HEARTLUNG TRANSPLANTATION Overall ISHLT 2006 J Heart Lung

HEART-LUNG TRANSPLANTATION Overall ISHLT 2006 J Heart Lung Transplant 2006; 25: 880 -892

NUMBER OF HEART-LUNG TRANSPLANTS REPORTED BY YEAR ISHLT 2006 J Heart Lung Transplant 2006; 25: 880 -892 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.

AVERAGE CENTER VOLUME Heart-Lung Transplants: January 1, 1998 - June 30, 2005 ISHLT 2006 J Heart Lung Transplant 2006; 25: 880 -892

DISTRIBUTION OF HEART-LUNG TRANSPLANTS BY CENTER VOLUME Heart-Lung Transplants: January 1, 1998 - June 30, 2005 ISHLT 2006 J Heart Lung Transplant 2006; 25: 880 -892

DISTRIBUTION OF HEART-LUNG TRANSPLANTS BY LUNG CENTER VOLUME Lung Transplants: January 1, 1998 - June 30, 2005 ISHLT 2006 J Heart Lung Transplant 2006; 25: 880 -892

HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival (Transplants: January 1982 - June 2004) Survival (%) Half-life = 3. 1 years Conditional Half-life = 8. 7 years N=3, 086 N alive at 18 years = 18 ISHLT 2006 J Heart Lung Transplant 2006; 25: 880 -892

HEART-LUNG TRANSPLANTATION Adult Recipients ISHLT 2006 J Heart Lung Transplant 2006; 25: 880 -892

DIAGNOSIS IN ADULT HEART-LUNG TRANSPLANTS (1/1982 -6/2005) “Other” includes cancer, LAM, OB, sarcoidosis, bronchiectasis ISHLT 2006 J Heart Lung Transplant 2006; 25: 880 -892

DIAGNOSIS IN ADULT HEART-LUNG TRANSPLANTS (Transplants: January 1982 - June 2005) N (%) Diagnosis Congenital Heart Disease 702 (32. 2%) Primary Pulmonary Hypertension 531 (24. 4%) Cystic Fibrosis 342 (15. 7%) Acquired Heart Disease 97 ( 4. 5%) COPD/Emphysema 83 ( 3. 8%) Idiopathic Pulmonary Fibrosis 62 ( 2. 8%) Alpha-1 38 ( 1. 7%) Re-Transplant: Not Obliterative Bronchiolitis 29 ( 1. 3%) Sarcoidosis 28 ( 1. 3%) Re-Transplant: Obliterative Bronchiolitis 23 ( 1. 1%) Bronchiectasis 14 ( 0. 6%) Obliterative Bronchiolitis (not Re-Transplant) 9 ( 0. 4%) Other ISHLT 221 (10. 1%) 2006 J Heart Lung Transplant 2006; 25: 880 -892

DIAGNOSIS IN ADULT HEART-LUNG TRANSPLANTS BY ERA “Other” includes OB (non-Re. TX), Bronchiectasis, Sarcoidosis ISHLT 2006 J Heart Lung Transplant 2006; 25: 880 -892

ADULT HEART-LUNG TRANSPLANTATION Indications By Year (%) ISHLT J Heart Lung Transplant 2006; 25: 880 -892 2006

ADULT HEART-LUNG TRANSPLANTATION Indications By Year (Number) ISHLT 2006 J Heart Lung Transplant 2006; 25: 880 -892

HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival for Adult Recipients (Transplants: January 1982 - June 2004) Survival (%) Half-life = 3. 5 years Conditional Half-life = 9. 0 years N=2, 496 ISHLT 2006 J Heart Lung Transplant 2006; 25: 880 -892

HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival for Adult Recipients by Era (Transplants: January 1982 - June 2004) Survival (%) Half-life: 1982 -1995 = 3. 1 years; 1996 -1999 = 3. 6 years; 2000 -6/2005 = 5 years Conditional Half-life: 1982 -1995 = 8. 9 years ISHLT 2006 J Heart Lung Transplant 2006; 25: 880 -892

ADULT HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival By Diagnosis ISHLT 2006 J Heart Lung Transplant 2006; 25: 880 -892 (Transplants: January 1990 – June 2004)

ADULT HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival By Diagnosis Conditional on Survival to 1 Year (Transplants: January 1990 – June 2004) ISHLT 2006 J Heart Lung Transplant 2006; 25: 880 -892

ADULT HEART-LUNG RECIPIENTS Functional Status of Surviving Recipients (Follow-ups: April 1994 – June 2005) ISHLT 2006 J Heart Lung Transplant 2006; 25: 880 -892

ADULT HEART-LUNG RECIPIENTS Employment Status of Surviving Recipients (Follow-ups: April 1994 – June 2005) ISHLT 2006 J Heart Lung Transplant 2006; 25: 880 -892

ADULT HEART-LUNG RECIPIENTS: Rehospitalization Post-transplant of Surviving Recipients (Follow-ups: April 1994 - June 2005) ISHLT 2006 J Heart Lung Transplant 2006; 25: 880 -892

ADULT HEART-LUNG RECIPIENTS Induction Immunosuppression For transplants between January 2001 through June 2005 ISHLT 2006 J Heart Lung Transplant 2006; 25: 880 -892

ADULT HEART-LUNG RECIPIENTS Induction Immunosuppression (Transplants: January 2000 - December 2004) ISHLT 2006 J Heart Lung Transplant 2006; 25: 880 -892

ADULT HEART-LUNG RECIPIENTS Induction Immunosuppression (Transplants: January 2000 - December 2004) Any Induction ISHLT Polyclonal ALG/ATG 2006 J Heart Lung Transplant 2006; 25: 880 -892 OKT 3 IL 2 R-antagonist

ADULT HEART-LUNG RECIPIENTS Maintenance Immunosuppression at Time of Follow-up For follow-ups between January 2001 through June 2005 ISHLT NOTE: Different patients are analyzed in Year 1 and Year 5 2006 J Heart Lung Transplant 2006; 25: 880 -892

ADULT HEART-LUNG RECIPIENTS Maintenance Immunosuppression Drug Combinations at Time of Follow-up For follow-ups between January 2001 through June 2005 ISHLT NOTE: Different patients are analyzed in Year 1 and Year 5 2006 J Heart Lung Transplant 2006; 25: 880 -892

POST-HEART-LUNG TRANSPLANT MORBIDITY FOR ADULTS Cumulative Prevalence in Survivors within 1 Year Post-Transplant (Follow-ups: April 1994 - June 2005) ISHLT 2006 J Heart Lung Transplant 2006; 25: 880 -892

POST-HEART-LUNG TRANSPLANT MORBIDITY FOR ADULTS Cumulative Prevalence in Survivors within 5 Years Post-Transplant (Follow-ups: April 1994 - June 2005) ISHLT 2006 J Heart Lung Transplant 2006; 25: 880 -892

Freedom from Coronary Artery Vasculopathy For Adult Heart-Lung Recipients (Follow-ups: April 1994 -June 2005) ISHLT 2006 J Heart Lung Transplant 2006; 25: 880 -892

Freedom from Bronchiolitis Obliterans For Adult Heart-Lung Recipients (Follow-ups: April 1994 -June 2005) ISHLT 2006 J Heart Lung Transplant 2006; 25: 880 -892

Freedom from Severe Renal Dysfunction* For Adult Heart-Lung Recipients (Follow-ups: April 1994 -June 2005) *Severe renal dysfunction = Creatinine > 2. 5 mg/dl, dialysis or renal transplant ISHLT 2006 J Heart Lung Transplant 2006; 25: 880 -892

MALIGNANCY POST-HEART-LUNG TRANSPLANT FOR ADULTS Cumulative Prevalence in Survivors (Follow-ups: April 1994 -June 2005) Malignancy/Type No Malignancy (all types combined) Malignancy Type 1 -Year Survivors 5 -Year Survivors 10 -Year Survivors 278 (91. 7%) 90 (89. 1%) 47 (83. 9%) 25 (8. 3%) 11 (10. 9%) 9 (16. 1%) Skin 2 3 5 Lymph 18 5 2 Other 1 1 1 Type Not Reported 4 2 1 ISHLT 2006 J Heart Lung Transplant 2006; 25: 880 -892

Freedom from Malignancy For Adult Heart-Lung Recipients (Follow-ups: April 1994 - June 2005) ISHLT 2006 J Heart Lung Transplant 2006; 25: 880 -892

ADULT HEART-LUNG TRANSPLANT RECIPIENTS: Cause of Death (Deaths: January 1992 - June 2005) 0 -30 Days (N = 205) 31 Days - 1 Year (N = 127) >1 Year - 3 Years (N = 100) >3 Years - 5 Years (N = 59) >5 Years (N = 106) 0 5 (3. 9%) 26 (26. 0%) 23 (39. 0%) 21 (19. 8%) 2 (1. 0%) 3 (2. 4%) 1 (1. 0%) 0 1 (0. 9%) LYMPHOMA 0 4 (3. 1%) 4 (4. 0%) 3 (5. 1%) 1 (0. 9%) MALIGNANCY, OTHER 0 1 (0. 8%) 6 (6. 0%) 2 (3. 4%) 5 (4. 7%) CMV 0 1 (0. 8%) 0 1 (1. 7%) 0 INFECTION, NON-CMV 39 (19. 0%) 52 (40. 9%) 31 (31. 0%) 3 (5. 1%) 16 (15. 1%) GRAFT FAILURE 64 (31. 2%) 26 (20. 5%) 17 (17. 0%) 10 (16. 9%) 27 (25. 5%) CARDIOVASCULAR 19 (9. 3%) 7 (5. 5%) 5 (5. 0%) 7 (11. 9%) 8 (7. 5%) TECHNICAL 39 (19. 0%) 2 (1. 6%) 1 (1. 0%) 1 (1. 7%) 0 OTHER 42 (20. 5%) 26 (20. 5%) 9 (9. 0%) 9 (15. 3%) 27 (25. 5%) CAUSE OF DEATH BRONCHIOLITIS ACUTE REJECTION ISHLT 2006 J Heart Lung Transplant 2006; 25: 880 -892

HEART-LUNG TRANSPLANTATION Pediatric Recipients ISHLT 2006 J Heart Lung Transplant 2006; 25: 904 -911

AGE DISTRIBUTION OF PEDIATRIC HEART-LUNG RECIPIENTS (Transplants: January 1982 - June 2005) ISHLT 2006 J Heart Lung Transplant 2006; 25: 904 -911

AGE DISTRIBUTION FOR DONORS OF PEDIATRIC HEARTLUNG RECIPIENTS (Transplants: January 1982 - June 2005) ISHLT 2006 J Heart Lung Transplant 2006; 25: 904 -911

Number of Transplants AGE DISTRIBUTION OF PEDIATRIC HEART-LUNG RECIPIENTS By Year of Transplant ISHLT 2006 J Heart Lung Transplant 2006; 25: 904 -911 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.

Percentage of Transplants AGE DISTRIBUTION OF PEDIATRIC HEART-LUNG RECIPIENTS By Era of Transplant ISHLT 2006 J Heart Lung Transplant 2006; 25: 904 -911

NUMBER OF CENTERS REPORTING PEDIATRIC HEART-LUNG TRANSPLANTS ISHLT 2006 J Heart Lung Transplant 2006; 25: 904 -911

DIAGNOSIS IN PEDIATRIC HEART –LUNG TRANSPLANT RECIPIENTS (Age: 11 -17 Years) “Other” includes Bronchiectasis, Alpha-1, and OB (non-Re. TX) ISHLT 2006 J Heart Lung Transplant 2006; 25: 904 -911

PEDIATRIC HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival By Diagnosis ISHLT 2006 J Heart Lung Transplant 2006; 25: 904 -911 (Transplants: January 1990 – June 2004)

PEDIATRIC HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival (Transplants: January 1982 - June 2004) ISHLT 2006 J Heart Lung Transplant 2006; 25: 904 -911

Survival (%) PEDIATRIC HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival by Era (Transplants: January 1982 - June 2004) ISHLT 2006 J Heart Lung Transplant 2006; 25: 904 -911

PEDIATRIC HEART-LUNG TRANSPLANT RECIPIENTS: Cause of Death (Deaths: January 1992 - June 2005) 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%) 14 (53. 8%) 8 (47. 1%) 7 (35. 0%) ACUTE REJECTION 2 (7. 1%) INFECTION, NON-CMV 5 (19. 2%) 9 (32. 1%) 5 (19. 2%) 1 (5. 9%) 5 (25. 0%) GRAFT FAILURE 13 (50. 0%) 2 (7. 1%) 5 (19. 2%) 5 (29. 4%) 3 (15. 0%) CARDIOVASCULAR 2 (7. 7%) 3 (10. 7%) 1 (5. 9%) 2 (10. 0%) TECHNICAL 3 (11. 5%) 1 (3. 6%) OTHER 3 (11. 5%) 10 (35. 7%) 2 (11. 8%) 3 (15. 0%) ISHLT 2006 J Heart Lung Transplant 2006; 25: 904 -911 2 (7. 7%)