HEART TRANSPLANTATION Pediatric Recipients ISHLT 2008 J Heart

HEART TRANSPLANTATION Pediatric Recipients ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

Number of Transplants AGE DISTRIBUTION OF PEDIATRIC HEART RECIPIENTS (Transplants: January 1996 - June 2007) ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

AGE DISTRIBUTION FOR DONORS OF PEDIATRIC HEART RECIPIENTS Number of Transplants (Transplants: January 1996 - June 2007) ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

AGE DISTRIBUTION OF PEDIATRIC HEART RECIPIENTS Number of Transplants By Year of Transplant ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983 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 hearts transplanted worldwide has increased and/or decreased in recent years.

Number of Pediatric Cases Reporting NUMBER OF CENTERS REPORTING PEDIATRIC HEART TRANSPLANTS ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

AVERAGE CENTER VOLUME Pediatric Heart Transplants: January 1, 1997 - June 30, 2007 ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

DISTRIBUTION OF TRANSPLANTS BY CENTER VOLUME Pediatric Heart Transplants: January 1, 1997 - June 30, 2007 ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

PEDIATRIC HEART RE-TRANSPLANTS By Transplant Year Retransplants: January 1994 – December 2006 ISHLT Year of transplant 2008 J Heart Lung Transplant 2008; 27: 937 -983

PEDIATRIC HEART RE-TRANSPLANTS By Intertransplant Interval Retransplants: January 1994 - June 2007 Time Between Previous and Current Transplant ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

KAPLAN-MEIER SURVIVAL RATES FOR PEDIATRIC HEART RETRANSPLANTS STRATIFIED BY INTER-TRANSPLANT INTERVAL Retransplants: January 1994 - June 2006 Time (years) since most recent transplant ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

DIAGNOSIS IN PEDIATRIC HEART TRANSPLANT RECIPIENTS (Age: < 1 Year) 1/1996 -6/2007 % of Cases 1988 -1995 ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

DIAGNOSIS IN PEDIATRIC HEART TRANSPLANT RECIPIENTS (Age: 1 -10 Years) 1/1996 -6/2007 % of Cases 1988 -1995 ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

DIAGNOSIS IN PEDIATRIC HEART TRANSPLANT RECIPIENTS (Age: 11 -17 Years) 1/1996 -6/2007 % of Cases 1988 -1995 ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

Survival (%) PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival (Transplants: 1/1982 -6/2006) ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

PEDIATRIC HEART TRANSPLANTATION Conditional Kaplan-Meier Survival (%) (Transplants: 1/1982 -6/2006) ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

PEDIATRIC HEART TRANSPLANTATION Conditional Kaplan-Meier Survival for Recent Era Survival (%) (Transplants: 1/1999 -6/2006) ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival by Era Survival (%) (Transplants: 1/1982 -6/2006) ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival by Era (Transplants: 1/1982 -6/2005) Survival (%) Age: < 1 Year ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983 Last updated based on data as of December 2006

PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival by Era (Transplants: 1/1982 -6/2005) Survival (%) Age: 1 -10 Years ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983 Last updated based on data as of December 2006

PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival by Era (Transplants: 1/1982 -6/2005) Survival (%) Age: 11 -17 Years ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983 Last updated based on data as of December 2006

PEDIATRIC HEART TRANSPLANTS: AVERAGE CENTER VOLUME DISTRIBUTION BY LOCATION Transplants between January 2000 and June 2007 ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

PEDIATRIC HEART TRANSPLANTS: AGE DISTRIBUTION BY LOCATION Transplants between January 2000 and June 2007 ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

PEDIATRIC HEART TRANSPLANTS: DIAGNOSIS DISTRIBUTION BY LOCATION Transplants between January 2000 and June 2007 ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

PEDIATRIC HEART TRANSPLANTS: DONOR AGE DISTRIBUTION BY LOCATION Transplants between January 2000 and June 2007 ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

PEDIATRIC HEART TRANSPLANTS (1/1995 -6/2006) Risk Factors For 1 Year Mortality N=3, 395 ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983 Reference diagnosis = cardiomyopathy

PEDIATRIC HEART TRANSPLANTS (1/1995 -6/2005) Borderline Significant Risk Factors For 1 Year Mortality N=3, 395 ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

PEDIATRIC HEART TRANSPLANTS (1/1995 -6/2006) Risk Factors for 1 Year Mortality N=3, 395 ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

PEDIATRIC HEART TRANSPLANTS (1/1995 -6/2006) Risk Factors for 1 Year Mortality Recipient Age ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983 N=3, 395

PEDIATRIC HEART TRANSPLANTS (1/1995 -6/2006) Risk Factors for 1 Year Mortality Donor Age ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983 N=3, 395

PEDIATRIC HEART TRANSPLANTS (1/1995 -6/2006) Risk Factors for 1 Year Mortality Pre-Transplant Creatinine ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983 N=3, 395

PEDIATRIC HEART TRANSPLANTS (1/1995 -6/2006) Risk Factors for 1 Year Mortality Center Volume for Pediatric Transplants ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983 N=3, 395

PEDIATRIC HEART TRANSPLANTS (1/1995 -6/2006) Risk Factors for 1 Year Mortality Donor BSA ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983 N=3, 395

PEDIATRIC HEART TRANSPLANTS (1/1995 -6/2006) Factors Not Significant for 1 Year Mortality Recipient Factors: IV inotropes, sternotomy, history of malignancy, hospitalized, diabetes Donor Factors: Gender, clinical infection, history of diabetes Transplant Factors: CMV mismatch, ischemia time, HLA mismatch ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

PEDIATRIC HEART TRANSPLANTS (1/1995 -6/1997) Risk Factors For 10 Year Mortality ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983 N=697

PEDIATRIC HEART TRANSPLANTS (1/1995 -6/1997) Risk Factors for 10 Year Mortality ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983 N=697

PEDIATRIC HEART TRANSPLANTS (1/1995 -6/1997) Risk Factors for 10 Year Mortality Pre-Transplant Creatinine ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983 N=697

PEDIATRIC HEART TRANSPLANTS (1/1995 -6/1997) Risk Factors for 10 Year Mortality Donor Weight ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983 N=697

PEDIATRIC HEART TRANSPLANTS (1/1995 -6/1997) Risk Factors for 10 Year Mortality Center Volume for Pediatric Transplants ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983 N=697

PEDIATRIC HEART TRANSPLANTS (1/1995 -6/1997) Risk Factors for 10 Year Mortality BSA Ratio (Donor BSA/Recipient BSA) ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983 N=697

PEDIATRIC HEART TRANSPLANTS (1/1995 -6/2000) Factors Not Significant for 10 Year Mortality Recipient Factors: PRA, diabetes, repeat transplant, transfusions, hospitalized, gender, PGE, VAD, bilirubin Donor Factors: Cause of death, age, clinical infection Transplant Factors: Ischemia time, HLA mismatch, CMV mismatch ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

PEDIATRIC HEART RECIPIENTS Functional Status of Surviving Recipients (Follow-ups: April 1994 - June 2007) ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

PEDIATRIC HEART RECIPIENTS Rehospitalization Post-transplant of Surviving Recipients (Follow-ups: April 1994 - June 2007) ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

PEDIATRIC HEART RECIPIENTS Induction Immunosuppression % of Patients (Transplants: January 2001 - June 2007) ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983 Analysis is limited to patients who were alive at the time of the follow-up

PEDIATRIC HEART RECIPIENTS Induction Immunosuppression (Transplants: January 2001 - June 2007) ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983 Test of increasing trend over time: Any induction p < 0. 0001 Polyclonal p < 0. 0001 IL 2 p = 0. 0029 Analysis is limited to patients who were alive at the time of the follow-up

PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival by Induction Group (Transplants: January 2000 – June 2005) Conditional on Survival to 14 Days Survival (%) No comparisons were statistically significant. ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983 Last updated based on data as of December 2006

PEDIATRIC HEART TRANSPLANTATION Survival (%) Kaplan-Meier Survival by Induction Group and Rejection Between Transplant Discharge and 1 -Year Follow-up (1 -Year Follow-ups: July 2004 - June 2006) Conditional on Survival to 1 Year No pair-wise comparisons of survival by induction were statistically significant within either rejection grouping except No induction/Rejection vs. Polyclonal/Rejection (p=0. 0329). ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival by Induction Group (Transplants: January 2000 – June 2005) Conditional on Survival to 14 Days Survival (%) Age: < 1 Year ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983 Last updated based on data as of December 2006

PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival by Induction Group (Transplants: January 2000 – June 2005) Survival (%) Conditional on Survival to 14 Days Age: 1 -10 Years No comparisons were statistically significant. ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983 Last updated based on data as of December 2006

PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival by Induction Group (Transplants: January 2000 – June 2005) Survival (%) Conditional on Survival to 14 Days Age: 11 -17 Years ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983 Last updated based on data as of December 2006

PEDIATRIC HEART RECIPIENTS % of Patients Maintenance Immunosuppression at Time of Follow-up (Follow-ups: January 2001 - June 2007) NOTE: Different patients are analyzed in Year 1 and Year 5 ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983 Analysis is limited to patients who were alive at the time of the follow-up

PEDIATRIC HEART RECIPIENTS % of Patients Maintenance Immunosuppression at Time of Follow-up for Same Patients at Each Time Point (Follow-ups: January 2001 - June 2007) ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983 Analysis is limited to patients who were alive at the time of the follow-up

PEDIATRIC HEART RECIPIENTS % of Patients Maintenance Immunosuppression Drug Combinations at Time of Follow-up (Follow-ups: January 2001 - June 2007) ISHLT NOTE: Different patients are analyzed in Year 1 and Year 5 2008 J Heart Lung Transplant 2008; 27: 937 -983 Analysis is limited to patients who were alive at the time of the follow-up

PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival Based on Prednisone Use Survival (%) Conditional on Survival to 1 Year (Transplants: April 1994 - June 2006) p < 0. 0001 ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival Based on Prednisone Use for a Recent Era Survival (%) Conditional on Survival to 1 Year (Transplants: January 1998 – June 2006) p = 0. 0050 ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival Stratified by Tacrolimus vs. Cyclosporine Use at Discharge (Transplants: January 1998 - June 2006) Conditional on Survival to 14 Days Survival (%) p = 0. 1706 ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival Based on Rejection within 1 st Year Survival (%) (1 -Year Follow-ups: July 2004 - June 2006) p = 0. 0346 ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival Based on Rejection within 1 st Year Survival (%) Stratified by Calcineurin Use at Discharge (1 -Year Follow-ups: July 2004 - June 2006) ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival Based on Rejection within 1 st Year Survival (%) Stratified by Calcineurin Use at Discharge: Age = 0 -10 Years (1 -Year Follow-ups: July 2004 - June 2006) ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival Based on Rejection within 1 st Year Survival (%) Stratified by Calcineurin Use at Discharge: Age = 11 -17 Years (1 -Year Follow-ups: July 2004 - June 2006) ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

PERCENTAGE OF PEDIATRIC HEART TRANSPLANT RECIPIENTS EXPERIENCING ACUTE REJECTION IN 1 ST YEAR % experiencing acute rejection within 1 year Stratified by Induction (Follow-ups: July 2004 - June 2007) Overall < 1 1 -10 10 -17 Female Male Overall: p = 0. 042 ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983 Analysis is limited to patients who were alive at the time of the follow-up

PERCENTAGE OF PEDIATRIC HEART TRANSPLANT RECIPIENTS EXPERIENCING ACUTE REJECTION IN 1 ST YEAR % experiencing acute rejection within 1 year Stratified by Type of Induction (Follow-ups: July 2004 - June 2007) Overall < 1 1 -10 10 -17 Female Male Overall: No induct vs. IL 2 R (p=0. 001); Polyclonal vs. IL 2 R (p = 0. 006) 1 -10: No induct vs. IL 2 R (p=0. 019) 11 -17: No induction vs. IL 2 R (p=0. 037) Female: No induction vs. IL 2 R (p = 0. 006); Polyclonal vs. IL 2 R (p =0. 026) Male: No induction vs. IL 2 R (p = 0. 034) ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983 Analysis is limited to patients who were alive at the time of the follow-up

PERCENTAGE OF PEDIATRIC HEART TRANSPLANT RECIPIENTS EXPERIENCING ACUTE REJECTION IN 1 ST YEAR % experiencing acute rejection within 1 year Stratified by Maintenance Immunosuppression and Induction (Follow-ups: July 2004 - June 2007) Overall < 1 1 -10 10 -17 Overall: all comparisons were statistically significant at 0. 05 except Cy. A + no induction vs. Cy. A + induction and TAC + no induction vs. TAC + induction <1 year: Cy. A + no induction vs. TAC + no induction: p=0. 001; Cy. A + no induction vs. TAC + induction: p=0. 001; Cy. A + induction vs. TAC + no induction: p=0. 032; Cy. A + induction vs. TAC + induction: p= 0. 026 1 -10 years: Cy. A + induction vs. TAC + induction: p =0. 006; Cy. A + induction vs. TAC + no induction: p = 0. 0001 11 -17 years: Cy. A + no induction vs. TAC + no induction: p = 0. 001; Cy. A + induction vs. TAC + no induction: p < 0. 0001; Cy. A + induction vs. TAC + induction: p =0. 008 ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983 Analysis is limited to patients who were alive at the time of the follow-up

PERCENTAGE OF PEDIATRIC HEART TRANSPLANT RECIPIENTS EXPERIENCING ACUTE REJECTION IN 1 ST YEAR % experiencing acute rejection within 1 year Stratified by Maintenance Immunosuppression (Follow-ups: July 2004 - June 2007) Overall < 1 1 -10 10 -17 Overall: Cy. A +MMF vs. TAC + MMF (p < 0. 0001); Cy. A + MMF vs. TAC + AZA (p =0. 001); <1: Cy. A + MMF vs. TAC + MMF (p =0. 0004); Cy. A + MMF vs. TAC + AZA )p=0. 016). 1 -10: Cy. A + MMF vs. TAC + MMF (p = 0. 010). 11 -17: Cy. A + MMF vs. TAC + MMF (p =0. 0002). ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983 Analysis is limited to patients who were alive at the time of the follow-up

PERCENTAGE OF PEDIATRIC HEART TRANSPLANT RECIPIENTS EXPERIENCING ACUTE REJECTION IN 1 ST YEAR % experiencing acute rejection within 1 year Stratified by Calcineurin Inhibitor Use at Discharge (Follow-ups: July 2004 - June 2007) Overall < 1 1 -10 10 -17 Overall: Cy. A vs. TAC (p < 0. 0001) <1: Cy. A vs. TAC (p=0. 0005) 1 -10: Cy. A vs. TAC (p < 0. 0008) 11 -17: Cy. A vs. TAC (p < 0. 0001) ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983 Analysis is limited to patients who were alive at the time of the follow-up

FREEDOM FROM CORONARY ARTERY VASCULOPATHY % Freedom from CAV For Pediatric Heart Recipients (Follow-ups: April 1994 - June 2007) ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

FREEDOM FROM CORONARY ARTERY VASCULOPATHY For Pediatric Heart Recipients (Follow-ups: April 1994 - June 2007) % Freedom from CAV Stratified by Induction p = 0. 7992 ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

FREEDOM FROM CORONARY ARTERY VASCULOPATHY For Pediatric Heart Recipients (Follow-ups: April 1994 - June 2007) % Freedom from CAV Stratified by Age Group ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

FREEDOM FROM CORONARY ARTERY VASCULOPATHY For Pediatric Heart Recipients (Follow-ups: January 1999 -June 2007) % Freedom from CAV Stratified by Age Group ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

FREEDOM FROM CORONARY ARTERY VASCULOPATHY For Pediatric Heart Recipients (Follow-ups: April 1994 - June 2007) % Freedom from CAV Stratified by Ischemia Time ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

FREEDOM FROM CORONARY ARTERY VASCULOPATHY % Freedom from CAV For Pediatric Heart Recipients (Follow-ups: January 1999 - June 2007) Stratified by Ischemia Time for Recent Era ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

FREEDOM FROM CORONARY ARTERY VASCULOPATHY For Pediatric Heart Recipients (Follow-ups: April 1994 - June 2007) % Freedom from CAV Stratified by Ischemia Time and Recipient Age ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

GRAFT SURVIVAL FOLLOWING REPORT OF CORONARY ARTERY VASCULOPATHY Survival since Report of CAV (%) For Pediatric Heart Recipients (Follow-ups: April 1994 - June 2007) Stratified by Age Group ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

% Freedom from Severe Renal Dysfunction FREEDOM FROM SEVERE RENAL DYSFUNCTION* For Pediatric Heart 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

MALIGNANCY POST-HEART TRANSPLANTATION FOR PEDIATRICS Cumulative Prevalence in Survivors (Follow-ups: April 1994 - June 2007) Malignancy/Type 1 -Year Survivors No Malignancy 5 -Year Survivors 3, 065 (98. 1%) 1, 177 (95%) Malignancy (all types combined) Malignancy Type 58 (1. 9%) 62 (5%) 54 57 Other 3 6 22 1 Type Not Reported 1 NOTE: Multiple types may be reported; sum of types may be greater than total number with malignancy. ISHLT 253 (91. 7%) 23 (8. 3%) Lymph Skin 10 -Year Survivors 2008 J Heart Lung Transplant 2008; 27: 937 -983 1

FREEDOM FROM MALIGNANCY % Freedom from Malignancy For Pediatric Heart Recipients (Follow-ups: April 1994 - June 2007) ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

PEDIATRIC HEART RECIPIENTS Incidence of Hypertension between 1 and 3 Years (Transplants: April 1993 - June 2004) 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 Azathioprine 22. 2 25. 7 0. 2649 Cyclosporine 20. 8 27. 1 0. 0569 MMF 22. 1 22. 8 0. 8454 Prednisone 29. 7 8. 4 <. 0001 Rapamycin 50. 0 22. 1 - Tacrolimus 30. 8 19. 6 0. 0007 ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

PEDIATRIC HEART RECIPIENTS Incidence of Hypertension between 3 and 8 Years (Transplants: April 1993 - June 1999) Maintenance Immunosuppression at discharge and 1 year % HTN reported between 3 and 8 years P-value For Patients on drug For Patients not on drug Azathioprine 37. 5 44. 7 0. 4159 Cyclosporine 36. 7 42. 9 0. 5334 MMF 38. 1 37. 6 0. 9627 Prednisone 47. 7 21. 5 0. 0003 Rapamycin . 37. 3 - Tacrolimus 40. 9 34. 5 0. 5515 ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

PEDIATRIC HEART RECIPIENTS Relationship of Rejection and Coronary Artery Vasculopathy (Follow-ups: July 2004 – June 2007) Rejection During 1 st Year Reported CAV between 1 st and 3 rd years post-transplant Yes No All Yes 1 5. 5% 17 94. 4% 18 100% No 1 3. 4% 28 96. 6% 29 100% p = 0. 7279 ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983

PEDIATRIC HEART TRANSPLANT RECIPIENTS: Cause of Death (Deaths: January 1992 - June 2007) CAUSE OF DEATH 0 -30 Days 31 Days - 1 (N = 444) Year (N = 392) >1 Year - 3 Years (N = 294) >3 Years - 5 Years (N = 216) >5 Years - 10 Years (N = 323) >10 Years (N = 144) CORONARY ARTERY VASCULOPATHY 5 (1. 1%) 31 (7. 9%) 59 (20. 1%) 65 (30. 1%) 92 (28. 5%) 44 (30. 6%) ACUTE REJECTION 42 (9. 5%) 94 (24. 0%) 69 (23. 5%) 29 (13. 4%) 36 (11. 1%) 8 (5. 6%) LYMPHOMA 10 (2. 6%) 11 (3. 7%) 5 (2. 3%) 32 (9. 9%) 9 (6. 3%) MALIGNANCY, OTHER 4 (1. 0%) 2 (0. 7%) 1 (0. 5%) 4 (1. 2%) 10 (6. 9%) 1 (0. 2%) 8 (2. 0%) 1 (0. 3%) 53 (11. 9%) 64 (16. 3%) 20 (6. 8%) 8 (3. 7%) 14 (4. 3%) 10 (6. 9%) 101 (22. 7%) 21 (5. 4%) 10 (3. 4%) 15 (6. 9%) 17 (5. 3%) 4 (2. 8%) GRAFT FAILURE 95 (21. 4%) 41 (10. 5%) 53 (18. 0%) 49 (22. 7%) 68 (21. 1%) 32 (22. 2%) TECHNICAL 24 (5. 4%) 3 (0. 8%) 2 (0. 7%) 2 (0. 9%) 4 (1. 2%) OTHER 26 (5. 9%) 30 (7. 7%) 33 (11. 2%) 25 (11. 6%) 35 (10. 8%) 12 (8. 3%) MULTIPLE ORGAN FAILURE 41 (9. 2%) 47 (12. 0%) 10 (3. 4%) 6 (2. 8%) 9 (2. 8%) 7 (4. 9%) RENAL FAILURE 1 (0. 2%) 3 (0. 8%) PULMONARY 29 (6. 5%) 23 (5. 9%) 15 (5. 1%) 8 (3. 7%) 6 (1. 9%) 5 (3. 5%) CEREBROVASCULAR 26 (5. 9%) 13 (3. 3%) 9 (3. 1%) 2 (0. 9%) 6 (1. 9%) 1 (0. 7%) CMV INFECTION, NON-CMV PRIMARY FAILURE ISHLT 1 (0. 5%) 2008 J Heart Lung Transplant 2008; 27: 937 -983 2 (1. 4%)

PEDIATRIC HEART TRANSPLANT RECIPIENTS: Cause of Death (Deaths: January 1998 - June 2007) CAUSE OF DEATH CAV 0 -30 Days 31 Days - 1 (N = 189) Year (N = 208) >1 Year - 3 Years (N = 179) >3 Years - 5 Years (N = 142) >5 Years - 10 Years (N = 257) >10 Years (N =137) 2 (1. 1%) 13 (6. 3%) 30 (16. 8%) 39 (27. 5%) 71 (27. 6%) 42 (30. 7%) 20 (10. 6%) 39 (18. 8%) 34 (19. 0%) 20 (14. 1%) 27 (10. 5%) 8 (5. 8%) LYMPHOMA 6 (2. 9%) 6 (3. 4%) 3 (2. 1%) 27 (10. 5%) 9 (6. 6%) MALIGNANCY, OTHER 1 (0. 5%) 1 (0. 6%) 3 (1. 2%) 9 (6. 6%) CMV 4 (1. 9%) 1 (0. 6%) ACUTE REJECTION INFECTION, NON-CMV 23 (12. 2%) 30 (14. 4%) 11 (6. 1%) 3 (2. 1%) 10 (3. 9%) 8 (5. 8%) PRIMARY FAILURE 39 (20. 6%) 7 (3. 4%) 4 (2. 2%) 6 (4. 2%) 9 (3. 5%) 4 (2. 9%) GRAFT FAILURE 29 (15. 3%) 21 (10. 1%) 39 (21. 8%) 40 (28. 2%) 59 (23. 0%) 30 (21. 9%) TECHNICAL 11 (5. 8%) OTHER 19 (10. 1%) 22 (10. 6%) 28 (15. 6%) 18 (12. 7%) 30 (11. 7%) 12 (8. 8%) MULTIPLE ORGAN FAILURE 22 (11. 6%) 33 (15. 9%) 9 (5. 0%) 5 (3. 5%) 7 (2. 7%) 7 (5. 1%) 3 (1. 4%) 1 (0. 7%) RENAL FAILURE 2 (1. 1%) 4 (1. 6%) 2 (1. 5%) PULMONARY 11 (5. 8%) 20 (9. 6%) 10 (5. 6%) 6 (4. 2%) 5 (1. 9%) 5 (3. 6%) CEREBROVASCULAR 13 (6. 9%) 9 (4. 3%) 4 (2. 2%) 1 (0. 7%) 5 (1. 9%) 1 (0. 7%) ISHLT 2008 J Heart Lung Transplant 2008; 27: 937 -983