Download presentation
Presentation is loading. Please wait.
Published byCameron Freeman Modified over 11 years ago
1
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 HEART TRANSPLANTATION Pediatric Recipients
2
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 AGE DISTRIBUTION OF PEDIATRIC HEART RECIPIENTS (Transplants: January 1996 - June 2003)
3
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 AGE DISTRIBUTION FOR DONORS OF PEDIATRIC HEART RECIPIENTS (Transplants: January 1996 - June 2003)
4
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 AGE DISTRIBUTION OF PEDIATRIC HEART RECIPIENTS By Year of Transplant Number of Transplants
5
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 NUMBER OF CENTERS REPORTING PEDIATRIC HEART TRANSPLANTS
6
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 DIAGNOSIS IN PEDIATRIC HEART TRANSPLANT RECIPIENTS (Age: < 1 Year) 1988-19951/1996-6/2003
7
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 DIAGNOSIS IN PEDIATRIC HEART TRANSPLANT RECIPIENTS (Age: 1-10 Years) 1988-19951/1996-6/2003
8
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 DIAGNOSIS IN PEDIATRIC HEART TRANSPLANT RECIPIENTS (Age: 11-17 Years) 1988-19951/1996-6/2003l
9
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival (1/1982-6/2002)
10
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART TRANSPLANTATION Conditional Kaplan-Meier Survival (1/1982-6/2002)
11
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART TRANSPLANTATION Conditional Kaplan-Meier Survival for Recent Era (1/1998-6/2002)
12
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival by Era (1/1982-6/2002) Survival (%)
13
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival by Era (1/1982-6/2002) Age: < 1 Year Survival (%)
14
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival by Era (1/1982-6/2002) Age: 1-10 Years Survival (%)
15
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival by Era (1/1982-6/2002) Age: 11-17 Years Survival (%)
16
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART TRANSPLANTS (1/1995-6/2002) Risk Factors For 1 Year Mortality N=2,290
17
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART TRANSPLANTS (1/1995-6/2002) Risk Factors for 1 Year Mortality
18
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART TRANSPLANTS (1/1995-6/2002) Risk Factors for 1 Year Mortality Donor Age
19
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART TRANSPLANTS (1/1995-6/2002) Risk Factors for 1 Year Mortality Recipient Pulmonary Capillary Wedge Pressure (PCW)
20
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART TRANSPLANTS (1/1995-6/2002) Risk Factors for 1 Year Mortality Recipient PA systolic
21
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART TRANSPLANTS (1/1995-6/2002) Factors Not Significant for 1 Year Mortality Recipient Factors: IV inotropes, PGE, ECMO, sternotomy, history of malignancy, weight, height, dialysis, recent infection, gender, age
22
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART TRANSPLANTS (1/1995-6/2002) Factors Not Significant for 1 Year Mortality Donor Factors: Gender, clinical infection, history of diabetes, height, COD Transplant Factors: Donor/recipient weight ratio, CMV mismatch, ABO identical/compatible, year of transplant, ischemia time, HLA mismatch, transplant center volume
23
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART TRANSPLANTS (1/1995-6/1998) Risk Factors For 5 Year Mortality N=1,234
24
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART TRANSPLANTS (1/1995-6/1998) Risk Factors for 5 Year Mortality
25
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART TRANSPLANTS (1/1995-6/1998) Risk Factors for 5 Year Mortality Recipient Age
26
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART TRANSPLANTS (1/1995-6/1998) Factors Not Significant for 5 Year Mortality Recipient Factors: IV inotropes, PGE, ECMO, history of malignancy, recent infection, gender, hospitalized at time of transplant, bilirubin
27
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART TRANSPLANTS (1/1995-6/1998) Factors Not Significant for 5 Year Mortality Donor Factors: Gender, clinical infection, history of diabetes, age, COD Transplant Factors: Donor/recipient weight ratio, CMV mismatch, ABO identical/compatible, year of transplant, repeat transplant, ischemia time, HLA mismatch, transplant center volume
28
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART TRANSPLANTS (1/1995-6/1998) Risk Factors For 5 Year Mortality Conditional on 1 Year Survival N=968
29
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART RECIPIENTS Functional Status (Follow-ups: April 1994-June 2003)
30
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART RECIPIENTS Rehospitalization Post-transplant (Follow-ups: April 1994 - June 2003)
31
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART RECIPIENTS Induction Immunosuppression (Follow-ups: January 2001 - June 2003)
32
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART RECIPIENTS Induction Immunosuppression (Follow-ups: January 2001 - June 2003)
33
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART RECIPIENTS Maintenance Immunosuppression at Time of Follow-up For follow-ups between January 2000 through June 2003 NOTE: Different patients are analyzed in Year 1 and Year 5
34
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART RECIPIENTS Maintenance Immunosuppression Drug Combinations at Time of Follow-up For follow-ups between January 2001 through June 2003 NOTE: Different patients are analyzed in Year 1 and Year 5
35
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 POST-HEART TRANSPLANT MORBIDITY FOR PEDIATRICS Cumulative Prevalence in Survivors within 1 Year Post-Transplant (Follow-ups: April 1994 - June 2003)
36
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 POST-HEART TRANSPLANT MORBIDITY FOR PEDIATRICS Cumulative Prevalence in Survivors within 5 Years Post-Transplant (Follow-ups: April 1994 - June 2003)
37
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 POST-HEART TRANSPLANT MORBIDITY FOR PEDIATRICS Cumulative Prevalence in Survivors within 7 Years Post-Transplant (Follow-ups: April 1994 - June 2003)
38
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 FREEDOM FROM CAV For Pediatric Heart Recipients (Follow-ups: April 1994-June 2003)
39
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 FREEDOM FROM CAV For Pediatric Heart Recipients (Follow-ups: April 1994-June 2003) Stratified by Age Group
40
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 SURVIVAL FOLLOWING REPORT OF CAV For Pediatric Heart Recipients (Follow-ups: April 1994-June 2003) Stratified by Age Group
41
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 FREEDOM FROM SEVERE RENAL DYSFUNCTION* For Pediatric Heart Recipients (Follow-ups: April 1994-June 2003) * Severe renal dysfunction = Creatinine > 2.5 mg/dl, dialysis or renal transplant
42
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 MALIGNANCY POST-HEART TRANSPLANTATION FOR PEDIATRICS Cumulative Prevalence in Survivors (Follow-ups: April 1994-June 2003) Malignancy/Type1-Year Survivors 5-Year Survivors 7-Year Survivors No Malignancy 1974 (98.2%)568 (95.6%)251 (94%) Malignancy (all types combined) 37 (1.8%)26 (4.4%)16 (6%) Malignancy Type Lymph332316 Other33 Type Not Reported 1
43
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 FREEDOM FROM MALIGNANCY For Pediatric Heart Recipients (Follow-ups: April 1994-June 2003)
44
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival Based on Prednisone Use (Transplants: April 1994 - June 2002) p = 0.02
45
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival Based on Rejection within 1 st Year (Transplants: April 1994 - June 2001) P = 0.016
46
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART RECIPIENTS Incidence of Hypertension between 1 and 3 Years (Transplants: April 1993 - June 2000) Maintenance Immunosuppression at discharge and 1 year % HTN reported between 1 and 3 years P-value For Patients on drug For Patients not on drug Azathioprine22.0%19.3%0.5 Cyclosporine19.7%19.5%0.9 MMF18.3%21.2%0.6 Prednisone28.8%6.5%<.0001 Rapamycin.19.9% Tacrolimus22.1%19.2%0.6
47
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART RECIPIENTS Relationship of Rejection and CAV (Follow-ups: April 1994 – June 2003) Rejection During 1 st Year Reported CAV between 1 st and 2 nd years post- transplant Reported CAV between 1 st and 3 rd years post- transplant YesNoYesNo Yes27 5.0% 515 95.0% 33 8.2% 367 91.8% No8 1.6% 502 98.4% 11 3.0% 351 97.0% p = 0.002
48
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART RECIPIENTS Growth Following Transplantation: Height Stratified by Prednisone Use at Discharge and at 1 Year
49
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART RECIPIENTS Growth Following Transplantation: Weight Stratified by Prednisone Use at Discharge and at 1 Year
50
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PERCENTAGE OF PEDIATRIC HEART TRANSPLANT RECIPIENTS TREATED FOR REJECTION IN 1ST YEAR Stratified by Type of Induction (Transplants: January 1, 2000 - June 30, 2002)
51
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 NUMBER OF REJECTION EPISODES FOR PEDIATRIC HEART TRANSPLANT RECIPIENTS TREATED FOR REJECTION IN 1ST YEAR Stratified by Type of Induction (Transplants: January 1, 2000 - June 30, 2002)
52
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PERCENTAGE OF PEDIATRIC HEART TRANSPLANT RECIPIENTS TREATED FOR REJECTION IN 1ST YEAR Stratified by Maintenance Immunosuppression (Transplants: January 1, 2000 - June 30, 2002)
53
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 NUMBER OF REJECTION EPISODES FOR PEDIATRIC HEART TRANSPLANT RECIPIENTS TREATED FOR REJECTION IN 1ST YEAR Stratified by Maintenance Immunosuppression (Transplants: January 1, 2000 - June 30, 2002)
54
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival by Induction Group (Transplants: January 2000 – June 2002) Conditional on Survival to 14 Days
55
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival by Induction Group (Transplants: January 2000 – June 2002) Conditional on Survival to 14 Days Age: < 1 Year
56
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival by Induction Group (Transplants: January 2000 – June 2002) Conditional on Survival to 14 Days Age: 1-10 Years
57
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival by Induction Group (Transplants: January 2000 – June 2002) Conditional on Survival to 14 Days Age: 11-17 Years
58
2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 PEDIATRIC HEART TRANSPLANT RECIPIENTS: Cause of Death (Deaths: January 1992 - June 2003) CAUSE OF DEATH 0-30 Days (N = 310) 31 Days - 1 Year (N = 258) >1 Year - 3 Years (N = 166) >3 Years - 5 Years (N = 106) >5 Years (N = 199) CAV 3 (1.0%)25 (9.7%)35 (21.1%)42 (39.6%)64 (32.2%) ACUTE REJECTION 26 (8.4%)72 (27.9%)45 (27.1%)16 (15.1%)24 (12.1%) LYMPHOMA 5 (1.9%)8 (4.8%)2 (1.9%)17 (8.5%) MALIGNANCY, OTHER 4 (1.6%)1 (0.6%)1 (0.9%)8 (4.0%) CMV 1 (0.3%)7 (2.7%)1 (0.6%) INFECTION, NON-CMV 40 (12.9%)43 (16.7%)12 (7.2%)5 (4.7%)12 (6.0%) PRIMARY FAILURE 55 (17.7%)12 (4.7%)5 (3.0%)7 (6.6%)11 (5.5%) GRAFT FAILURE 78 (25.2%)31 (12.0%)31 (18.7%)21 (19.8%)40 (20.1%) TECHNICAL 21 (6.8%)3 (1.2%)2 (1.2%)1 (0.9%)1 (0.5%) OTHER 8 (2.6%)8 (3.1%)9 (5.4%)4 (3.8%)10 (5.0%) MULTIPLE ORGAN FAILURE 34 (11.0%)26 (10.1%)3 (1.8%)1 (0.9%)3 (1.5%) RENAL FAILURE 1 (0.3%)1 (0.4%) PULMONARY 24 (7.7%)14 (5.4%)8 (4.8%)5 (4.7%)7 (3.5%) CEREBROVASCULAR 19 (6.1%)7 (2.7%)6 (3.6%)1 (0.9%)2 (1.0%)
Similar presentations
© 2025 SlidePlayer.com. Inc.
All rights reserved.