Download presentation
Presentation is loading. Please wait.
Published byAutumn McCracken Modified over 11 years ago
1
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 LUNG TRANSPLANTATION Overall
2
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 NUMBER OF LUNG TRANSPLANTS REPORTED BY YEAR AND PROCEDURE TYPE 13 1546 83 188 418 706 922 1086 1229 1365 1370 1443 1436 1412 1497 1563 1655
3
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 AVERAGE CENTER VOLUME Lung Transplants: January 1, 1998 - June 30, 2003
4
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 DISTRIBUTION OF TRANSPLANTS BY CENTER VOLUME Lung Transplants: January 1, 1998 - June 30, 2003
5
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 LUNG TRANSPLANTS: Donor Age by Year of Transplant
6
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 AGE DISTRIBUTION OF LUNG TRANSPLANT RECIPIENTS (1/1985-6/2003)
7
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 AGE DISTRIBUTION OF LUNG TRANSPLANT RECIPIENTS BY ERA
8
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 LUNG TRANSPLANTATION Kaplan-Meier Survival (Transplants: January 1990 - June 2002)
9
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 LUNG TRANSPLANTATION Adult Recipients
10
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTATION: Indications (1/1995-6/2003) DIAGNOSISSLT (N = 5,793)BLT (N = 5,166)TOTAL (N = 10,959) COPD/Emphysema3,091 ( 53% )1,201 ( 23% )4,292 ( 39% ) IPF1,369 ( 24% )503 ( 9.7% )1,872 ( 17% ) CF131 ( 2.3% )1,615 ( 31% )1,746 ( 16% ) Alpha-1493 ( 8.5% )491 ( 9.5% )984 ( 9.0% ) PPH66 ( 1.1% )391 ( 7.6% )457 ( 4.2% ) Sarcoidosis143 ( 2.5% )144 ( 2.8% )287 ( 2.6% ) Bronchiectasis21 ( 0.4% )254 ( 4.9% )275 ( 2.5% ) LAM50 ( 0.9% )72 ( 1.4% )122 ( 1.1% ) Congenital Heart Disease13 ( 0.2% )107 ( 2.1% )120 ( 1.1% ) Re-TX: OB67 ( 1.2% )48 ( 0.9% )115 ( 1.0% ) OB (Non-ReTX)33 ( 0.6% )65 ( 1.3% )98 ( 0.9% ) Re-TX: Non-OB49 ( 0.8% )42 ( 0.8% )91 ( 0.8% ) Connective Tissue Disease29 ( 0.5% )27 ( 0.5% )56 ( 0.5% ) Histiocytosis X18 ( 0.3% )17 ( 0.3% )35 ( 0.3% ) Cancer5 ( 0.1% )11 ( 0.2% )16 ( 0.1% ) Other215 ( 3.7% )178 ( 3.4% )393 ( 3.6% )
11
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTATION: Indications (Transplants: January 1995 - June 2003) Single Lung Transplants Bilateral/Double Lung Transplants
12
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTATION Indications By Year (%)
13
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTATION Indications By Year (Number)
14
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Era (Transplants: January 1988 – June 2002) Survival comparisons by era 1988-92 vs. 1993-97: p = 0.0004 1988-92 vs. 1998-2002: p < 0.0001 1993-97 vs. 1998-2002: p = 0.0001
15
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Age Group (Transplants: January 1990 – June 2002)
16
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Gender (Transplants: January 1990 – June 2002)
17
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival By Diagnosis (Transplants: January 1990 – June 2002) Year ALPHA-1 (N=1,356) CF (N= 1,923) COPD (N= 4,955) IPF (N= 2,119) PPH (N= 737) SARCOIDOSIS (N = 317) 174.778.679.967.564.866.7 360.063.062.451.654.452.8 550.252.946.840.045.244.9 740.244.933.728.337.340.4 1026.034.118.217.520.329.8 Survival comparisons Alpha-1 vs. IPF: p < 0.0001Alpha-1 vs. PPH: p = 0.0009 CF vs. COPD: p = 0.0001CF vs. IPF: p < 0.0001 CF vs. PPH: p < 0.0001CF vs. Sarcoidosis: p = 0.0014
18
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival By Diagnosis Conditional on Survival to 3 Months (Transplants: January 1990 – June 2002) Year ALPHA-1 (N=1,075) CF (N= 1,541) COPD (N= 4,152) IPF (N= 1,618) PPH (N= 503) SARCOIDOSIS (N = 222) 187.590.089.583.988.982.8 370.372.269.964.174.765.5 558.860.752.449.662.155.7 747.051.537.835.251.250.1 1030.439.020.421.827.836.9 Survival comparisons Alpha-1 vs. IPF: p < 0.0001Alpha-1 vs. COPD: p = 0.002 CF vs. COPD: p < 0.0001CF vs. IPF: p < 0.0001 PPH vs. COPD: p < 0.0001PPH vs. IPF: p < 0.0001 COPD vs. IPF: p = 0.002
19
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival By Diagnosis Conditional on Survival to 1 Year (Transplants: January 1990 – June 2002) Year ALPHA-1 (N=898) CF (N= 1,298) COPD (N=3,508) IPF (N= 1,279) PPH (N= 429) SARCOIDOSIS (N = 176) 1100.0 380.380.178.176.484.079.1 567.267.358.659.269.967.2 753.857.142.241.957.660.5 1034.743.322.825.931.344.6 Survival comparisons Alpha-1 vs. IPF: p = 0.0002Alpha-1 vs. COPD: p < 0.0001 CF vs. COPD: p < 0.0001CF vs. IPF: p < 0.0001 PPH vs. COPD: p < 0.0001PPH vs. IPF: p < 0.0001
20
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival By Diagnosis (Transplants: January 1990 – June 2002)
21
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival By Diagnosis Conditional on Survival to 3 Months (Transplants: January 1990 – June 2002)
22
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival By Diagnosis Conditional on Survival to 1 Year (Transplants: January 1990 – June 2002)
23
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival for Eisenmengers Syndrome (Transplants: January 1990 – June 2002)
24
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival By Procedure Type (Transplants: January 1990 – June 2002) Diagnosis: Alpha-1 Antitrypsin Deficiency P = 0.02
25
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Procedure Type (Transplants: January 1990 – June 2002) Diagnosis: Emphysema/COPD P < 0.0001
26
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Procedure Type (Transplants: January 1990 – June 2002) Diagnosis: IPF P = 0.5
27
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Procedure Type (Transplants: January 1990 – June 2002) Diagnosis: PPH P = 0.3
28
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Procedure Type and Era (Transplants: January 1990 – June 2002) Diagnosis: Emphysema/COPD, Single Lung
29
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Procedure Type and Era (Transplants: January 1990 – June 2002) Diagnosis: Emphysema/COPD, Double/Bilateral Lung
30
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Procedure Type and Era (Transplants: January 1990 – June 2002) Diagnosis: IPF, Single Lung
31
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Procedure Type and Era (Transplants: January 1990 – June 2002) Diagnosis: IPF, Double/Bilateral Lung
32
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Donor CMV status/Recipient CMV status (Transplants: October 1999 – June 2002)
33
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTS (1995-6/2002) Risk Factors for 1 Year Mortality (N=8,043)
34
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTS (1995-6/2002) Risk Factors for 1 Year Mortality (N=8,043)
35
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTS (1995-6/2002) Risk Factors for 1 Year Mortality (N=8,043)
36
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTS (1/1995-6/2002) Risk Factors for 1 Year Mortality
37
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTS (1/1995-6/2002) Risk Factors for 1 Year Mortality Recipient Age
38
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTS (1/1995-6/2002) Risk Factors for 1 Year Mortality Center volume
39
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTS (1/1995-6/2002) Risk Factors for 1 Year Mortality Recipient Pulmonary Vascular Resistance (PVR)
40
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTS (1/1995-6/2002) Risk Factors for 1 Year Mortality FEV1 (% predicted) in Recipients with IPF
41
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTS (1/1995-6/2002) Risk Factors for 1 Year Mortality Recipient Bilirubin
42
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTS (1995-6/2002) Factors Not Significant for 1 Year Mortality Recipient factors: pCO 2, chronic steroid use, transfusions, recent infection requiring IV drug therapy Donor factors: Clinical infection, history of hypertension, history of cancer Transplant factors: Procedure type, ABO compatibility, HLA mismatch, year of transplant, height ratio
43
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTS (1995-6/1998) Risk Factors for 5 Year Mortality (N=4,178)
44
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTS (1/1995-6/1998) Risk Factors for 5 Year Mortality
45
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTS (1/1995-6/1998) Risk Factors for 5 Year Mortality Recipient Age
46
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTS (1/1995-6/1998) Risk Factors for 5 Year Mortality Donor Age
47
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTS (1/1995-6/1998) Risk Factors for 5 Year Mortality Donor weight
48
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTS (1/1995-6/1998) Risk Factors for 5 Year Mortality Recipient Pulmonary Vascular Resistance (PVR)
49
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTS (1995-6/1998) Factors Not Significant for 5 Year Mortality Recipient factors: Hospitalized, chronic steroid use, transfusions, history of malignancy, PRA, gender, FVC, FEV1, height, weight Donor factors: Gender, clinical infection, history of hypertension, history of cancer, history of diabetes, height Transplant factors: Procedure type, ABO compatibility
50
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTS (1995-6/1998) Risk Factors for 5 Year Mortality Conditional on Survival to 1 Year (N=2,982)
51
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTS (1/1995-6/1998) Risk Factors for 5 Year Mortality Conditional on Survival to 1 Year
52
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTS (1/1995-6/1998) Risk Factors for 5 Year Mortality Condtional on Survival to 1 Year Recipient Age
53
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTS (1995-6/1997) Factors Not Significant for Conditional 5 Year Mortality Recipient factors: Diagnosis, ventilator, inotropes, hospitalized at transplant, pCO 2, gender, chronic steroid use, transfusions, history of malignancy, PRA, repeat transplant, FeV1, FVC, height, weight Donor factors: Gender, clinical infection, history of hypertension, history of cancer, history of diabetes, COD, age, height, weight Transplant factors: ABO compatibility, HLA mismatch, CMV mismatch
54
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANTS (1995-6/1997) Factors Not Significant for Conditional 5 Year Mortality Post-transplant factors: Hospitalized for infection, stroke, dialysis, prolonged graft dysfunction
55
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG RECIPIENTS Functional Status (Follow-ups: April 1994 – June 2003)
56
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG RECIPIENTS Employment Status (Follow-ups: April 1994 – June 2003)
57
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG RECIPIENTS: Rehospitalization Post-transplant (Follow-ups: April 1994 - June 2003)
58
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG RECIPIENTS Induction Immunosuppression (Follow-ups: January 2001 - June 2003)
59
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG RECIPIENTS Induction Immunosuppression (Follow-ups: January 2000 - December 2002)
60
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG 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
61
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG RECIPIENTS Maintenance Immunosuppression at Time of Follow-up For follow-ups between January 2000 through June 2003 1 Year Follow-up (N = 1,753)5 Year Follow-up (N = 814) NOTE: Different patients are analyzed in Year 1 and Year 5
62
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG RECIPIENTS Maintenance Immunosuppression Drug Combinations 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
63
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 POST-LUNG TRANSPLANT MORBIDITY FOR ADULTS Cumulative Prevalence in Survivors within 1 Year Post-Transplant (Follow-ups: April 1994 - June 2003)
64
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 POST-LUNG TRANSPLANT MORBIDITY FOR ADULTS Cumulative Prevalence in Survivors within 5 Years Post-Transplant (Follow-ups: April 1994 - June 2003)
65
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 POST-LUNG TRANSPLANT MORBIDITY FOR ADULTS Cumulative Prevalence in Survivors within 7 Years Post-Transplant (Follow-ups: April 1994 - June 2003)
66
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 Freedom from Bronchiolitis Obliterans For Adult Lung Recipients (Follow-ups: April 1994-June 2003)
67
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 Freedom from Severe Renal Dysfunction* For Adult Lung Recipients (Follow-ups: April 1994-June 2003) * Severe renal dysfunction = Creatinine > 2.5 mg/dl, dialysis or renal transplant
68
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 MALIGNANCY POST-LUNG TRANSPLANTATION FOR ADULTS Cumulative Prevalence in Survivors (Follow-ups: April 1994 - June 2003) Malignancy/Type1-Year Survivors5-Year Survivors7-Year Survivors No Malignancy 6006 (96.2%)1137 (87%)386 (81.4%) Malignancy (all types combined) 237 (3.8%)170 (13%)88 (18.6%) Malignancy Type* Skin448655 Lymph1223718 Other484125 Type Not Reported 19101 * 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; 1), bladder (2; 1; 0), lung (2; 4; 2), breast (1; 5; 4); prostate (0; 5; 3), cervical (1; 1; 1). Numbers in parentheses represent the number of reported cases within each time period.
69
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 Freedom from Malignancy For Adult Lung Recipients (Follow-ups: April 1994-June 2003)
70
2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 ADULT LUNG TRANSPLANT RECIPIENTS: Cause Of Death (Deaths: January 1992- June 2003) CAUSE OF DEATH 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) BRONCHIOLITIS5 (0.5%)74 (5.5%)313 (28.6%)185 (32.3%)142 (31.1%) ACUTE REJECTION46 (4.9%)27 (2.0%)21 (1.9%)4 (0.7%)2 (0.4%) LYMPHOMA1 (0.1%)44 (3.3%)23 (2.1%)9 (1.6%)18 (3.9%) MALIGNANCY, OTHER27 (2.0%)52 (4.7%)43 (7.5%)40 (8.8%) CMV1 (0.1%)56 (4.2%)17 (1.6%)4 (0.7%)2 (0.4%) INFECTION, NON-CMV220 (23.5%)521 (38.7%)284 (25.9%)113 (19.8%)79 (17.3%) GRAFT FAILURE286 (30.5%)236 (17.5%)175 (16.0%)99 (17.3%)58 (12.7%) CARDIOVASCULAR108 (11.5%)58 (4.3%)36 (3.3%)24 (4.2%)21 (4.6%) TECHNICAL78 (8.3%)37 (2.8%)12 (1.1%)1 (0.2%)2 (0.4%) OTHER192 (20.5%)265 (19.7%)163 (14.9%)90 (15.7%)92 (20.2%)
Similar presentations
© 2025 SlidePlayer.com. Inc.
All rights reserved.