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HEART-LUNG TRANSPLANTATION Overall ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982.

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Presentation on theme: "HEART-LUNG TRANSPLANTATION Overall ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982."— Presentation transcript:

1 HEART-LUNG TRANSPLANTATION Overall ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

2 NUMBER OF HEART-LUNG TRANSPLANTS REPORTED BY YEAR ISHLT 2005 NOTE: This figure includes only the heart-lung transplants that are reported to the ISHLT Transplant Registry. As such, this should not be construed as evidence that the number of heart-lung transplants worldwide has declined in recent years. J Heart Lung Transplant 2005;24: 945-982

3 AVERAGE CENTER VOLUME Heart-Lung Transplants: January 1, 1998 - June 30, 2004 ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

4 DISTRIBUTION OF HEART-LUNG TRANSPLANTS BY CENTER VOLUME Heart-Lung Transplants: January 1, 1998 - June 30, 2004 ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

5 DISTRIBUTION OF HEART-LUNG TRANSPLANTS BY LUNG CENTER VOLUME Lung Transplants: January 1, 1998 - June 30, 2004 ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

6 HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival (Transplants: January 1982 - June 2003) N=3,080 Half-life = 2.9 years Conditional Half-life = 8.6 years Survival (%) ISHLT 2005 N followed at longest time point: 1,899 J Heart Lung Transplant 2005;24: 945-982

7 HEART-LUNG TRANSPLANTATION Adult Recipients ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

8 DIAGNOSIS IN ADULT HEART-LUNG TRANSPLANTS (1/1982-6/2004) Other includes cancer, LAM, OB, sarcoidosis, bronchiectasis ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

9 DIAGNOSIS IN ADULT HEART-LUNG TRANSPLANTS (Transplants: January 1982 - June 2004) Diagnosis N (%) Congenital Heart Disease746 (32.4%) Primary Pulmonary Hypertension574 (24.9%) Cystic Fibrosis357 (15.5%) Acquired Heart Disease98 (4.3%) COPD/Emphysema92 (4.0%) Idiopathic Pulmonary Fibrosis64 (2.8%) Alpha-157 (2.5%) Re-Transplant: Not Obliterative Bronchiolitis30 (1.3%) Sarcoidosis27 (1.2%) Re-Transplant: Obliterative Bronchiolitis24 (1.0%) Bronchiectasis15 (0.7%) Obliterative Bronchiolitis (not Re-Transplant) 8 (0.3%) Other212 (9.2%) ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

10 DIAGNOSIS IN ADULT HEART-LUNG TRANSPLANTS BY ERA 1982-19951/1996-6/2004 Other includes OB (non-ReTX), Bronchiectasis, Sarcoidosis ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

11 ADULT HEART-LUNG TRANSPLANTATION Indications By Year (%) ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

12 ADULT HEART-LUNG TRANSPLANTATION Indications By Year (Number) ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

13 HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival for Adult Recipients (Transplants: January 1982 - June 2003) N=2,488 Half-life = 3.2 years Conditional Half-life = 9.0 years Survival (%) ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

14 ADULT HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival By Diagnosis (Transplants: January 1990 – June 2003) ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

15 ADULT HEART-LUNG RECIPIENTS Functional Status of Surviving Recipients (Follow-ups: April 1994 – June 2004) ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

16 ADULT HEART-LUNG RECIPIENTS Employment Status of Surviving Recipients (Follow-ups: April 1994 – June 2004) ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

17 ADULT HEART-LUNG RECIPIENTS: Rehospitalization Post-transplant of Surviving Recipients (Follow-ups: April 1994 - June 2004) ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

18 ADULT HEART-LUNG RECIPIENTS Induction Immunosuppression For follow-ups between January 2001 through June 2004 ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

19 ADULT HEART-LUNG RECIPIENTS Induction Immunosuppression (Follow-ups: January 2000 - December 2003) ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

20 ADULT HEART-LUNG RECIPIENTS Maintenance Immunosuppression at Time of Follow-up For follow-ups between January 2001 through June 2004 NOTE: Different patients are analyzed in Year 1 and Year 5 ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

21 ADULT HEART-LUNG RECIPIENTS Maintenance Immunosuppression Drug Combinations at Time of Follow-up For follow-ups between January 2001 through June 2004 NOTE: Different patients are analyzed in Year 1 and Year 5 ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

22 POST-HEART-LUNG TRANSPLANT MORBIDITY FOR ADULTS Cumulative Prevalence in Survivors within 1 Year Post-Transplant (Follow-ups: April 1994 - June 2004) ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

23 POST-HEART-LUNG TRANSPLANT MORBIDITY FOR ADULTS Cumulative Prevalence in Survivors within 5 Years Post-Transplant (Follow-ups: April 1994 - June 2004) ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

24 Freedom from Coronary Artery Vasculopathy For Adult Heart-Lung Recipients (Follow-ups: April 1994-June 2004) ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

25 Freedom from Bronchiolitis Obliterans For Adult Heart-Lung Recipients (Follow-ups: April 1994-June 2004) ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

26 Freedom from Severe Renal Dysfunction* For Adult Heart-Lung Recipients (Follow-ups: April 1994-June 2004) *Severe renal dysfunction = Creatinine > 2.5 mg/dl, dialysis or renal transplant ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

27 MALIGNANCY POST-HEART-LUNG TRANSPLANT FOR ADULTS Cumulative Prevalence in Survivors (Follow-ups: April 1994-June 2004) Malignancy/Type1-Year Survivors5-Year Survivors No Malignancy 264 (92.0%)77 (87.5%) Malignancy (all types combined) 23 (8.0%)11 (12.5%) Malignancy Type Skin23 Lymph165 Other11 Type Not Reported42 ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

28 Freedom from Malignancy For Adult Heart-Lung Recipients (Follow-ups: April 1994- June 2004) ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

29 ADULT HEART-LUNG TRANSPLANT RECIPIENTS: Cause of Death (Deaths: January 1992 - June 2004) CAUSE OF DEATH 0-30 Days (N = 195) 31 Days - 1 Year (N = 124) >1 Year - 3 Years (N = 101) >3 Years - 5 Years (N = 58) >5 Years (N = 94) BRONCHIOLITIS 04 (3.2%)26 (25.7%)22 (37.9%)21 (21.4%) ACUTE REJECTION 3 (1.5%)3 (2.4%)1 (1.0%)1 (1.7%)1 (1.0%) LYMPHOMA 03 (2.4%)4 (4.0%)3 (5.2%)1 (1.0%) MALIGNANCY, OTHER 01 (0.8%)6 (5.9%)2 (3.4%)5 (5.1%) CMV 02 (1.6%)01 (1.7%)0 INFECTION, NON-CMV 39 (20.0%)53 (43.7%)32 (31.7%)3 (5.2%)14 (14.3%) GRAFT FAILURE 62 (31.8%)23 (18.5%)17 (16.8%)9 (15.5%)23 (23.5%) CARDIOVASCULAR 17 (8.7%)7 (5.6%)5 (5.0%)8 (13.8%)7 (7.1%) TECHNICAL 41 (21.0%)2 (1.6%)1 (1.0%)00 OTHER 33 (16.9%)26 (21.0%) 9 (8.9%)9 (15.5%)26 (26.5%) ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

30 HEART-LUNG TRANSPLANTATION Pediatric Recipients ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

31 AGE DISTRIBUTION OF PEDIATRIC HEART-LUNG RECIPIENTS (Transplants: January 1982 - June 2004) ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

32 AGE DISTRIBUTION FOR DONORS OF PEDIATRIC HEART- LUNG RECIPIENTS (Transplants: January 1982 - June 2004) ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

33 AGE DISTRIBUTION OF PEDIATRIC HEART-LUNG RECIPIENTS By Year of Transplant Number of Transplants ISHLT 2005 NOTE: This figure includes only the heart transplants that are reported to the ISHLT Transplant Registry. As such, this should not be construed as evidence that the number of pediatric heart- lung transplants worldwide has declined in recent years. J Heart Lung Transplant 2005;24: 945-982

34 NUMBER OF CENTERS REPORTING PEDIATRIC HEART-LUNG TRANSPLANTS ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

35 DIAGNOSIS IN PEDIATRIC HEART –LUNG TRANSPLANT RECIPIENTS (Age: 11-17 Years) Other includes Alpha-1, Bronchiectasis, IPF and OB (non-ReTX) ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

36 PEDIATRIC HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival By Diagnosis (Transplants: January 1990 – June 2003) ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

37 PEDIATRIC HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival (Transplants: January 1982 - June 2003) ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

38 PEDIATRIC HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival by Era (Transplants: January 1982 - June 2003) Survival (%) ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982

39 PEDIATRIC HEART-LUNG TRANSPLANT RECIPIENTS: Cause of Death (Deaths: January 1992 - June 2004) CAUSE OF DEATH0-30 Days (N = 27) 31 Days - 1 Year (N = 28) >1 Year - 3 Years (N = 25) >3 Years - 5 Years (N = 17) >5 Years (N = 18) BRONCHIOLITIS 1 (3.6%)13 (52.0%)8 (47.1%)6 (33.3%) ACUTE REJECTION 2 (7.1%) INFECTION, NON-CMV 5 (18.5%)9 (32.1%)5 (20.0%)1 (5.9%)5 (27.8%) GRAFT FAILURE 12 (44.4%)2 (7.1%)5 (20.0%)4 (23.5%)3 (16.7%) CARDIOVASCULAR 2 (7.4%)3 (10.7%)1 (5.9%)2 (11.1%) TECHNICAL 3 (11.1%)1 (3.6%) OTHER 5 (18.5%)10 (35.7%)2 (8.0%)2 (11.8%)2 (11.1%) ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982


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