HEARTLUNG TRANSPLANTATION Overall ISHLT 2005 J Heart Lung
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HEART-LUNG TRANSPLANTATION Overall ISHLT 2005 J Heart Lung Transplant 2005; 24: 945 -982
NUMBER OF HEART-LUNG TRANSPLANTS REPORTED BY YEAR ISHLT 2005 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 heartlung transplants worldwide has declined in recent years. J Heart Lung Transplant 2005; 24: 945 -982
AVERAGE CENTER VOLUME Heart-Lung Transplants: January 1, 1998 - June 30, 2004 ISHLT 2005 J Heart Lung Transplant 2005; 24: 945 -982
DISTRIBUTION OF HEART-LUNG TRANSPLANTS BY CENTER VOLUME Heart-Lung Transplants: January 1, 1998 - June 30, 2004 ISHLT 2005 J Heart Lung Transplant 2005; 24: 945 -982
DISTRIBUTION OF HEART-LUNG TRANSPLANTS BY LUNG CENTER VOLUME Lung Transplants: January 1, 1998 - June 30, 2004 ISHLT 2005 J Heart Lung Transplant 2005; 24: 945 -982
HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival (Transplants: January 1982 - June 2003) Survival (%) Half-life = 2. 9 years Conditional Half-life = 8. 6 years N=3, 080 N followed at longest time point: 1, 899 ISHLT 2005 J Heart Lung Transplant 2005; 24: 945 -982
HEART-LUNG TRANSPLANTATION Adult Recipients ISHLT 2005 J Heart Lung Transplant 2005; 24: 945 -982
DIAGNOSIS IN ADULT HEART-LUNG TRANSPLANTS (1/1982 -6/2004) “Other” includes cancer, LAM, OB, sarcoidosis, bronchiectasis ISHLT 2005 J Heart Lung Transplant 2005; 24: 945 -982
DIAGNOSIS IN ADULT HEART-LUNG TRANSPLANTS (Transplants: January 1982 - June 2004) N (%) Diagnosis Congenital Heart Disease 746 (32. 4%) Primary Pulmonary Hypertension 574 (24. 9%) Cystic Fibrosis 357 (15. 5%) Acquired Heart Disease 98 (4. 3%) COPD/Emphysema 92 (4. 0%) Idiopathic Pulmonary Fibrosis 64 (2. 8%) Alpha-1 57 (2. 5%) Re-Transplant: Not Obliterative Bronchiolitis 30 (1. 3%) Sarcoidosis 27 (1. 2%) Re-Transplant: Obliterative Bronchiolitis 24 (1. 0%) Bronchiectasis 15 (0. 7%) Obliterative Bronchiolitis (not Re-Transplant) 8 (0. 3%) Other ISHLT 212 (9. 2%) 2005 J Heart Lung Transplant 2005; 24: 945 -982
DIAGNOSIS IN ADULT HEART-LUNG TRANSPLANTS BY ERA 1982 -1995 1/1996 -6/2004 “Other” includes OB (non-Re. TX), Bronchiectasis, Sarcoidosis ISHLT 2005 J Heart Lung Transplant 2005; 24: 945 -982
ADULT HEART-LUNG TRANSPLANTATION Indications By Year (%) ISHLT 2005 J Heart Lung Transplant 2005; 24: 945 -982
ADULT HEART-LUNG TRANSPLANTATION Indications By Year (Number) ISHLT 2005 J Heart Lung Transplant 2005; 24: 945 -982
HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival for Adult Recipients (Transplants: January 1982 - June 2003) Survival (%) Half-life = 3. 2 years Conditional Half-life = 9. 0 years N=2, 488 ISHLT 2005 J Heart Lung Transplant 2005; 24: 945 -982
ADULT HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival By Diagnosis ISHLT (Transplants: January 1990 – June 2003) 2005 J Heart Lung Transplant 2005; 24: 945 -982
ADULT HEART-LUNG RECIPIENTS Functional Status of Surviving Recipients (Follow-ups: April 1994 – June 2004) ISHLT 2005 J Heart Lung Transplant 2005; 24: 945 -982
ADULT HEART-LUNG RECIPIENTS Employment Status of Surviving Recipients (Follow-ups: April 1994 – June 2004) ISHLT 2005 J Heart Lung Transplant 2005; 24: 945 -982
ADULT HEART-LUNG RECIPIENTS: Rehospitalization Post-transplant of Surviving Recipients (Follow-ups: April 1994 - June 2004) ISHLT 2005 J Heart Lung Transplant 2005; 24: 945 -982
ADULT HEART-LUNG RECIPIENTS Induction Immunosuppression For follow-ups between January 2001 through June 2004 ISHLT 2005 J Heart Lung Transplant 2005; 24: 945 -982
ADULT HEART-LUNG RECIPIENTS Induction Immunosuppression (Follow-ups: January 2000 - December 2003) ISHLT 2005 J Heart Lung Transplant 2005; 24: 945 -982
ADULT HEART-LUNG RECIPIENTS Maintenance Immunosuppression at Time of Follow-up For follow-ups between January 2001 through June 2004 ISHLT NOTE: Different patients are analyzed in Year 1 and Year 5 2005 J Heart Lung Transplant 2005; 24: 945 -982
ADULT HEART-LUNG RECIPIENTS Maintenance Immunosuppression Drug Combinations at Time of Follow-up For follow-ups between January 2001 through June 2004 ISHLT NOTE: Different patients are analyzed in Year 1 and Year 5 2005 J Heart Lung Transplant 2005; 24: 945 -982
POST-HEART-LUNG TRANSPLANT MORBIDITY FOR ADULTS Cumulative Prevalence in Survivors within 1 Year Post-Transplant (Follow-ups: April 1994 - June 2004) ISHLT 2005 J Heart Lung Transplant 2005; 24: 945 -982
POST-HEART-LUNG TRANSPLANT MORBIDITY FOR ADULTS Cumulative Prevalence in Survivors within 5 Years Post-Transplant (Follow-ups: April 1994 - June 2004) ISHLT 2005 J Heart Lung Transplant 2005; 24: 945 -982
Freedom from Coronary Artery Vasculopathy For Adult Heart-Lung Recipients (Follow-ups: April 1994 -June 2004) ISHLT 2005 J Heart Lung Transplant 2005; 24: 945 -982
Freedom from Bronchiolitis Obliterans For Adult Heart-Lung Recipients (Follow-ups: April 1994 -June 2004) ISHLT 2005 J Heart Lung Transplant 2005; 24: 945 -982
Freedom from Severe Renal Dysfunction* For Adult Heart-Lung Recipients (Follow-ups: April 1994 -June 2004) *Severe renal dysfunction = Creatinine > 2. 5 mg/dl, dialysis or renal transplant ISHLT 2005 J Heart Lung Transplant 2005; 24: 945 -982
MALIGNANCY POST-HEART-LUNG TRANSPLANT FOR ADULTS Cumulative Prevalence in Survivors (Follow-ups: April 1994 -June 2004) Malignancy/Type 1 -Year Survivors 5 -Year Survivors 264 (92. 0%) 77 (87. 5%) 23 (8. 0%) 11 (12. 5%) No Malignancy (all types combined) Malignancy Type Skin 2 3 Lymph 16 5 Other 1 1 Type Not Reported 4 2 ISHLT 2005 J Heart Lung Transplant 2005; 24: 945 -982
Freedom from Malignancy For Adult Heart-Lung Recipients (Follow-ups: April 1994 - June 2004) ISHLT 2005 J Heart Lung Transplant 2005; 24: 945 -982
ADULT HEART-LUNG TRANSPLANT RECIPIENTS: Cause of Death (Deaths: January 1992 - June 2004) 0 -30 Days (N = 195) 31 Days - 1 Year (N = 124) >1 Year - 3 Years (N = 101) >3 Years - 5 Years (N = 58) >5 Years (N = 94) 0 4 (3. 2%) 26 (25. 7%) 22 (37. 9%) 21 (21. 4%) 3 (1. 5%) 3 (2. 4%) 1 (1. 0%) 1 (1. 7%) 1 (1. 0%) LYMPHOMA 0 3 (2. 4%) 4 (4. 0%) 3 (5. 2%) 1 (1. 0%) MALIGNANCY, OTHER 0 1 (0. 8%) 6 (5. 9%) 2 (3. 4%) 5 (5. 1%) CMV 0 2 (1. 6%) 0 1 (1. 7%) 0 INFECTION, NON-CMV 39 (20. 0%) 53 (43. 7%) 32 (31. 7%) 3 (5. 2%) 14 (14. 3%) GRAFT FAILURE 62 (31. 8%) 23 (18. 5%) 17 (16. 8%) 9 (15. 5%) 23 (23. 5%) CARDIOVASCULAR 17 (8. 7%) 7 (5. 6%) 5 (5. 0%) 8 (13. 8%) 7 (7. 1%) TECHNICAL 41 (21. 0%) 2 (1. 6%) 1 (1. 0%) 0 0 OTHER 33 (16. 9%) 26 (21. 0%) 9 (8. 9%) 9 (15. 5%) 26 (26. 5%) CAUSE OF DEATH BRONCHIOLITIS ACUTE REJECTION ISHLT 2005 J Heart Lung Transplant 2005; 24: 945 -982
HEART-LUNG TRANSPLANTATION Pediatric Recipients ISHLT 2005 J Heart Lung Transplant 2005; 24: 945 -982
AGE DISTRIBUTION OF PEDIATRIC HEART-LUNG RECIPIENTS (Transplants: January 1982 - June 2004) ISHLT 2005 J Heart Lung Transplant 2005; 24: 945 -982
AGE DISTRIBUTION FOR DONORS OF PEDIATRIC HEARTLUNG RECIPIENTS (Transplants: January 1982 - June 2004) ISHLT 2005 J Heart Lung Transplant 2005; 24: 945 -982
Number of Transplants AGE DISTRIBUTION OF PEDIATRIC HEART-LUNG RECIPIENTS By Year of Transplant ISHLT 2005 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 heartlung transplants worldwide has declined in recent years. J Heart Lung Transplant 2005; 24: 945 -982
NUMBER OF CENTERS REPORTING PEDIATRIC HEART-LUNG TRANSPLANTS ISHLT 2005 J Heart Lung Transplant 2005; 24: 945 -982
DIAGNOSIS IN PEDIATRIC HEART –LUNG TRANSPLANT RECIPIENTS (Age: 11 -17 Years) “Other” includes Alpha-1, Bronchiectasis, IPF and OB (non-Re. TX) ISHLT 2005 J Heart Lung Transplant 2005; 24: 945 -982
PEDIATRIC HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival By Diagnosis ISHLT (Transplants: January 1990 – June 2003) 2005 J Heart Lung Transplant 2005; 24: 945 -982
PEDIATRIC HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival (Transplants: January 1982 - June 2003) ISHLT 2005 J Heart Lung Transplant 2005; 24: 945 -982
Survival (%) PEDIATRIC HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival by Era (Transplants: January 1982 - June 2003) ISHLT 2005 J Heart Lung Transplant 2005; 24: 945 -982
PEDIATRIC HEART-LUNG TRANSPLANT RECIPIENTS: Cause of Death (Deaths: January 1992 - June 2004) CAUSE OF DEATH 0 -30 Days (N = 27) 31 Days - 1 Year (N = 28) >1 Year - 3 Years (N = 25) >3 Years - 5 Years (N = 17) >5 Years (N = 18) BRONCHIOLITIS 1 (3. 6%) 13 (52. 0%) 8 (47. 1%) 6 (33. 3%) ACUTE REJECTION 2 (7. 1%) INFECTION, NON-CMV 5 (18. 5%) 9 (32. 1%) 5 (20. 0%) 1 (5. 9%) 5 (27. 8%) GRAFT FAILURE 12 (44. 4%) 2 (7. 1%) 5 (20. 0%) 4 (23. 5%) 3 (16. 7%) CARDIOVASCULAR 2 (7. 4%) 3 (10. 7%) 1 (5. 9%) 2 (11. 1%) TECHNICAL 3 (11. 1%) 1 (3. 6%) OTHER 5 (18. 5%) 10 (35. 7%) 2 (11. 8%) 2 (11. 1%) ISHLT 2 (8. 0%) 2005 J Heart Lung Transplant 2005; 24: 945 -982