALL LUNGS 1986 - 2013 YEAR Percent Survival ANZCOTR 2013 0-16 yrs vs 40-49yrs p<0.05 17-39yrs vs 40-49yrs p<0.05 Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
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ACTUARIAL SURVIVAL DONOR AGE ALL LUNGS 1986 – 2013 ANZCOTR 2013
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ACTUARIAL SURVIVAL ISCHAEMIC TIME ALL LUNGS 1986 - 2013 ANZCOTR 2013
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ACTUARIAL SURVIVAL ISCHAEMIC TIME ALL LUNGS 1986 - 2013 Year Percent Survival ANZCOTR 2013 p=ns Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
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ACTUARIAL SURVIVAL CROSSMATCH ALL LUNGS 1986 - 2013 ANZCOTR 2013
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ACTUARIAL SURVIVAL CROSSMATCH LUNGS 1986 - 2013 Year Percent Survival ANZCOTR 2013 p=ns Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
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ACTUARIAL SURVIVAL CMV STATUS ALL LUNGS 1986 - 2013 ANZCOTR 2013
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ACTUARIAL SURVIVAL CMV STATUS LUNGS 1986 - 2013 ANZCOTR 2013 Percent Survival Years R-D+ vs R+ p<0.05 R+ve = R+ve/D+ve or R+ve/D-ve Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
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ACTUARIAL SURVIVAL HLA MISMATCH ALL LUNGS 1986 - 2013 ANZCOTR 2013
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ACTUARIAL SURVIVAL HLA MISMATCH ALL LUNGS 1986 – 2013 ANZCOTR 2013 Years Percent Survival MM0-1 v MM5 p<0.05 MM0-1 v MM6 p<0.05 Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
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ACTUARIAL SURVIVAL HLA DR LOCUS MISMATCH ALL LUNGS 1986 -2013 ANZCOTR 2013 Percent Survival Years p=ns Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
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ACTUARIAL SURVIVAL HLA DR LOCUS MISMATCH LUNGS 1986 – 2013 ANZCOTR 2013
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CAUSE OF DEATH - ALL LUNGS 1986 - 2012 ANZCOTR 2012
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CAUSE OF DEATH - LUNGS 1986 - 2013 n = 1219 ANZCOTR 2013
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CAUSE OF DEATH ALL LUNGS < 5 YEARS POST TX CAUSE OF DEATH ALL LUNGS ≥ 5 YEARS POST TX ANZCOTR 2013
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