Download presentation
Presentation is loading. Please wait.
Published byAvery Hall Modified over 11 years ago
1
LUNG TRANSPLANTATION Overall ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
2
NUMBER OF LUNG TRANSPLANTS REPORTED BY YEAR AND PROCEDURE TYPE ISHLT 2008 NOTE: This figure includes only the lung transplants that are reported to the ISHLT Transplant Registry. As such, this should not be construed as representing changes in the number of lung transplants performed worldwide. 14 15 45 83 189 418 707 923 1087 1229 1366 1375 1461 1457 1481 1574 1615 1788 2196 2168 1789 1924 J Heart Lung Transplant 2008;27: 937-983
3
AVERAGE CENTER VOLUME Lung Transplants: January 1, 2000 - June 30, 2007 ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
4
DISTRIBUTION OF TRANSPLANTS BY CENTER VOLUME Lung Transplants: January 1, 2000 - June 30, 2007 ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
5
LUNG TRANSPLANTS: Transplant Recipient Age by Year of Transplant ISHLT 2008 Transplants between January 1987 and June 2007 J Heart Lung Transplant 2008;27: 937-983
6
AGE DISTRIBUTION OF LUNG TRANSPLANT RECIPIENTS (1/1985-6/2007) ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
7
AGE DISTRIBUTION OF LUNG TRANSPLANT RECIPIENTS BY ERA ISHLT 2008 Transplants with unknown recipient age were excluded from this tabulation. J Heart Lung Transplant 2008;27: 937-983
8
LUNG TRANSPLANTS: Donor Age by Year of Transplant ISHLT 2008 Transplants between January 1987 and June 2007 J Heart Lung Transplant 2008;27: 937-983
9
DONOR AGE DISTRIBUTION FOR LUNG TRANSPLANTS (1/1985-6/2007) ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
10
DONOR AGE DISTRIBUTION FOR LUNG TRANSPLANTS BY ERA ISHLT 2008 Transplants with unknown donor age were excluded from this tabulation. J Heart Lung Transplant 2008;27: 937-983
11
LUNG TRANSPLANTATION Adult Recipients ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
12
AGE DISTRIBUTION OF ADULT LUNG TRANSPLANT RECIPIENTS (1/1985-6/2007) ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
13
AGE DISTRIBUTION OF ADULT LUNG TRANSPLANT RECIPIENTS BY ERA ISHLT 2008 Mean age by era 1985-1995 = 45.0 years 1996-6/2006 = 49.1 years J Heart Lung Transplant 2008;27: 937-983
14
AGE DISTRIBUTION OF ADULT LUNG TRANSPLANT RECIPIENTS BY ERA ISHLT 2008 Mean age by era 1985-1994 = 44.7 years 1995-1999 = 47.3 years 2000-6/2007 = 49.8 years J Heart Lung Transplant 2008;27: 937-983
15
ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival (Transplants: January 1994 - June 2006) P < 0.0001 ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
16
ADULT LUNG TRANSPLANTATION: Indications (1/1995-6/2007) DIAGNOSISSLT (N = 9,017)BLT (N = 10,775)TOTAL (N = 19,792) COPD/Emphysema4,549 ( 50% )2,637 ( 24% )7,186 ( 36% ) Idiopathic Pulmonary Fibrosis2,497 ( 28% )1,472 ( 14% )3,969 ( 20% ) Cystic Fibrosis169 ( 1.9% )3,049 ( 28% )3,218 ( 16% ) Alpha-1644 ( 7.1% )865 ( 8.0% )1,509 ( 7.6% ) Primary Pulmonary Hypertension67 ( 0.7% )622 ( 5.8% )689 ( 3.5% ) Sarcoidosis191 ( 2.1% )324 ( 3.0% )515 ( 2.6% ) Bronchiectasis35 ( 0.4% )519 ( 4.8% )554 ( 2.8% ) LAM64 ( 0.7% )130 ( 1.2% )194 ( 1.0% ) Congenital Heart Disease17 ( 0.2% )138 ( 1.3% )155 ( 0.8% ) Re-Transplant: Obliterative Bronchiolitis 124 ( 1.4% )109 ( 1.0% )233 ( 1.2% ) Obliterative Bronchiolitis (Not Re-Transplant) 48 ( 0.5% )114 ( 1.1% )162 ( 0.8% ) Re-Transplant: Not Obliterative Bronchiolitis 93 ( 1.0% )81 ( 0.8% )174 ( 0.9% ) Connective Tissue Disease61 ( 0.7% )92 ( 0.9% )153 ( 0.8% ) Interstitial Pneumonitis29 ( 0.3% )16 ( 0.1% )45 ( 0.2% ) Cancer6 ( 0.1% )13 ( 0.1% )19 ( 0.1% ) Other423 ( 4.7% )594 ( 5.5% )1,017 ( 5.1% ) ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
17
ADULT LUNG TRANSPLANTATION: Distribution of Procedure Type for Major Indications (1992-2006) ISHLT 2008 Year of TX Alpha-1COPDCystic FibrosisIPFPPH DoubleSingleDoubleSingleDoubleSingleDoubleSingleDoubleSingle 199227.073.015.784.397.03.010.389.726.373.7 199338.161.915.584.594.85.216.583.553.846.2 199441.758.317.982.185.814.214.086.064.635.4 199543.756.320.979.189.510.527.972.190.59.5 199644.355.726.673.487.013.026.673.482.018.0 199745.754.326.773.392.87.222.277.890.010.0 199847.352.728.971.192.57.520.179.986.813.2 199947.352.727.172.990.59.523.176.986.014.0 200057.142.928.471.695.05.032.667.492.08.0 200158.941.127.672.494.55.528.771.390.79.3 200253.546.537.262.896.43.635.164.988.311.7 200365.134.939.960.196.13.940.959.194.55.5 200472.127.943.556.596.23.843.456.693.96.1 200575.524.548.052.097.82.245.654.488.111.9 200676.423.657.442.699.10.949.250.8100.00.0 J Heart Lung Transplant 2008;27: 937-983
18
ADULT LUNG TRANSPLANTATION Procedure Type within Indication, by Year 2008 ISHLT J Heart Lung Transplant 2008;27: 937-983
19
ADULT LUNG TRANSPLANTATION: Indications for Single Lung Transplants (Transplants: January 1995 - June 2007) ISHLT 2008 *Other includes: Sarcoidosis: 2.1% Bronchiectasis: 0.4% Congenital Heart Disease: 0.2% LAM: 0.7% OB (non-ReTx): 0.5% Miscellaneous:5.8% J Heart Lung Transplant 2008;27: 937-983
20
ADULT LUNG TRANSPLANTATION: Indications for Bilateral/Double Lung Transplants (Transplants: January 1995 - June 2007) ISHLT 2008 *Other includes: Sarcoidosis: 3.0% Bronchiectasis: 4.8% Congenital Heart Disease: 1.3% LAM: 1.2% OB (non-ReTx): 1.1% Miscellaneous:6.6% J Heart Lung Transplant 2008;27: 937-983
21
ADULT LUNG TRANSPLANTATION Indications By Year (%) ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
22
ADULT LUNG TRANSPLANTATION Indications By Year (Number) ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
23
ADULT LUNG TRANSPLANTS: AGE DISTRIBUTION BY LOCATION Transplants between January 2000 and June 2007 ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
24
ADULT LUNG TRANSPLANTS: DIAGNOSIS DISTRIBUTION BY LOCATION Transplants between January 2000 and June 2007 ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
25
ADULT LUNG TRANSPLANTS: DONOR AGE DISTRIBUTION BY LOCATION Transplants between January 2000 and June 2007 ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
26
ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Era (Transplants: January 1988 – June 2006) Survival comparisons by era 1988-94 vs. 1995-99: p = 0.0009 1988-94: vs. 2000-6/06: p <0.0001 1995-99 vs. 2000-6/06: p <0.0001 ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
27
ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Age Group (Transplants: January 1990 – June 2006) ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
28
ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Gender (Transplants: January 1990 – June 2006) ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
29
ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival By Diagnosis (Transplants: January 1990 – June 2006) Year ALPHA-1 (N=1,925) CF (N=3,275) COPD (N=7,760) IPF (N=3,931) PPH (N=970) SARCOIDOSIS (N=506) 177.981.882.172.567.269.9 363.966.26557.15756.5 554.1565044.648.550.8 74448.337.433.841.542.7 1031.238.621.821.13031 Survival comparisons Alpha-1 vs. CF: p = 0.0003 CF vs. COPD: p < 0.0001 Alpha-1 vs. COPD: p = 0.0009CF vs. IPF: p < 0.0001 Alpha-1 vs. IPF: p < 0.0001CF vs. PPH: p < 0.0001 Alpha-1 vs. PPH: p = 0.0027 CF vs. Sarcoidosis: p < 0.0001 Alpha-1 vs. Sarcoidosis p = 0.0263COPD vs. IPF: p <0.0001 Note: Other comparisons are not statistically different. ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
30
ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival By Diagnosis Conditional on Survival to 3 Months (Transplants: January 1990 – June 2006) Year ALPHA-1 (N=1,655) CF (N=2,851) COPD (N=6,892) IPF (N=3,197) PPH (N=697) SARCOIDOSIS (N=410) 189.391.190.286.490.884.2 373.273.871.46876.968 56262.454.953.265.461.1 750.553.841.140.356.151.4 1035.84323.925.140.537.3 Survival comparisons Alpha-1 vs. CF: p = 0.0081 CF vs. Sarcoidosis : p = 0.0137 Alpha-1 vs. COPD: p < 0.0001 PPH vs. COPD: p < 0.0001 Alpha-1 vs. IPF: p < 0.0001 PPH vs. IPF: p < 0.0001 Alpha-1 vs. PPH: p = 0.0094 PPH vs. Sarcoidosis: p = 0.0105 CF vs. COPD: p < 0.0001 COPD vs. IPF: p = 0.0319 CF vs. IPF: p < 0.0001 IPF vs. Sarcoidosis: p = 0.0252 Note: Other comparisons are not statistically different. ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
31
ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival By Diagnosis Conditional on Survival to 1 Year (Transplants: January 1990 – June 2006) Year ALPHA-1 (N=1,442) CF (N=2,475) COPD (N=5,983) IPF (N=2,595) PPH (N=616) SARCOIDOSIS (N=319) 110099.810099.999.8100 38280.979.178.684.680.8 569.468.460.861.57272.6 756.558.945.546.661.761.1 1040.147.226.52944.644.3 Survival comparisons Alpha-1 vs. IPF: p < 0.0001 Alpha-1 vs. COPD: p < 0.0001 Alpha-1 vs. PPH: p = 0.0200CF vs. COPD: p < 0.0001 CF vs. IPF: p < 0.0001PPH vs. COPD: p < 0.0001 PPH vs. IPF: p < 0.0001COPD vs. Sarcoidosis: p = 0.0001 IPF vs. Sarcoidosis: p = 0.0006 Note: Other comparisons are not statistically different. ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
32
ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival By Diagnosis (Transplants: January 1990 – June 2006) ISHLT 2008 Survival comparisons Alpha-1 vs. CF: p = 0.0003 Alpha-1 vs. COPD p = 0.0009 Alpha-1 vs. IPF p < 0.0001 Alpha-1 vs. PPH: p = 0.0027 Alpha-1 vs. Sarcoidosis: p = 0.0263 CF vs. COPD: p < 0.0001 CF vs. IPF: p < 0.0001 CF vs. PPH: p < 0.0001 CF vs. Sarcoidosis: p < 0.0001 COPD vs. IPF: p <0.0001 J Heart Lung Transplant 2008;27: 937-983
33
ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival By Diagnosis Conditional on Survival to 3 Months (Transplants: January 1990 – June 2006) ISHLT 2008 Survival comparisons Alpha-1 vs. CF: p = 0.0081 Alpha-1 vs. IPF: p < 0.0001 Alpha-1 vs. COPD: p < 0.0001 Alpha-1 vs. PPH: p = 0.0094 CF vs. COPD: p < 0.0001 CF vs. IPF: p < 0.0001 CF vs. Sarcoidosis: p = 0.0137 PPH vs. COPD: p < 0.0001 PPH vs. IPF: p < 0.0001 PPH vs. Sarcoidosis: p = 0.0105 COPD vs. IPF: p = 0.0319 IPF vs. Sarcoidosis: p = 0.0252 J Heart Lung Transplant 2008;27: 937-983
34
ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival By Diagnosis Conditional on Survival to 1 Year (Transplants: January 1990 – June 2006) ISHLT 2008 Survival comparisons Alpha-1 vs. IPF: p < 0.0001 Alpha-1 vs. COPD: p < 0.0001 Alpha-1 vs. PPH: p=0.0200 CF vs. COPD: p < 0.0001 CF vs. IPF: p < 0.0001 PPH vs. COPD: p < 0.0001 PPH vs. IPF: p < 0.0001 COPD vs. Sarcoidosis: p = 0.0001 IPF vs. Sarcoidosis: p = 0.0006 J Heart Lung Transplant 2008;27: 937-983
35
ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival for Eisenmengers Syndrome (Transplants: January 1990 – June 2006) ISHLT 2008 p = 0.0860 N at risk= 35 N at risk = 14 J Heart Lung Transplant 2008;27: 937-983
36
ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival By Procedure Type (Transplants: January 1990 – June 2006) Diagnosis: Alpha-1 Antitrypsin Deficiency P = 0.0012 ISHLT 2008 N at risk = 80 N at risk = 106 N at risk at 5 years = 354 N at risk at 5 years = 303 J Heart Lung Transplant 2008;27: 937-983
37
ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival By Procedure Type and Age (Transplants: January 1990 – June 2006) Diagnosis: Alpha-1 Antitrypsin Deficiency ISHLT 2008 N at risk at 10 years: Single Lung, <50 = 67; Double Lung, <50 = 65; Single Lung, 50+ = 39; Double Lung, 50+ = 15 p = 0.0654 J Heart Lung Transplant 2008;27: 937-983
38
ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Procedure Type (Transplants: January 1990 – June 2006) Diagnosis: Emphysema/COPD P < 0.0001 ISHLT 2008 N at risk at 5 years = 580 N at risk at 5 years = 1,571 J Heart Lung Transplant 2008;27: 937-983
39
ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Procedure Type and Age (Transplants: January 1990 – June 2006) Diagnosis: Emphysema/COPD P < 0.0001 ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
40
ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Procedure Type (Transplants: January 1990 – June 2006) Diagnosis: Idiopathic Pulmonary Fibrosis P = 0.0133 ISHLT 2008 N at risk at 5 years = 196 N at risk at 5 years = 566 J Heart Lung Transplant 2008;27: 937-983
41
ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Procedure Type (Transplants: January 1990 – June 2006) Diagnosis: Primary Pulmonary Hypertension P = 0.0051 ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
42
ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Procedure Type and Era (Transplants: January 1990 – June 2006) Diagnosis: Emphysema/COPD, Single Lung ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
43
ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Procedure Type and Era (Transplants: January 1990 – June 2006) Diagnosis: Emphysema/COPD, Double Lung ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
44
ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Procedure Type and Era (Transplants: January 1990 – June 2006) Diagnosis: Idiopathic Pulmonary Fibrosis, Single Lung ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
45
ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Procedure Type and Era (Transplants: January 1990 – June 2006) Diagnosis: Idiopathic Pulmonary Fibrosis, Double Lung ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
46
ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Donor CMV status/Recipient CMV status (Transplants: October 1999 – June 2006) ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
47
ADULT LUNG TRANSPLANTS (1995-6/2006) Risk Factors for 1 Year Mortality (N=11,079) ISHLT 2008 *Other = All diagnoses other than COPD, PPH, IPF, cystic fibrosis, pulmonary fibrosis, bronchiectasis, alpha-1 antitrypsin deficiency, and LAM. J Heart Lung Transplant 2008;27: 937-983
48
ADULT LUNG TRANSPLANTS (1995-6/2006) Risk Factors for 1 Year Mortality ISHLT 2008 (N=11,079) J Heart Lung Transplant 2008;27: 937-983
49
ADULT LUNG TRANSPLANTS (1995-6/2006) Risk Factors for 1 Year Mortality ISHLT 2008 (N=11,079) J Heart Lung Transplant 2008;27: 937-983
50
ADULT LUNG TRANSPLANTS (1995-6/2006) Borderline Significant Risk Factors for 1 Year Mortality ISHLT 2008 (N=11,079) J Heart Lung Transplant 2008;27: 937-983
51
ADULT LUNG TRANSPLANTS (1/1995-6/2006) Risk Factors for 1 Year Mortality ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
52
ADULT LUNG TRANSPLANTS (1/1995-6/2006) Risk Factors for 1 Year Mortality Recipient Age ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
53
ADULT LUNG TRANSPLANTS (1/1995-6/2006) Risk Factors for 1 Year Mortality Center Volume ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
54
ADULT LUNG TRANSPLANTS (1/1995-6/2006) Risk Factors for 1 Year Mortality Recipient Pre-Transplant Bilirubin ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
55
ADULT LUNG TRANSPLANTS (1/1995-6/2006) Risk Factors for 1 Year Mortality Recipient Oxygen Required at Rest ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
56
ADULT LUNG TRANSPLANTS (1/1995-6/2006) Risk Factors for 1 Year Mortality Recipient Pre-Transplant Cardiac Output ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
57
ADULT LUNG TRANSPLANTS (1/1995-6/2006) Risk Factors for 1 Year Mortality Recipient FEV1 (% predicted) ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
58
ADULT LUNG TRANSPLANTS (1/1995-6/2006) Risk Factors for 1 Year Mortality Recipient PVR ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
59
ADULT LUNG TRANSPLANTS (1995-6/2006) Diagnosis = COPD/Emphysema Risk Factors for 1 Year Mortality (N=4,384) ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
60
ADULT LUNG TRANSPLANTS (1995-6/2006) Diagnosis = COPD/Emphysema Borderline Significant Risk Factors for 1 Year Mortality (N=4,384) ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
61
ADULT LUNG TRANSPLANTS (1/1995-6/2006) Diagnosis = COPD/Emphysema Risk Factors for 1 Year Mortality ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
62
ADULT LUNG TRANSPLANTS (1/1995-6/2006) Diagnosis = COPD/Emphysema Risk Factors for 1 Year Mortality Recipient Age ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
63
ADULT LUNG TRANSPLANTS (1/1995-6/2006) Diagnosis = COPD/Emphysema Risk Factors for 1 Year Mortality Center volume ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
64
ADULT LUNG TRANSPLANTS (1/1995-6/2006) Diagnosis = COPD/Emphysema Risk Factors for 1 Year Mortality Recipient Oxygen Required at Rest ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
65
ADULT LUNG TRANSPLANTS (1/1995-6/2006) Diagnosis = COPD/Emphysema Risk Factors for 1 Year Mortality Recipient Pre-Transplant Bilirubin ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
66
ADULT LUNG TRANSPLANTS (1/1995-6/2006) Diagnosis = COPD/Emphysema Risk Factors for 1 Year Mortality Recipient PCO 2 at Transplant ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
67
ADULT LUNG TRANSPLANTS (1995-6/2006) Diagnosis = IPF Risk Factors for 1 Year Mortality (N=2,270) ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
68
ADULT LUNG TRANSPLANTS (1995-6/2006) Diagnosis = IPF Borderline Significant Risk Factors for 1 Year Mortality (N=2,270) ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
69
ADULT LUNG TRANSPLANTS (1/1995-6/2006) Diagnosis = IPF Risk Factors for 1 Year Mortality ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
70
ADULT LUNG TRANSPLANTS (1/1995-6/2006) Diagnosis = IPF Risk Factors for 1 Year Mortality Recipient Age ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
71
ADULT LUNG TRANSPLANTS (1/1995-6/2006) Diagnosis = IPF Risk Factors for 1 Year Mortality Recipient Weight ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
72
ADULT LUNG TRANSPLANTS (1/1995-6/2006) Diagnosis = IPF Risk Factors for 1 Year Mortality Donor Weight ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
73
ADULT LUNG TRANSPLANTS (1/1995-6/2006) Diagnosis = IPF Risk Factors for 1 Year Mortality Recipient O 2 Required at Rest ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
74
ADULT LUNG TRANSPLANTS (1/1995-6/2006) Diagnosis = IPF Risk Factors for 1 Year Mortality Center volume ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
75
ADULT LUNG TRANSPLANTS (1/1995-6/2006) Diagnosis = IPF Risk Factors for 1 Year Mortality Ischemia Time ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
76
ADULT LUNG TRANSPLANTS (1/1995-6/2006) Diagnosis = IPF Risk Factors for 1 Year Mortality Recipient Bilirubin ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
77
ADULT LUNG TRANSPLANTS (1/1995-6/2006) Diagnosis = IPF Risk Factors for 1 Year Mortality Recipient FEV1 (% predicted) ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
78
ADULT LUNG TRANSPLANTS (1995-6/2002) Risk Factors for 5 Year Mortality (N=6,273) ISHLT 2008 *Other = All diagnoses other than COPD, PPH, IPF, cystic fibrosis, pulmonary fibrosis, bronchiectasis, alpha-1 antitrypsin deficiency, and LAM. NOTE: COPD/Single lung is the reference group J Heart Lung Transplant 2008;27: 937-983
79
ADULT LUNG TRANSPLANTS (1995-6/2002) Risk Factors for 5 Year Mortality (N=6,273) ISHLT 2008 *Other = All diagnoses other than COPD, PPH, IPF, cystic fibrosis, pulmonary fibrosis, bronchiectasis, alpha-1 antitrypsin deficiency, and LAM. J Heart Lung Transplant 2008;27: 937-983
80
ADULT LUNG TRANSPLANTS (1995-6/2002) Risk Factors for 5 Year Mortality (N=6,273) ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
81
ADULT LUNG TRANSPLANTS (1995-6/2002) Borderline Significant Risk Factors for 5 Year Mortality (N=6,273) ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
82
ADULT LUNG TRANSPLANTS (1/1995-6/2002) Risk Factors for 5 Year Mortality ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
83
ADULT LUNG TRANSPLANTS (1/1995-6/2002) Risk Factors for 5 Year Mortality Recipient Age ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
84
ADULT LUNG TRANSPLANTS (1/1995-6/2002) Risk Factors for 5 Year Mortality Donor Age ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
85
ADULT LUNG TRANSPLANTS (1/1995-6/2002) Risk Factors for 5 Year Mortality Oxygen Required at Rest ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
86
ADULT LUNG TRANSPLANTS (1/1995-6/2002) Risk Factors for 5 Year Mortality Center Volume ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
87
ADULT LUNG TRANSPLANTS (1/1995-6/2002) Risk Factors for 5 Year Mortality Pre-Transplant Recipient Body Surface Area ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
88
ADULT LUNG TRANSPLANTS (1/1995-6/2002) Risk Factors for 5 Year Mortality Donor Height ISHLT 2008 NOTE: Results should be considered in the context of height ratio (next slide) J Heart Lung Transplant 2008;27: 937-983
89
ADULT LUNG TRANSPLANTS (1/1995-6/2002) Risk Factors for 5 Year Mortality Donor/Recipient Height Ratio ISHLT 2008 NOTE: Results should be considered in the context of donor height (previous slide) J Heart Lung Transplant 2008;27: 937-983
90
ADULT LUNG TRANSPLANTS (1995-6/2002) Risk Factors for 5 Year Mortality Conditional on Survival to 1 Year (N=4,735) ISHLT 2008 NOTE: COPD/single lung is the reference group. J Heart Lung Transplant 2008;27: 937-983
91
ADULT LUNG TRANSPLANTS (1995-6/2002) Risk Factors for 5 Year Mortality Conditional on Survival to 1 Year (N=4,735) ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
92
ADULT LUNG TRANSPLANTS (1995-6/2002) Risk Factors for 5 Year Mortality Conditional on Survival to 1 Year (N=4,735) ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
93
ADULT LUNG TRANSPLANTS (1995-6/2002) Borderline Significant Risk Factors for 5 Year Mortality Conditional on Survival to 1 Year (N=4,735) ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
94
ADULT LUNG TRANSPLANTS (1/1995-6/2002) Risk Factors for 5 Year Mortality Conditional on Survival to 1 Year ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
95
ADULT LUNG TRANSPLANTS (1/1995-6/2002) Risk Factors for 5 Year Mortality Conditional on 1 Year Survival Recipient Age ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
96
ADULT LUNG TRANSPLANTS (1/1995-6/2002) Risk Factors for 5 Year Mortality Conditional on 1 Year Survival Donor/Recipient Weight Ratio ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
97
ADULT LUNG TRANSPLANTS (1/1995-6/2002) Risk Factors for 5 Year Mortality Conditional on 1 Year Survival Donor Height ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
98
ADULT LUNG TRANSPLANTS (1/1995-6/2002) Risk Factors for 5 Year Mortality Conditional on 1 Year Survival Center Volume ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
99
ADULT LUNG TRANSPLANTS (1/1995-6/2002) Risk Factors for 5 Year Mortality Conditional on 1 Year Survival Recipient BSA ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
100
ADULT LUNG TRANSPLANTS (1/1995-6/2002) Risk Factors for 5 Year Mortality Conditional on 1 Year Survival Recipient Pre-Transplant FEV1 ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
101
ADULT LUNG RECIPIENTS Functional Status of Surviving Recipients (Follow-ups: April 1994 – June 2007) ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
102
ADULT LUNG RECIPIENTS Employment Status of Surviving Recipients (Follow-ups: April 1994 – June 2007) ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
103
ADULT LUNG RECIPIENTS: Rehospitalization Post-transplant of Surviving Recipients (Follow-ups: April 1994 - June 2007) ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
104
ADULT LUNG RECIPIENTS Induction Immunosuppression (Transplants: January 2002 - June 2007) Analysis limited to patients receiving prednisone ISHLT 2008 Analysis is limited to patients who were alive at the time of the follow-up J Heart Lung Transplant 2008;27: 937-983
105
ADULT LUNG RECIPIENTS Induction Immunosuppression (Transplants: January 2000 - December 2006) Analysis limited to patients receiving prednisone ISHLT 2008 Any Induction Polyclonal ALG/ATG IL2R-antagonist Campath Analysis is limited to patients who were alive at the time of the follow-up J Heart Lung Transplant 2008;27: 937-983
106
SURVIVAL BY INDUCTION USAGE For Adult Lung Recipients (Transplants: April 1994-June 2006) Conditional on survival to 14 days ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
107
SURVIVAL BY INDUCTION USAGE For Adult Lung Recipients (Transplants: January 2000-June 2006) Conditional on survival to 14 days ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
108
ADULT LUNG RECIPIENTS Maintenance Immunosuppression at Time of Follow-up For follow-ups between January 2002 through June 2007 Analysis limited to patients receiving prednisone NOTE: Different patients are analyzed in Year 1 and Year 5 ISHLT 2008 Analysis is limited to patients who were alive at the time of the follow-up J Heart Lung Transplant 2008;27: 937-983
109
ADULT LUNG RECIPIENTS Maintenance Immunosuppression at Time of Follow-up For follow-ups between January 2002 through June 2007 Analysis limited to patients receiving prednisone NOTE: Different patients are analyzed in Year 1 and Year 5 ISHLT 2008 Analysis is limited to patients who were alive at the time of the follow-up J Heart Lung Transplant 2008;27: 937-983
110
ADULT LUNG RECIPIENTS Maintenance Immunosuppression at Time of Follow-up For follow-ups between January 2002 through June 2007 Analysis limited to patients receiving prednisone 1 Year Follow-up (N = 5,001)5 Year Follow-up (N = 2,178) NOTE: Different patients are analyzed in Year 1 and Year 5 ISHLT 2008 Analysis is limited to patients who were alive at the time of the follow-up J Heart Lung Transplant 2008;27: 937-983
111
ADULT LUNG RECIPIENTS Maintenance Immunosuppression Drug Combinations at Time of Follow-up For follow-ups between January 2002 through June 2007 Conventional Combinations Analysis limited to patients receiving prednisone ISHLT 2008 Analysis is limited to patients who were alive at the time of the follow-up J Heart Lung Transplant 2008;27: 937-983
112
ADULT LUNG RECIPIENTS Maintenance Immunosuppression Drug Combinations at Time of Follow-up For follow-ups between January 2002 through June 2007 Other Combinations Analysis limited to patients receiving prednisone ISHLT 2008 Analysis is limited to patients who were alive at the time of the follow-up J Heart Lung Transplant 2008;27: 937-983
113
PERCENTAGE OF ADULT LUNG TRANSPLANT RECIPIENTS EXPERIENCING REJECTION IN 1ST YEAR Stratified by Type of Induction (Follow-ups: July 1, 2004 - June 30, 2007) ISHLT 2008 No induction: N = 1,897 Polyclonal: N = 358 IL2R- antagonist: N = 1,186 Analysis is limited to patients who were alive at the time of the follow-up J Heart Lung Transplant 2008;27: 937-983
114
PERCENTAGE OF ADULT LUNG TRANSPLANT RECIPIENTS EXPERIENCING REJECTION IN 1ST YEAR Stratified by Type of Induction (Follow-ups: July 1, 2004 - June 30, 2007) ISHLT 2008 18-34: N = 528 35-49: N = 676 50-59: N = 1,356 60-65: N = 877 66+: N = 177 Female: N = 1,684 Male: N = 1,930 18-3435-4950-5960-6566+FemaleMale 18-34: no induct vs. IL2 (p=0.041); poly vs. IL2R (p=0.009); 35-49: poly vs. IL2R (p =0.020); 50-59: no induct vs. IL2R (p<0.0001); 60-65: no induct vs. poly (p=0.044); no induct vs. IL2R (p=0.016); 66+: no induct vs. IL2R (p=0.004). For female: no induct vs. IL2R (p<0.0001) For male: no induct vs.IL2R (p<0.0001); poly vs. IL2R (p = 0.002) Analysis is limited to patients who were alive at the time of the follow-up J Heart Lung Transplant 2008;27: 937-983
115
PERCENTAGE OF ADULT LUNG TRANSPLANT RECIPIENTS EXPERIENCING REJECTION IN 1ST YEAR Stratified by Maintenance Immunosuppression (Follow-ups: July 1, 2004 - June 30, 2007) all comparisons were statistically significant at 0.05 except TAC + MMF vs. TAC+ AZA ISHLT 2008 Cyclosporine + MMF: N = 330 Cyclosporine + AZA: N = 551 Tacrolimus + MMF: N = 1,297 Tacrolimus + AZA: N = 898 Analysis is limited to patients who were alive at the time of the follow-up J Heart Lung Transplant 2008;27: 937-983
116
PERCENTAGE OF ADULT LUNG TRANSPLANT RECIPIENTS EXPERIENCING REJECTION IN 1ST YEAR Stratified by Maintenance Immunosuppression (Follow-ups: July 1, 2004 - June 30, 2007) 18-34: CyA + MMF vs. Cya + AZA (p=0.039); CyA + AZA vs. TAC + MMF (p=0.0001); CyA + AZA vs. TAC + AZA (p=0.002) 35-49: all comparisons are statistically significant at 0.05 except CyA + MMF vs. Cya + AZA and TAC + MMF vs. TAC + AZA 50-59: all comparisons were statistically significant at 0.01 except TAC + MMF vs. TAC + AZA 60-65: all comparisons are statistically significant at 0.05 except CyA + MMF vs. TAC + AZA and TAC + MMF vs. TAC + AZA 66+: CyA + AZA vs. TAC + MMF (p <0.0001); CyA + AZA vs. TAC + AZA (p=0.011) Females: all comparisons were statistically significant at 0,05 except TAC + MMF vs. TAC + AZA Males: all comparisons were statistically significant at 0.01 except TAC + MMF vs. TAC + AZA ISHLT 2008 18-3435-4950-5960-65 66+ Female Male Analysis is limited to patients who were alive at the time of the follow-up J Heart Lung Transplant 2008;27: 937-983
117
POST-LUNG TRANSPLANT MORBIDITY FOR ADULTS Cumulative Prevalence in Survivors within 1 Year Post-Transplant (Follow-ups: April 1994 - June 2007) ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
118
POST-LUNG TRANSPLANT MORBIDITY FOR ADULTS Cumulative Prevalence in Survivors within 1 and 5 Years Post-Transplant (Follow-ups: April 1994 - June 2007) ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
119
POST-LUNG TRANSPLANT MORBIDITY FOR ADULTS Cumulative Prevalence in Survivors within 10 Years Post-Transplant (Follow-ups: April 1994 - June 2007) ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
120
FREEDOM FROM BRONCHIOLITIS OBLITERANS For Adult Lung Recipients (Follow-ups: April 1994-June 2007) Conditional on Survival to 14 days ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
121
FREEDOM FROM BRONCHIOLITIS OBLITERANS STRATIFIED BY INDUCTION USE For Adult Lung Recipients Follow-ups: April 1994-June 2007) Conditional on Survival to 14 days ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
122
FREEDOM FROM SEVERE RENAL DYSFUNCTION * For Adult Lung Recipients (Follow-ups: April 1994-June 2007) * Severe renal dysfunction = Creatinine > 2.5 mg/dl (221 μmol/L), dialysis or renal transplant ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
123
MALIGNANCY POST-LUNG TRANSPLANTATION FOR ADULTS Cumulative Prevalence in Survivors (Follow-ups: April 1994 - June 2007) Malignancy/Type1-Year Survivors5-Year Survivors10-Year Survivors No Malignancy 10,279 (96.4%)2,514 (87.7%)268 (72.2%) Malignancy (all types combined) 386 (3.6%)351 (12.3%)103 (27.8%) Malignancy Type* Skin 9419465 Lymph 1736321 Other 9911029 Type Not Reported 20112 * Recipients may have experienced more than one type of malignancy so sum of individual malignancy types may be greater than total number with malignancy. Other malignancies reported include: adenocarcinoma (2; 2; 0), bladder (2; 1; 0), lung (2; 4; 0), breast (1; 5; 2); prostate (0; 5; 1), cervical (1; 1; 0); liver (1; 1; 1); colon (1; 1; 0). Numbers in parentheses represent the number of reported cases within each time period. ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
124
FREEDOM FROM MALIGNANCY For Adult Lung Recipients (Follow-ups: April 1994-June 2007) ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
125
ADULT LUNG TRANSPLANT RECIPIENTS: Cause Of Death (Deaths: January 1992- June 2007) CAUSE OF DEATH 0-30 Days (N = 1,622) 31 Days – 1 Year (N = 2,781) >1 Year – 3 Years (N = 2,481) >3 Years – 5 Years (N = 1,445) >5 Years – 10 Years (N = 1,592) >10 Years (N = 310) BRONCHIOLITIS8 (0.5%)129 (4.6%)648 (26.1%)412 (28.5%)394 (24.7%)62 (20.0%) ACUTE REJECTION70 (4.3%)50 (1.8%)40 (1.6%)10 (0.7%)11 (0.7%)0 LYMPHOMA1 (0.1%)74 (2.7%)56 (2.3%)26 (1.8%)41 (2.6%)15 (4.8%) MALIGNANCY, OTHER2 (0.1%)71 (2.6%)145 (5.8%)114 (7.9%)151 (9.5%)22 (7.1%) CMV086 (3.1%)25 (1.0%)5 (0.3%)3 (0.2%)0 INFECTION, NON-CMV330 (20.3%)1,011 (36.4%)578 (23.3%)278 (19.2%)292 (18.3%)59 (19.0%) GRAFT FAILURE458 (28.2%)504 (18.1%)462 (18.6%)274 (19.0%)286 (18.0%)61 (19.7%) CARDIOVASCULAR180 (11.1%)109 (3.9%)77 (3.1%)63 (4.4%)76 (4.8%)17 (5.5%) TECHNICAL134 (8.3%)63 (2.3%)16 (0.6%)4 (0.3%)11 (0.7%)4 (1.3%) OTHER439 (27.1%)684 (24.6%)434 (17.5%)259 (17.9%)327 (20.5%)70 (22.6%) ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
Similar presentations
© 2025 SlidePlayer.com. Inc.
All rights reserved.