1. HEART-LUNG TRANSPLANTATION
Overall
ISHLT
2009

2. NUMBER OF HEART-LUNG TRANSPLANTS REPORTED BY YEAR
This figure includes only the heart-lung transplants that are reported to the ISHLT Transplant Registry. As such, this should not necessarily be construed as evidence that the number of heart-lung transplants performed worldwide has declined.
ISHLT
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.
2009

3. AVERAGE CENTER VOLUME Heart-Lung Transplants: January 1, 1998 - June 30, 2008
ISHLT
2009

4. DISTRIBUTION OF HEART-LUNG TRANSPLANTS BY CENTER VOLUME Heart-Lung Transplants: January 1, June 30, 2008
ISHLT
2009

5. DISTRIBUTION OF HEART-LUNG TRANSPLANTS BY LUNG CENTER VOLUME Lung Transplants: January 1, June 30, 2008
ISHLT
2009

6. HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival for All Ages (Transplants: January June 2007)
Survival was calculated using the Kaplan-Meier method, which incorporates information from all transplants for whom any follow-up has been provided. Since many patients are still alive and some patients have been lost to follow-up, the survival rates are estimates rather than exact rates because the time of death is not known for all patients. Therefore, 95% confidence limits are provided about the survival rate estimate; the survival rate shown is the best estimate but the true rate will most likely fall within these limits.
The half-life is the estimated time point at which 50% of all of the recipients have died. The conditional half-life is the estimated time point at which 50% of the recipients who survive to at least 1 year have died. Because the decline in survival is greatest during the first year following transplantation, the conditional survival provides a more realistic expectation of survival time for recipients who survive the early post-transplant period.
ISHLT
2009

7. HEART-LUNG TRANSPLANTATION
Adult Recipients
ISHLT
2009

8. DIAGNOSIS IN ADULT HEART-LUNG TRANSPLANTS (January 1982 - June 2008)
“Other” includes cancer, LAM, OB, sarcoidosis, bronchiectasis
ISHLT
2009

9. DIAGNOSIS IN ADULT HEART-LUNG TRANSPLANTS (Transplants: January 1982 - June 2008)
Congenital Heart Disease
921 (34.9%)
Idiopathic Pulmonary Arterial Hypertension
719 (27.2%)
Cystic Fibrosis
373 (14.1%)
COPD/Emphysema
101 ( 3.8%)
Acquired Heart Disease
77 ( 2.9%)
Idiopathic Pulmonary Fibrosis
76 ( 2.9%)
Alpha-1
53 ( 2.0%)
Sarcoidosis
37 ( 1.4%)
Re-Transplant: Not Obliterative Bronchiolitis
31 ( 1.2%)
Re-Transplant: Obliterative Bronchiolitis
24 ( 0.9%)
Bronchiectasis
20 ( 0.8%)
Obliterative Bronchiolitis (not Re-Transplant)
14 ( 0.5%)
Other
193 ( 7.3%)
ISHLT
2009

10. DIAGNOSIS IN ADULT HEART-LUNG TRANSPLANTS BY ERA (Transplants: January 1982 - June 2008)
“Other” includes OB (non-ReTX), Bronchiectasis, Sarcoidosis
ISHLT
2009

11. ADULT HEART-LUNG TRANSPLANTATION Indications By Year (%)
ISHLT
2009

12. ADULT HEART-LUNG TRANSPLANTATION Indications By Year (Number)
ISHLT
2009

13. ADULT HEART-LUNG TRANSPLANTS: AGE DISTRIBUTION BY LOCATION Transplants between January 2000 and June 2008
ISHLT
2009

14. ADULT HEART-LUNG TRANSPLANTS: DIAGNOSIS DISTRIBUTION BY LOCATION Transplants between January 2000 and June 2008
NOTE: Transplants with unknown diagnoses are excluded from this tabulation.
ISHLT
2009

15. ADULT HEART-LUNG TRANSPLANTS: DONOR AGE DISTRIBUTION BY LOCATION Transplants between January 2000 and June 2008
NOTE: Transplants with unknown donor ages are excluded from this tabulation.
ISHLT
2009

16. HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival for Adult Recipients (Transplants: January June 2007)
Survival was calculated using the Kaplan-Meier method, which incorporates information from all transplants for whom any follow-up has been provided. Since many patients are still alive and some patients have been lost to follow-up, the survival rates are estimates rather than exact rates because the time of death is not known for all patients. Therefore, 95% confidence limits are provided about the survival rate estimate; the survival rate shown is the best estimate but the true rate will most likely fall within these limits.
The half-life is the estimated time point at which 50% of all of the recipients have died. The conditional half-life is the estimated time point at which 50% of the recipients who survive to at least 1 year have died. Because the decline in survival is greatest during the first year following transplantation, the conditional survival provides a more realistic expectation of survival time for recipients who survive the early post-transplant period.
ISHLT
2009

17. HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival for Adult Recipients by Era (Transplants: January June 2007)
Survival was calculated using the Kaplan-Meier method, which incorporates information from all transplants for whom any follow-up has been provided. Since many patients are still alive and some patients have been lost to follow-up, the survival rates are estimates rather than exact rates because the time of death is not known for all patients. Survival rates were compared using the log-rank test statistic. A significant p-value means that at least one of the groups is different than the others but it doesn’t identify which group it is.
The half-life is the estimated time point at which 50% of all of the recipients have died. The conditional half-life is the estimated time point at which 50% of the recipients who survive to at least 1 year have died. Because the decline in survival is greatest during the first year following transplantation, the conditional survival provides a more realistic expectation of survival time for recipients who survive the early post-transplant period.
ISHLT
2009

18. ADULT HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival By Diagnosis (Transplants: January 1990 – June 2007)
Survival was calculated using the Kaplan-Meier method, which incorporates information from all transplants for whom any follow-up has been provided. Since many patients are still alive and some patients have been lost to follow-up, the survival rates are estimates rather than exact rates because the time of death is not known for all patients. Survival rates were compared using the log-rank test statistic.
The half-life is the estimated time point at which 50% of all of the recipients have died.
ISHLT
2009

19. ADULT HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival By Diagnosis Conditional on Survival to 1 Year (Transplants: January 1990 – June 2007)
Survival was calculated using the Kaplan-Meier method, which incorporates information from all transplants for whom any follow-up has been provided. Since many patients are still alive and some patients have been lost to follow-up, the survival rates are estimates rather than exact rates because the time of death is not known for all patients. Survival rates were compared using the log-rank test statistic.
The half-life is the estimated time point at which 50% of all of the recipients have died.
ISHLT
2009

20. ADULT HEART-LUNG RECIPIENTS Functional Status of Surviving Recipients (Follow-ups: April 1994 – June 2008)
This figure shows the functional status reported on the 1-year, 3-year, 5-year and 7-year annual follow-ups. Because all follow-ups between April 1994 and June 2008 were included, the bars do not include the same patients.
ISHLT
2009

21. ADULT HEART-LUNG RECIPIENTS Functional Status of Surviving Recipients For the Same Patients (Follow-ups: April 1994 – June 2008)
This figure shows the functional status reported on the 1-year, 3-year and 5-year annual follow-ups for the same patients.
ISHLT
2009

22. ADULT HEART-LUNG RECIPIENTS Employment Status of Surviving Recipients (Follow-ups: April 1994 – June 2008)
This figure shows the employment status reported on the 1-year, 3-year, 5-year and 7-year annual follow-ups. Because all follow-ups between April 1994 and June 2008 were included, the bars do not include the same patients.
ISHLT
2009

23. ADULT HEART-LUNG RECIPIENTS: Rehospitalization Post-transplant of Surviving Recipients (Follow-ups: April June 2008)
This figure shows the hospitalizations reported on the 1-year, 3-year, 5-year and 7-year annual follow-ups, representing the hospitalizations between discharge and 1 year, between the 2-year and 3-year follow-up, between the 4-year and 5-year follow-up and between the 6-year and 7-year follow-up, respectively. Because all follow-ups between April 1994 and June 2008 were included, the bars do not include the same patients.
ISHLT
2009

24. ADULT HEART-LUNG RECIPIENTS Induction Immunosuppression For transplants between January 2001 through June 2008
ISHLT
2009
Analysis is limited to patients who were alive at the time of the follow-up

25. ADULT HEART-LUNG RECIPIENTS Induction Immunosuppression (Transplants: January 2000 - December 2007)
NOTE: Analysis is limited to the patients who survived discharge
ISHLT
2009
Analysis is limited to patients who were alive at the time of the follow-up

26. ADULT HEART-LUNG RECIPIENTS Induction Immunosuppression (Transplants: January 2000 - December 2007)
NOTE: Analysis is limited to the patients who survived discharge
Any Induction Polyclonal ALG/ATG OKT IL2R-antagonist
ISHLT
2009
Analysis is limited to patients who were alive at the time of the follow-up

27. ADULT HEART-LUNG RECIPIENTS Maintenance Immunosuppression at Time of Follow-up For follow-ups between January 2001 through June 2008
NOTE: Analysis is limited to the patients who were alive at the time of the follow-up
This figure shows the maintenance immunosuppression reported as being provided at the time of the 1-year and 5-year annual follow-up forms. To provide a snapshot of current practice, only follow-ups occurring between January 2001 and June 2008 were included. Therefore, this figure does not represent changes in practice between the 1-year follow-up and 5-year follow-up on a cohort of patients. The patients in the 1-year tabulation are not the same patients as in the 5-year tabulation.
NOTE: Different patients are analyzed in Year 1 and Year 5
ISHLT
2009
Analysis is limited to patients who were alive at the time of the follow-up

28. ADULT HEART-LUNG RECIPIENTS Maintenance Immunosuppression Drug Combinations at Time of Follow-up For follow-ups between January 2001 through June 2008
NOTE: Analysis is limited to the patients who were alive at the time of the follow-up
This figure shows the maintenance immunosuppression reported as being provided at the time of the 1-year and 5-year annual follow-up forms. To provide a snapshot of current practice, only follow-ups occurring between January 2001 and June 2008 were included. Therefore, this figure does not represent changes in practice between the 1-year follow-up and 5-year follow-up on a cohort of patients. The patients in the 1-year tabulation are not the same patients as in the 5-year tabulation.
NOTE: Different patients are analyzed in Year 1 and Year 5
ISHLT
2009
Analysis is limited to patients who were alive at the time of the follow-up

29. POST-HEART-LUNG TRANSPLANT MORBIDITY FOR ADULTS Cumulative Prevalence in Survivors within 1 Year Post-Transplant (Follow-ups: April June 2008)
This table shows the percentage of patients experiencing various morbidities as reported on the 1-year annual follow-up form. The percentages are based on patients with known responses. Because the outcomes are reported to be unknown at different rates the number with known responses for each outcome are also provided.
ISHLT
2009

30. POST-HEART-LUNG TRANSPLANT MORBIDITY FOR ADULTS Cumulative Prevalence in Survivors within 5 Years Post-Transplant (Follow-ups: April June 2008)
This table shows the percentage of patients experiencing various morbidities as reported within 5 years following transplantation. The percentages are based on patients with known responses. To reduce bias, only patients with responses reported on every follow-up through the 5-year annual follow-up were included. Because the outcomes are reported to be unknown at different rates the number with known responses for each outcome are also provided.
ISHLT
2009

31. Freedom from Coronary Artery Vasculopathy For Adult Heart-Lung Recipients (Follow-ups: April 1994-June 2008)
Freedom from CAV rates were computed using the Kaplan-Meier method.
The development of CAV is reported on annual follow-ups; a date of diagnosis is not provided. For this figure the date of follow-up was used as the date of occurrence. Patients were included in the analysis until an unknown response for CAV was reported. Therefore, the rates seen here may differ from those reported in the cumulative prevalence slide which is based on only those patients with known responses for CAV at all follow-up time points.
ISHLT
2009

32. Freedom from Bronchiolitis Obliterans Syndrome For Adult Heart-Lung Recipients (Follow-ups: April 1994-June 2008)
Freedom from bronchiolitis obliterans rates were computed using the Kaplan-Meier method.
The development of bronchiolitis obliterans is reported on annual follow-ups; a date of diagnosis is not provided. For this figure the date of follow-up was used as the date of occurrence. Patients were included in the analysis until an unknown response for bronchiolitis obliterans was reported. Therefore, the rates seen here may differ from those reported in the cumulative prevalence slide which is based on only those patients with known responses for bronchiolitis obliterans at all follow-up time points.
ISHLT
2009

33. Freedom from Severe Renal Dysfunction
Freedom from Severe Renal Dysfunction* For Adult Heart-Lung Recipients (Follow-ups: April 1994-June 2008)
Freedom from severe renal dysfunction rates were computed using the Kaplan-Meier method.
The development of severe renal dysfunction is reported on annual follow-ups; a date of diagnosis is not provided. For this figure the date of follow-up was used as the date of occurrence. Patients were included in the analysis until an unknown response for severe renal dysfunction was reported. Therefore, the rates seen here may differ from those reported in the cumulative prevalence slide which is based on only those patients with known responses for severe renal dysfunction at all follow-up time points.
ISHLT
2009

34. MALIGNANCY POST-HEART-LUNG TRANSPLANT FOR ADULTS Cumulative Prevalence in Survivors (Follow-ups: April 1994-June 2008)
Malignancy/Type
1-Year Survivors
5-Year Survivors
10-Year Survivors
No Malignancy
352 (93.1%)
119 (88.8%)
32 (84.2%)
Malignancy (all types combined)
26 (6.9%)
15 (11.2%)
6 (15.8%)
Malignancy Type*
Skin 2 4 6
Lymph 18
Other 3
Type Not Reported
This table shows the percentage of patients with malignancies reported within 1 year, within 5 years and within 10 years following transplantation. The percentages are based on patients with known responses. To reduce bias, only patients with responses reported on every follow-up through the 5-year (or 10-year) annual follow-up were included in the “5-Year Survivors” (or “10-Year Survivors”) column.
* Recipients may have experienced more than one type of malignancy so sum of individual malignancy types may be greater than total number with malignancy.
ISHLT
2009

35. Freedom from Malignancy For Adult Heart-Lung Recipients (Follow-ups: April 1994- June 2008)
Freedom from malignancy rates were computed using the Kaplan-Meier method.
The development of malignancy is reported on annual follow-ups; a date of diagnosis is not provided. For this figure the date of follow-up was used as the date of occurrence. Patients were included in the analysis until an unknown response for malignancy was reported. Therefore, the rates seen here may differ from those reported in the cumulative prevalence slide which is based on only those patients with known responses for malignancy at all follow-up time points.
ISHLT
2009

36. ADULT HEART-LUNG TRANSPLANT RECIPIENTS: Cause of Death (Deaths: January 1992 - June 2008)
0-30 Days
(N = 282)
31 Days - 1 Year (N = 217)
>1 Year - 3 Years (N = 187)
>3 Years - 5 Years (N = 134)
>5 Years
(N = 274)
BRONCHIOLITIS
4 (1.8%)
39 (20.9%)
26 (19.4%)
43 (15.7%)
ACUTE REJECTION
3 (1.1%)
6 (2.8%)
2 (1.1%)
1 (0.7%)
1 (0.4%)
LYMPHOMA
8 (3.7%)
10 (5.3%)
5 (3.7%)
5 (1.8%)
MALIGNANCY, OTHER
3 (1.4%)
7 (3.7%)
4 (3.0%)
16 (5.8%)
CMV
1 (0.5%)
INFECTION, NON-CMV
51 (18.1%)
76 (35.0%)
60 (32.1%)
43 (32.1%)
80 (29.2%)
GRAFT FAILURE
82 (29.1%)
52 (24.0%)
31 (16.6%)
25 (18.7%)
54 (19.7%)
CARDIOVASCULAR
24 (8.5%)
9 (4.1%)
12 (6.4%)
9 (6.7%)
18 (6.6%)
TECHNICAL
57 (20.2%)
OTHER
65 (23.0%)
25 (13.4%)
19 (14.2%)
57 (20.8%)
Percentages are based on only known causes of death.
ISHLT
2009

37. ADULT HEART-LUNG TRANSPLANT RECIPIENTS: Relative Incidence of Leading Causes of Death (Deaths: January June 2008)
ISHLT
2009

38. HEART-LUNG TRANSPLANTATION
Pediatric Recipients
ISHLT
2009

39. AGE DISTRIBUTION OF PEDIATRIC HEART-LUNG RECIPIENTS (Transplants: January 1982 - June 2008)
ISHLT
2009

40. AGE DISTRIBUTION FOR DONORS OF PEDIATRIC HEART-LUNG RECIPIENTS (Transplants: January June 2008)
NOTE: Transplants where donor age is unknown are excluded from this tabulation.
ISHLT
2009

41. AGE DISTRIBUTION OF PEDIATRIC HEART-LUNG RECIPIENTS By Year of Transplant
Number of Transplants
This figure includes only the pediatric heart-lung transplants that are reported to the ISHLT Transplant Registry. As such, this should not necessarily be construed as evidence that the number of pediatric heart-lung transplants performed worldwide has declined.
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.
ISHLT
2009

42. AGE DISTRIBUTION OF PEDIATRIC HEART-LUNG RECIPIENTS By Era of Transplant
Percentage of Transplants
This figure includes only the pediatric heart-lung transplants that are reported to the ISHLT Transplant Registry. As such, this should not necessarily be construed as evidence that the number of pediatric heart-lung transplants performed worldwide has declined.
ISHLT
2009

43. NUMBER OF CENTERS REPORTING PEDIATRIC HEART-LUNG TRANSPLANTS
NEED TO UPDATE
ISHLT
2009

44. NUMBER OF CENTERS REPORTING PEDIATRIC HEART-LUNG TRANSPLANTS Stratified by center volume
ISHLT
2009

45. DIAGNOSIS IN PEDIATRIC HEART –LUNG TRANSPLANT RECIPIENTS (Transplants: 1986-2007)
“Other” includes Bronchiectasis, Alpha-1, and OB (non-ReTX)
ISHLT
NOTE: Unknown diagnoses were excluded from this tabulation.
2009

46. PEDIATRIC HEART-LUNG TRANSPLANTS: AGE DISTRIBUTION BY LOCATION Transplants between January 2000 and June 2008
ISHLT
2009

47. PEDIATRIC HEART-LUNG TRANSPLANTS: DIAGNOSIS DISTRIBUTION BY LOCATION Transplants between January 2000 and June 2008
ISHLT
2009

48. PEDIATRIC HEART-LUNG TRANSPLANTS: DONOR AGE DISTRIBUTION BY LOCATION Transplants between January 2000 and June 2008
ISHLT
2009

49. PEDIATRIC HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival By Diagnosis (Transplants: January 1990 – June 2007)
Survival was calculated using the Kaplan-Meier method, which incorporates information from all transplants for whom any follow-up has been provided. Since many patients are still alive and some patients have been lost to follow-up, the survival rates are estimates rather than exact rates because the time of death is not known for all patients.
Survival rates were compared using the log-rank test statistic.
ISHLT
2009

50. PEDIATRIC HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival (Transplants: January 1982 - June 2007)
Survival was calculated using the Kaplan-Meier method, which incorporates information from all transplants for whom any follow-up has been provided. Since many patients are still alive and some patients have been lost to follow-up, the survival rates are estimates rather than exact rates because the time of death is not know for all patients. The half-life is the estimated time point at which 50% of all of the recipients have died.
Survival rates were compared using the log-rank test statistic.
ISHLT
2009

51. PEDIATRIC HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival by Era (Transplants: January June 2007)
Survival was calculated using the Kaplan-Meier method, which incorporates information from all transplants for whom any follow-up has been provided. Since many patients are still alive and some patients have been lost to follow-up, the survival rates are estimates rather than exact rates because the time of death is not know for all patients.
The half-life is the estimated time point at which 50% of all of the recipients have died. The conditional half-life is the estimated time point at which 50% of the recipients who survive to at least 1 year have died. Because the decline in survival is greatest during the first year following transplantation, the conditional survival provides a more realistic expectation of survival time for recipients who survive the early post-transplant period.
Survival rates were compared using the log-rank test statistic.
ISHLT
2009

52. PEDIATRIC HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival by Era (Transplants: January June 2007) Conditional on Survival to 1 Year
Survival was calculated using the Kaplan-Meier method, which incorporates information from all transplants for whom any follow-up has been provided. Since many patients are still alive and some patients have been lost to follow-up, the survival rates are estimates rather than exact rates because the time of death is not know for all patients.
The half-life is the estimated time point at which 50% of all of the recipients have died. The conditional half-life is the estimated time point at which 50% of the recipients who survive to at least 1 year have died. Because the decline in survival is greatest during the first year following transplantation, the conditional survival provides a more realistic expectation of survival time for recipients who survive the early post-transplant period.
Survival rates were compared using the log-rank test statistic.
ISHLT
2009

53. PEDIATRIC HEART-LUNG TRANSPLANT RECIPIENTS: Cause of Death (Deaths: January 1992 - June 2008)
0-30 Days (N = 37)
31 Days - 1 Year (N = 49 )
>1 Year - 3 Years (N = 45 )
>3 Years - 5 Years (N = 31 )
>5 Years (N = 43)
BRONCHIOLITIS
2 (4.1%)
21 (46.7%)
10 (32.3%)
8 (18.6%)
ACUTE REJECTION
1 (2.2%)
LYMPHOMA
1 (3.2%)
2 (4.7%)
MALIGNANCY, OTHER
CMV
INFECTION, NON-CMV
6 (16.2%)
16 (32.7%)
4 (8.9%)
14 (32.6%)
GRAFT FAILURE
16 (43.2%)
9 (18.4%)
14 (31.1%)
14 (45.2%)
11 (25.6%)
CARDIOVASCULAR
2 (5.4%)
3 (6.1%)
2 (6.5%)
3 (7.0%)
TECHNICAL
Percentages are based on only known causes of death.
ISHLT
2009

54. PEDIATRIC HEART-LUNG TRANSPLANT RECIPIENTS: Cause of Death (Deaths: April 1994 - June 2008)
0-30 Days (N = 31)
31 Days - 1 Year (N = 35)
>1 Year - 3 Years (N = 39)
>3 Years - 5 Years (N = 27)
>5 Years
(N = 43)
BRONCHIOLITIS
1 (2.9%)
18 (46.2%)
9 (33.3%)
8 (18.6%)
ACUTE REJECTION
1 (2.6%)
LYMPHOMA
2 (5.7%)
1 (3.7%)
2 (4.7%)
MALIGNANCY, OTHER
CMV
INFECTION, NON-CMV
4 (12.9%)
12 (34.3%)
4 (10.3%)
14 (32.6%)
GRAFT FAILURE
14 (45.2%)
6 (17.1%)
11 (28.2%)
12 (44.4%)
11 (25.6%)
CARDIOVASCULAR
2 (6.5%)
3 (7.0%)
TECHNICAL
Percentages are based on only known causes of death.
ISHLT
2009

55. PEDIATRIC HEART-LUNG TRANSPLANT RECIPIENTS: Relative Incidence of Leading Causes of Death (Deaths: April June 2008)
ISHLT
2009