LUNG TRANSPLANTATION Adult Recipients 2014 JHLT 2014 Oct

LUNG TRANSPLANTATION Adult Recipients 2014 JHLT. 2014 Oct; 33(10): 1009 -1024

Table of Contents < Donor, recipient and center characteristics: slides 3 -24 < Post transplant survival and rejection: slides 25 -56 < Functional and employment status and rehospitalization post transplant: slides 58 -61 < Induction and maintenance immunosuppression: slides 62 -84 < Post transplant morbidities: slides 85 -107 < Multivariable analyses: slides 108 -169 2014 JHLT. 2014 Oct; 33(10): 1009 -1024

Donor, Recipient and Center Characteristics 2014 JHLT. 2014 Oct; 33(10): 1009 -1024

Adult Lung Retransplants by Year and Location Others % of retransplants 10 180 9 160 8 140 7 120 6 100 5 80 4 60 3 40 2 20 1 0 0 90 19 91 19 92 19 93 19 94 19 95 19 96 19 97 19 98 19 99 20 00 20 01 20 02 20 03 20 04 20 05 20 06 20 07 20 08 20 09 20 10 20 11 20 12 200 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 Overall % of Retxs North America 19 N of Retransplants Europe

Adult Lung Retransplants by Inter-transplant Interval (Retransplants: January 1990 – June 2013) % of Retransplants 40 30 20 27. 1 10 10. 5 16. 2 12. 8 19. 7 5. 3 8. 4 0 <1 month<1 year 1 -<3 years 3 -<5 years 5 -<10 years 10+ years Time Between Previous and Current Transplant 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 Not reported

Adult Lung Transplants Average Center Volume by Location (Transplants: January 2000 – June 2013) 60 Number of Centers 50 Other 11 North America 30 Europe 3 40 26 20 0 6 20 11 1 10 10 19 11 19 0 1 -4 5 -9 10 -19 5 6 2 30 -39 40 -49 50+ 14 9 20 -29 Average number of lung transplants per year 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 0 2 4 3

Adult Lung Transplants Average Center Volume by Location (Transplants: January 2008 – June 2013) 60 Other Number of Centers 50 North America 40 30 20 Europe 6 3 15 10 20 6 8 9 11 0 1 -4 0 16 13 5 5 -9 10 -19 20 -29 0 1 12 8 8 2 5 3 30 -39 40 -49 50+ Average number of lung transplants per year 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 5

Adult Lung Transplants Indications (Transplants: January 1995 – June 2013) Diagnosis SLT (N = 15, 321) BLT (N = 26, 579) TOTAL (N = 41, 900) COPD/Emphysema 6, 594 ( 43. 0%) 7, 078 ( 26. 6%) 13, 672 ( 32. 6%) Idiopathic Pulmonary Fibrosis 5, 354 ( 34. 9%) 4, 825 ( 18. 2%) 10, 179 ( 24. 3%) Cystic Fibrosis 234 ( 1. 5%) 6, 628 ( 24. 9%) 6, 862 ( 16. 4%) Alpha-1 771 ( 5. 0%) 1, 572 ( 5. 9%) 2, 343 ( 5. 6%) Idiopathic Pulmonary Arterial Hypertension 92 ( 0. 6%) 1, 158 ( 4. 4%) 1, 250 ( 3. 0%) Pulmonary Fibrosis, Other 677 ( 4. 4%) 970 ( 3. 6%) 1, 647 ( 3. 9%) Bronchiectasis 62 ( 0. 4%) 1, 069 ( 4. 0%) 1, 131 ( 2. 7%) Sarcoidosis 280 ( 1. 8%) 776 ( 2. 9%) 1, 056 ( 2. 5%) Retransplant: Obliterative Bronchiolitis 312 ( 2. 0%) 379 ( 1. 4%) 691 ( 1. 6%) Connective Tissue Disease 177 ( 1. 2%) 409 ( 1. 5%) 586 ( 1. 4%) Obliterative Bronchiolitis (Not Retransplant) 105 ( 0. 7%) 351 ( 1. 3%) 456 ( 1. 1%) LAM 138 ( 0. 9%) 302 ( 1. 1%) 440 ( 1. 1%) Retransplant: Not Obliterative Bronchiolitis 205 ( 1. 3%) 227 ( 0. 9%) 432 ( 1. 0%) Congenital Heart Disease 58 ( 0. 4%) 291 ( 1. 1%) 349 ( 0. 8%) Cancer 7 ( 0. 0%) 29 ( 0. 1%) 36 ( 0. 1%) 255 ( 1. 7%) 515 ( 1. 9%) 770 ( 1. 8%) Other 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 For some retransplants, diagnosis other than retransplant was reported, so the total number and percentage of retransplants may be greater.

Adult Lung Transplants Distribution of Procedure Type for Major Indications by Year Alpha-1 Year of TX Double Single COPD Cystic Fibrosis IPF IPAH Double Single 1998 49. 3 50. 7 29. 8 70. 2 93. 6 6. 4 19. 2 80. 8 87. 0 13. 0 1999 46. 6 53. 4 28. 1 71. 9 91. 3 8. 7 23. 3 76. 7 86. 4 13. 6 2000 57. 9 42. 1 29. 3 70. 7 93. 9 6. 1 30. 9 69. 1 93. 0 7. 0 2001 60. 1 39. 9 30. 0 70. 0 93. 8 6. 2 31. 4 68. 6 89. 8 10. 2 2002 56. 6 43. 4 38. 9 61. 1 96. 2 3. 8 35. 1 64. 9 87. 9 12. 1 2003 65. 7 34. 3 43. 0 57. 0 95. 6 4. 4 41. 6 58. 4 95. 5 4. 5 2004 73. 4 26. 6 45. 9 54. 1 96. 3 3. 7 44. 7 55. 3 94. 4 5. 6 2005 77. 0 23. 0 49. 0 51. 0 97. 3 2. 7 46. 0 54. 0 92. 4 7. 6 2006 71. 8 28. 2 58. 2 41. 8 98. 5 1. 5 47. 6 52. 4 100. 0 2007 81. 7 18. 3 63. 4 36. 6 97. 6 2. 4 49. 4 50. 6 94. 7 5. 3 2008 80. 2 19. 8 65. 4 34. 6 98. 6 1. 4 52. 0 48. 0 94. 1 5. 9 2009 86. 7 13. 3 66. 3 33. 7 99. 6 0. 4 51. 8 48. 2 97. 3 2. 7 2010 85. 8 14. 2 70. 3 29. 7 99. 4 0. 6 55. 8 44. 2 94. 7 5. 3 2011 87. 7 12. 3 72. 8 27. 2 98. 6 1. 4 54. 5 45. 5 96. 8 3. 2 2012 92. 1 7. 9 73. 9 26. 1 98. 4 1. 6 60. 1 39. 9 95. 0 2014 JHLT. 2014 Oct; 33(10): 1009 -1024

Adult Lung Transplants Procedure Type within Indication, by Year Bilateral/Double Lung Transplant Single Lung Transplant 120% 80% 60% 40% AT Def COPD 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 IPF IPAH 2012 2010 2008 2006 2004 2002 2000 1998 2012 2010 2008 2006 2004 2002 0% 2000 20% 1998 % of Transplants 100%

Adult Lung Transplants Indications for Single Lung Transplants (Transplants: January 1995 – June 2013) Alpha-1 COPD CF IPAH Retx Other* 35% 1% 3% *Other includes: 11% 2% 5% Pulmonary Fibrosis, Other: 4. 4% Bronchiectasis: 0. 4% Sarcoidosis: 1. 8% Connective Tissue Disease: 1. 2% OB (non-Retx): 0. 7% LAM: 0. 9% Congenital Heart Disease: 0. 4% Miscellaneous: 1. 7% 43% 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 For some retransplants, diagnosis other than retransplant was reported, so the total percentage of retransplants may be greater.

Adult Lung Transplants Indications for Bilateral/Double Lung Transplants (Transplants: January 1995 – June 2013) Alpha-1 18% 4% COPD CF IPAH Retx Other* 2% *Other includes: 18% 25% 6% Pulmonary Fibrosis, Other: 3. 6% Bronchiectasis: 4. 0% Sarcoidosis: 2. 9% Connective Tissue Disease: 1. 5% OB (non-Retx): 1. 3% LAM: 1. 1% Congenital Heart Disease: 1. 1% Miscellaneous: 2. 0% 27% 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 For some retransplants, diagnosis other than retransplant was reported, so the total percentage of retransplants may be greater.

Adult Lung Transplants Major Indications by Year (%) 100 CF IPF COPD Alpha-1 IPAH Retx 60 40 20 12 20 11 20 10 20 09 20 08 20 07 20 06 20 05 20 04 20 03 20 02 20 01 20 00 20 99 19 98 19 97 19 96 19 95 19 94 19 93 19 92 19 91 19 90 0 19 % of Transplants 80 Transplant Year 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 For some retransplants, diagnosis other than retransplant was reported, so the total percentage of retransplants may be greater.

Adult Lung Transplants Major Indications by Year (Number) 3, 500 CF IPF COPD Alpha-1 IPAH Retx 2, 500 2, 000 1, 500 1, 000 500 90 19 91 19 92 19 93 19 94 19 95 19 96 19 97 19 98 19 99 20 00 20 01 20 02 20 03 20 04 20 05 20 06 20 07 20 08 20 09 20 10 20 11 20 12 0 19 Number of Transplants 3, 000 Transplant Year 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 For some retransplants, diagnosis other than retransplant was reported, so the total number of retransplants may be greater.

Adult Lung Transplants Diagnosis Distribution by Location (Transplants: January 2000 – June 2013) 100% Other 80% Sarcoidosis % of Transplants Retx Pulmonary Fibrosis, Other 60% IPAH IPF CF 40% COPD Bronchiectasis Alpha-1 20% 0% Europe North America 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 Other For some retransplants, diagnosis other than retransplant was reported, so the total percentage of retransplants may be greater.

Adult Lung Transplants Diagnosis Distribution by Location and Era (Transplants: January 2000 – June 2013) % of Transplants 100% Alpha-1 CF Pulmonary Fibrosis, Other Bronchiectasis IPF Retx COPD IPAH Sarcoidosis 80% 60% 40% 20% 0% 2000 - 2004 2005 - 6/2013 2000 - 2004 Europe 2005 - 6/2013 North America 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 2000 - 2004 2005 - 6/2013 Other For some retransplants, diagnosis other than retransplant was reported, so the total percentage of retransplants may be greater.

Adult Lung Transplants Recipient Characteristics by Transplant Type (Transplants: January 2000 – June 2013) Primary (N=34, 408) First Retransplant (N=1, 443) p-value 55. 0 (23. 0 - 67. 0) 46. 0 (21. 0 - 65. 0) <0. 0001 Male 56. 3% 53. 4% Female 43. 7% 46. 6% Alpha-1 5. 0% 1. 2% COPD 32. 9% 5. 7% CF 16. 6% 6. 5% IPF 26. 5% 7. 6% IPAH 2. 7% 1. 4% Retx 0. 0% 65. 9% Other 16. 4% 11. 6% Europe 36. 4% 38. 8% North America 56. 9% 55. 6% Other 6. 7% 5. 5% Recipient age (years) Recipient gender Diagnosis Location 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 0. 0330 <0. 0001 0. 0714 Age is expressed as median (5 th-95 th percentiles)

Adult Lung Transplants Donor and Donor/Recipient Characteristics by Transplant Type (Transplants: January 2000 – June 2013) Primary (N=34, 408) First Retransplant* (N=1, 443) Donor age (years) Donor/recipient CMV status Donor cause of death 38. 0 (16. 0 - 61. 0) 38. 0 (16. 0 - 62. 0) D(-)/R(-) 17. 5% 11. 8% D(-)/R(+) 21. 8% 19. 4% p-value 0. 7457 <0. 0001 D(+)/R(-) 24. 2% 20. 0% D(+)/R(+) 36. 4% 48. 8% Head Trauma 40. 2% 42. 7% Stroke 39. 8% 37. 3% Other 20. 0% 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 0. 1879 Age is expressed as median (5 th-95 th percentiles) * at time of retransplant

Adult Lung Transplants Transplant Type Distribution by Era (Transplants: January 1990 – June 2013) Primary Retransplant 100% % of Transplants 80% 60% 40% 20% 0% 1990 -1997 1998 -2004 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 2005 -6/2013

Adult Lung Transplants Transplant Type Distribution by Recipient Age Group (Transplants: January 1990 – June 2013) Primary Retransplant 100% % of Transplants 80% 60% 40% 20% 0% 18 -34 35 -49 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 50 -59 60 -65 >65

Adult Lung Transplants Transplant Type Distribution by Recipient Age Group (Transplants: January 2005 – June 2013) Primary Retransplant 100% % of Transplants 80% 60% 40% 20% 0% 18 -34 35 -49 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 50 -59 60 -65 >65

Adult Lung Transplants Transplant Type Distribution by Recipient Gender (Transplants: January 1990 – June 2013) Primary Retransplant 100% % of Transplants 80% 60% 40% 20% 0% Male Female 2014 JHLT. 2014 Oct; 33(10): 1009 -1024

Adult Lung Transplants Transplant Type Distribution by Diagnosis (Transplants: January 1990 – June 2013) Primary Retransplant 100% % of Transplants 80% 60% 40% 20% 0% Alpha-1 COPD CF 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 IPF IPAH Retx Other*

Adult Lung Transplants Transplant Type Distribution by Location (Transplants: January 1990 – June 2013) Primary Retransplant 100% % of Transplants 80% 60% 40% 20% 0% Europe North America 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 Other

Post Transplant Survival and Rejection 2014 JHLT. 2014 Oct; 33(10): 1009 -1024

Adult Lung Transplants Kaplan-Meier Survival (Transplants: January 1990 – June 2012) 100 Median survival = 5. 6 years 90 80 N = 43, 501 Survival (%) 70 60 50 40 30 20 10 0 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024

Adult Lung Transplants Kaplan-Meier Survival Conditional on Survival to 1 Year (Transplants: January 1990 – June 2012) 100 Median survival = 7. 9 years 90 80 Survival (%) 70 60 50 N = 32, 448 40 30 20 10 0 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024

Adult Lung Transplants Kaplan-Meier Survival by Procedure Type (Transplants: January 1994 – June 2012) 100 Median survival (years): Bilateral/Double lung: 7. 1; Conditional = 9. 7 Single lung: 4. 6; Conditional = 6. 5 90 80 Survival (%) 70 p < 0. 0001 60 50 40 30 20 Bilateral/Double Lung (N=25, 041) 10 Single Lung (N=15, 251) 0 0 1 2 3 4 5 6 7 8 9 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 10 11 12 13 14 15 16 17 18

Adult Lung Retransplants Kaplan-Meier Survival (Retransplants: January 1982 – June 2011) 100 Median survival = 2. 5 years Conditional median survival = 6. 3 years f 90 80 N =1, 673 Survival (%) 70 60 50 40 30 20 10 0 0 1 2 3 4 5 6 7 8 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 9 10 11 12 13 14 15 16

Adult Lung Transplants Kaplan-Meier Survival by Transplant Type (Transplants: January 1990 – June 2012) 100 p < 0. 0001 90 Primary (N=41, 767) First Retransplant (N=1, 673) 80 Survival (%) 70 60 50 40 30 20 10 Median survival (years): Primary: 5. 7; Conditional=7. 9 Retransplant: 2. 5; Conditional=6. 3 0 0 1 2 3 4 5 6 7 8 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 9 10 11 12 13 14 15 16

Adult Lung Transplants Kaplan-Meier Survival by Inter-transplant Interval (Transplants: January 1990 – June 2012) 100 Primary 1 -<3 years 90 <1 month-<1 year. . . 3 -<5 years 5+ years All pair-wise comparisons were significant at p < 0. 05 except Primary vs. 5+ years, 1 month–<1 year vs. 1 -<3 years, 1 month-<1 year vs. 3 -<5 years, 1 -<3 years vs. 3 -<5 years and 3 -<5 years vs. 5+ years 80 Survival (%) 70 60 50 40 30 20 10 0 0 1 2 3 4 5 6 7 8 9 10 11 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 Retransplants are limited to first retransplant recipients

Adult Lung Transplants Kaplan-Meier Survival by Era (Transplants: January 1990 – June 2012) 100 Median survival (years): 1990 -1997: 4. 1; Conditional = 7. 0 1998 -2004: 5. 7; Conditional = 8. 3 2005 -6/2012: 6. 1; Conditional = NA 90 80 Survival (%) 70 All pair-wise comparisons were significant at p <0. 001 60 N at risk = 1, 250 50 40 30 N at risk = 61 1990 -1997 (N=8, 372) 20 1998 -2004 (N=12, 108) 2005 -6/2012 (N=23, 021) 10 N at risk = 792 0 0 1 2 3 4 5 6 7 8 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 9 10 11 12 13 14 15

Adult Lung Transplants Kaplan-Meier Survival by Era and Transplant Type (Transplants: January 1990 – June 2012) Primary 1990 -1997 (N=8, 041) Primary 2005 -6/2012 (N=21, 978) Frist Retx 1998 -2004 (N=335) 100 90 All pair-wise comparisons between transplant types within each era and between eras within each transplant type were significant at p < 0. 05 except for Retx: 1990 -1997 vs. 1998 -2004 Retx: 1998 -2004 vs. 2005 -6/2012 80 70 Survival (%) Primary 1998 -2004 (N=11, 748) First Retx 1990 -1997 (N=322) First Retx 2005 -6/2012 (N=1, 016) 60 50 40 30 20 10 0 Median survival (years): Primary: 1990 -97=4. 3; 1998 -04=5. 8; 2005 -6/12=6. 3 Retx: 1990 -97=1. 0; 1998 -04=1. 9; 2005 -6/12=3. 0 0 1 2 3 4 5 6 7 8 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 9 10 11 12 13 14 15

Adult Lung Transplants Kaplan-Meier Survival by Transplant Type and Age Group (Transplants: January 1990 – June 2012) Primary 18 -34 (N=7, 053) Primary 60+ (N=10, 564) First Retx 50 -59 (N=434) 100 Primary 50 -59 (N=14, 535) First Retx 35 -49 (N=491) All pair-wise comparisons between transplant types within each age group and between age groups for primary transplants were significant at p < 0. 05. No pair-wise comparisons between age groups for first retransplants were significant at p < 0. 05 except 18 -34 vs. 60+ and 35 -49 vs. 60+. 90 80 Survival (%) Primary 35 -49 (N=9, 615) First Retx 18 -34 (N=484) First Retx 60+ (N=264) 70 60 50 40 30 20 10 0 0 1 2 3 4 5 6 7 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 8 9 10 11 12 13 14

Adult Lung Transplants Kaplan-Meier Survival by Gender (Transplants: January 1990 – June 2012) 100 Male (N=23, 855) 90 Female (N=19, 644) 80 Survival (%) 70 60 50 p < 0. 0001 40 30 N at risk = 88 20 10 Median survival (years): Male = 5. 4; Female = 5. 8 N at risk = 78 0 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024

Adult Lung Transplants Kaplan-Meier Survival by Transplant Type and Gender (Transplants: January 1990 – June 2012) 100 90 80 Primary/Male (N=22, 963) Primary/Female (N=18, 803) First Retx/Male (N=865) First Retx/Female (N=807) Survival (%) 70 All pair-wise comparisons were significant at p < 0. 05 except Retx: male vs. female 60 50 40 30 20 Median survival (years): Primary: Male = 5. 5; Female = 6. 0 First Retx: Male = 2. 4; Female = 2. 6 10 0 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024

Adult Lung Transplants Kaplan-Meier Survival by Diagnosis (Transplants: January 1990 – June 2012) 100 90 Alpha-1 (N=2, 764) CF (N=6, 766) COPD (N=13, 973) IPF (N=9, 673) IPAH (N=1, 488) Sarcoidosis (N=1, 044) 80 Median survival (years): Alpha-1=6. 4; CF=8. 3; COPD=5. 5; IPF=4. 7; IPAH=5. 5; Sarcoidosis=5. 7 Survival (%) 70 60 50 40 All pair-wise comparisons with CF were significant at p < 0. 0001 Alpha-1 vs. COPD: p < 0. 0001 Alpha-1 vs. IPF: p < 0. 0001 COPD vs. IPF: p < 0. 001 IPF vs. IPAH: p = 0. 0362 30 20 10 0 0 1 2 3 4 5 6 7 8 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 9 10 11 12 13 14 15

Adult Lung Transplants Kaplan-Meier Survival by Transplant Type and Diagnosis (Transplants: January 1990 – June 2012) Primary/CF (N=6, 653) Primary/IPF (N=9, 541) First Retx/COPD (N=104) 100 90 All pair-wise comparisons between transplant types within COPD and CF and between diagnoses for primary transplants were significant at p < 0. 001. No other pair-wise comparisons within diagnosis or transplant type were significant at < 0. 05 80 70 Survival (%) Primary/COPD (N=13, 861) First Retx/CF (N=101) First Retx/IPF (N=129) 60 50 40 30 20 10 Median survival (years): Primary: CF=8. 3; COPD=5. 5; IPF=4. 7 Retransplant: CF=3. 2; COPD=1. 8; IPF=3. 1 0 0 1 2 3 4 5 6 7 8 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 9 10 11 12 13 14 15

Adult Lung Transplants Kaplan-Meier Survival by Diagnosis Conditional on Survival to 3 Months (Transplants: January 1990 – June 2012) 100 All pair-wise comparisons were significant at p < 0. 05 except Alpha-1 vs. Sarcoidosis, COPD vs. IPF, CF vs. IPAH and IPAH vs. Sarcoidosis 90 80 Median survival (years): Alpha-1=7. 7; CF=10. 0; COPD=6. 2; IPF=5. 9; IPAH=9. 2; Sarcoidosis=7. 3 Survival (%) 70 60 50 40 30 20 10 Alpha-1 (N=2, 401) CF (N=6, 009) COPD (N=12, 511) IPF (N=8, 183) IPAH (N=1, 131) Sarcoidosis (N=883) 0 0 1 2 3 4 5 6 7 8 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 9 10 11 12 13 14 15

Adult Lung Transplants Kaplan-Meier Survival by Transplant Type and Diagnosis Conditional on Survival to 3 Months (Transplants: January 1990 – June 2012) 100 No pair-wise comparisons between transplant types within each diagnosis and between diagnoses within each transplant type were significant at p < 0. 05 except Primary: CF vs. COPD and Primary: CF vs. IPF 90 80 Median survival (years): Primary: CF=10. 0; COPD=6. 2; IPF=5. 9 Retransplant: CF=NA; COPD=5. 9; IPF=NA Survival (%) 70 60 50 40 30 20 Primary/CF (N=5, 934) Primary/IPF (N=8, 094) First Retx/COPD (N=73) 10 0 0 1 2 3 4 5 Primary/COPD (N=12, 433) First Retx/CF (N=67) First Retx/IPF (N=86) 6 7 8 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 9 10 11 12 13 14 15

Adult Lung Transplants Kaplan-Meier Survival by Diagnosis Conditional on Survival to 1 Year (Transplants: January 1990 – June 2012) 100 Alpha-1 (N=2, 119) COPD (N=10, 973) IPAH (N=1, 008) 90 80 CF (N=5, 305) IPF (N=6, 853) Sarcoidosis (N=746) Survival (%) 70 60 50 40 30 All pair-wise comparisons were significant at p < 0. 05 except CF vs. IPAH, COPD vs. IPF and IPAH vs. Sarcoidosis 20 Median survival (years): Alpha-1=8. 7; CF=11. 1; COPD=7. 0; IPF=7. 0; IPAH=10. 1; Sarcoidosis=8. 9 10 0 0 1 2 3 4 5 6 7 8 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 9 10 11 12 13 14 15

Adult Lung Transplants Kaplan-Meier Survival by Procedure Type (Transplants: January 1990 – June 2012) Diagnosis: Alpha-1 Antitrypsin Deficiency 100 90 Single Lung (N=1, 122) 80 Bilateral/Double Lung (N=1, 641) Survival (%) 70 60 50 40 p < 0. 0001 30 N at risk = 34 20 10 N at risk = 27 0 0 1 2 3 4 5 6 7 8 9 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 10 11 12 13 14 15 16 17

Adult Lung Transplants Kaplan-Meier Survival by Procedure Type (Transplants: January 1990 – June 2012) Diagnosis: COPD/Emphysema 100 90 Single Lung (N = 7, 377) 80 Bilateral/Double Lung (N = 6, 585) Survival (%) 70 60 50 40 p < 0. 0001 30 N at risk = 28 20 N at risk = 39 10 0 0 1 2 3 4 5 6 7 8 9 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 10 11 12 13 14 15 16 17

Adult Lung Transplants Kaplan-Meier Survival by Procedure Type and Era (Transplants: January 1990 – June 2012) Diagnosis: COPD/Emphysema, Single Lung Survival (%) 100 90 1990 -1997 (N = 2, 047) 80 1998 -2004 (N = 2, 946) 70 2005 -6/2012 (N = 2, 384) 60 50 N at risk = 176 40 30 N at risk = 90 20 1990 -1997 vs. 1998 -2004: p < 0. 0001 1990 -1997 vs. 2005 -6/2012: p < 0. 0001 1998 -2004 vs. 2005 -6/2012: p = 0. 9981 10 0 0 1 2 3 4 5 N at risk = 156 6 7 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 8 9 10 11 12 13

Adult Lung Transplants Kaplan-Meier Survival by Procedure Type and Era (Transplants: January 1990 – June 2012) Diagnosis: COPD/Emphysema, Bilateral/Double Lung 100 1990 -1997 (N = 579) 90 1998 -2004 (N = 1, 625) 80 2005 -6/2012 (N = 4, 381) Survival (%) 70 60 N at risk = 233 50 40 N at risk = 59 30 20 1990 -1997 vs. 1998 -2004: p = 0. 0131 1990 -1997 vs. 2005 -6/2012: p = 0. 0031 1998 -2004 vs. 2005 -6/2012: p = 0. 7588 10 0 0 1 2 3 4 5 N at risk = 87 6 7 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 8 9 10 11 12 13

Adult Lung Transplants Kaplan-Meier Survival by Procedure Type (Transplants: January 1990 – June 2012) Diagnosis: Idiopathic Pulmonary Fibrosis 100 90 Single Lung (N=5, 366) 80 Bilateral/Double Lung (N=4, 304) Survival (%) 70 60 50 40 p < 0. 0001 30 N at risk = 15 20 10 N at risk = 36 0 0 1 2 3 4 5 6 7 8 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 9 10 11 12 13 14 15 16

Adult Lung Transplants Kaplan-Meier Survival by Procedure Type and Era (Transplants: January 1990 – June 2012) Diagnosis: Idiopathic Pulmonary Fibrosis, Single Lung Survival (%) 100 90 1990 -1997 (N = 945) 80 1998 -2004 (N = 1, 456) 70 2005 -6/2012 (N = 2, 965) 60 50 40 N at risk = 140 30 N at risk = 42 20 1990 -1997 vs. 1998 -2004: p = 0. 0154 1990 -1997 vs. 2005 -6/2012: p = 0. 0044 1998 -2004 vs. 2005 -6/2012: p = 0. 7211 10 0 0 1 2 3 4 5 N at risk = 67 6 7 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 8 9 10 11 12 13

Adult Lung Transplants Kaplan-Meier Survival by Procedure Type and Era (Transplants: January 1990 – June 2012) Diagnosis: Idiopathic Pulmonary Fibrosis, Bilateral/Double Lung 100 1990 -1997 (N = 254) 90 1998 -2004 (N = 757) 80 2005 -6/2012 (N = 3, 293) Survival (%) 70 60 N at risk = 148 50 40 N at risk = 22 30 20 N at risk = 36 1990 -1997 vs. 1998 -2004: p = 0. 0022 1990 -1997 vs. 2005 -6/2012: p < 0. 0001 1998 -2004 vs. 2005 -6/2012: p = 0. 0035 10 0 0 1 2 3 4 5 6 7 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 8 9 10 11 12 13

Adult Lung Transplants Kaplan-Meier Survival by Procedure Type (Transplants: January 1990 – June 2012) Diagnosis: Idiopathic Arterial Pulmonary Hypertension 100 90 Single Lung (N = 283) 80 Bilateral/Double Lung (N = 1, 205) Survival (%) 70 60 50 40 N at risk = 31 p < 0. 0001 30 20 N at risk = 20 10 0 0 1 2 3 4 5 6 7 8 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 9 10 11 12 13 14 15 16

Adult Lung Transplants Kaplan-Meier Survival by Procedure Type and Era (Transplants: January 1990 – June 2012) Diagnosis: Cystic Fibrosis, Bilateral/Double Lung 100 1990 -1997 (N=1, 107) 90 1998 -2004 (N=1, 946) 80 2005 -6/2012 (N=3, 590) Survival (%) 70 N at risk = 228 60 50 N at risk = 148 40 30 N at risk = 221 20 1990 -1997 vs. 1998 -2004: p < 0. 0001 1990 -1997 vs. 2005 -6/2012: p < 0. 0001 1998 -2004 vs. 2005 -6/2012: p = 0. 0032 10 0 0 1 2 3 4 5 6 7 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 8 9 10 11 12 13

Adult Lung Transplants % experiencing treated rejection within 1 year Percentage Experiencing Treated Rejection between Discharge and 1 -Year Follow-Up (Follow-ups: July 2004 – June 2013) 60 50 No pair-wise comparisons were significant at < 0. 05 except 18 -34 vs. 35 -49 and 18 -34 vs. 60 -65 40 30 20 10 0 Overall (N=11, 913) 18 -34 35 -49 50 -59 60 -65 >65 (N=1, 570) (N=1, 925) (N=3, 619) (N=3, 204) (N=1, 595) Analysis is limited to patients who were alive at the time of the follow-up 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 Female Male (N=5, 113) (N=6, 800) Treated rejection = Recipient was reported to (1) have at least one acute rejection episode that was treated with an anti-rejection agent; or (2) have been hospitalized for rejection.

Adult Lung Transplants % experiencing rejection within 1 year Percentage Experiencing Any Rejection between Discharge and 1 -Year Follow-Up (Follow-ups: July 2004 – June 2013) 60 50 No pair-wise comparisons were significant at < 0. 05 except 18 -34 vs. 35 -49 and 18 -34 vs. 60 -65 40 30 20 10 0 Overall (N=11, 913) 18 -34 35 -49 50 -59 60 -65 >65 (N=1, 570) (N=1, 925) (N=3, 619) (N=3, 204) (N=1, 595) Analysis is limited to patients who were alive at the time of the follow-up 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 Female Male (N=5, 113) (N=6, 800) No rejection = Recipient had (i) no acute rejection episodes and (ii) was reported either as not hospitalized for rejection or did not receive antirejection agents.

Adult Lung Transplants % experiencing treated rejection within 1 year Percentage Experiencing Treated Rejection between Discharge and 1 -Year Follow-Up (Follow-ups: July 2004 – June 2013) Primary (N=11, 443) First Retransplant (N=463) No pair-wise comparisons were significant at < 0. 05 Overall 18 -34 35 -49 50 -59 Analysis is limited to patients who were alive at the time of the follow-up 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 60 -65 >65 Female Male Treated rejection = Recipient was reported to (1) have at least one acute rejection episode that was treated with an anti-rejection agent; or (2) have been hospitalized for rejection.

Adult Lung Transplants Kaplan-Meier Survival by Donor/Recipient CMV Status (Transplants: October 1999 – June 2012) 100 D(-)/R(-) (N = 2, 817) D(-)/R(+) (N = 3, 517) 80 D(+)/R(-) (N = 3, 837) Survival (%) D(+)/R(+) (N = 5, 949) 60 40 20 All pair-wise comparisons were significant at p < 0. 05 except D(+)/R(-) vs. D(+)/R(+) 0 0 1 2 3 4 5 6 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 7 8 9 10 11 12

Adult Lung Transplants Kaplan-Meier Survival by Donor/Recipient CMV Status and Era (Transplants: October 1999 – June 2012) Era 1 = 10/1999 -2004; Era 2 = 2005 -6/2012 100 Survival (%) 80 D(-)/R(-) Era 1 (N=893) D(-)/R(-) Era 2 (N=1, 924) D(-)/R(+) Era 1 (N=1, 183) D(-)/R(+) Era 2 (N=2, 334) D(+)/R(-) Era 1 (N=1, 016) D(+)/R(-) Era 2 (N=2, 821) D(+)/R(+) Era 1 (N=1, 752) D(+)/R(+) Era 2 (N=4, 197) 60 40 No pair-wise comparisons between eras within each CMV group and between CMV groups within each era were significant at p<0. 05 except 10/1999 -2004: D(-)/R(-) vs. D(+)/R(-) and D(-)/R(-) vs. D(+)/R(+) 2005 -6/2012: D(-)/R(-) vs. D(+)/R(-), D(-)/R(-) vs. D(+)/R(+) and D(-)/R(+) vs. D(+)/R(-) 20 0 1 2 3 4 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 5 6 7

Adult Lung Transplants Percentage Experiencing Treated Rejection between Discharge and 1 -Year Follow-Up by Donor/Recipient CMV Status (Follow-ups: July 2004 – June 2013) % experiencing treated rejection within 1 year 50 D(-)/R(-) (N=1, 846) D(-)/R(+) (N=2, 245) D(+)/R(-) (N=2, 661) D(+)/R(+) (N=4, 086) 40 No pair-wise comparisons were significant at p < 0. 05 30 20 10 0 Analysis is limited to patients who were alive at the time of the follow-up 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 Treated rejection = Recipient was reported to (1) have at least one acute rejection episode that was treated with an anti-rejection agent; or (2) have been hospitalized for rejection.

Adult Lung Transplants Percentage Experiencing Any Rejection between Discharge and 1 Year Follow-Up by Donor/Recipient CMV Status % experiencing rejection within 1 year (Follow-ups: July 2004 – June 2013) 50 D(-)/R(-) (N=1, 846) D(-)/R(+) (N=2, 245) D(+)/R(-) (N=2, 661) D(+)/R(+) (N=4, 086) 40 No pair-wise comparisons were significant at p < 0. 05 30 20 10 0 Analysis is limited to patients who were alive at the time of the follow-up 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 Any rejection = Recipient was reported to (1) have at least one acute rejection episode; or (2) have been hospitalized for rejection.

Functional and Employment Status and Rehospitalization Post Transplant 2014 JHLT. 2014 Oct; 33(10): 1009 -1024

Adult Lung Transplants Functional Status of Surviving Recipients (Follow-ups: March 2005 – June 2013) 100% 10% 20% 80% 30% 40% 60% 50% 60% 40% 70% 80% 20% 90% 100% 0% 1 Year (N = 10, 758) 2 Years (N = 8, 605) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 3 Years (N =7, 080)

Adult Lung Transplants Employment Status of Surviving Recipients (Follow-ups: April 1994 – June 2013) 100% Working (FT/PT Status unknown) 80% Working Part Time 60% Working Full Time Retired 40% Not Working 20% 0% 1 Year (N = 13, 702) 3 Years (N = 8, 672) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 5 Years (N = 5, 576)

Adult Lung Transplants Rehospitalization Post Transplant of Surviving Recipients (Follow-ups: April 1994 – June 2013) 100% 80% 60% 40% 20% 0% Hospitalized, Rejection + Infection Hospitalized, Rejection Only No Hospitalization Hospitalized, Infection Only Hospitalized, Not Rejection/Not Infection 3 Years (N=12, 232) 1 Year (N=19, 500) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 5 Years (N=7, 939)

Induction and Maintenance Immunosuppression 2014 JHLT. 2014 Oct; 33(10): 1009 -1024

Adult Lung Transplants Induction Immunosuppression Analysis limited to patients receiving prednisone (Transplants: January 2002 – June 2013) 60 % of patients 50 40 30 20 10 0 Any Induction (N=8, 608) Polyclonal ALG/ATG (N=1, 649) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 IL-2 R Antagonist (N=6, 056) Alemtuzumab (N=922) Analysis is limited to patients who were alive at the time of the discharge

Adult Lung Transplants Induction Immunosuppression Analysis limited to patients receiving prednisone (Transplants: 2002, 2006 and January 2013 – June 2013) 70 2002 % of patients 60 2006 1/2013 -6/2013 50 40 30 20 10 0 Any Induction Polyclonal ALG/ATG 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 IL-2 R Antagonist Alemtuzumab Analysis is limited to patients who were alive at the time of the discharge

Adult Lung Transplants Induction Immunosuppression Analysis limited to patients receiving prednisone (Transplants: January 2000 – December 2012) 70 50 40 30 20 10 06 08 20 10 20 12 20 00 20 02 20 04 20 06 20 08 20 10 20 12 20 20 02 04 20 20 12 00 Any Induction 20 20 08 10 20 20 04 06 20 20 20 00 02 0 20 % of patients 60 Polyclonal ALG/ATG IL-2 R Antagonist 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 Alemtuzumab Analysis is limited to patients who were alive at the time of the discharge

Adult Lung Transplants Survival by Induction Usage Conditional on Survival to 14 Days (Transplants: April 1994 – June 2012) 100 p < 0. 0001 Survival (%) 75 50 N at risk = 51 No induction (N = 10, 725) 25 Induction (N = 9, 602) N at risk = 142 0 0 1 2 3 4 5 6 7 8 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 9 10 11 12 13 14 15 16

Adult Lung Transplants Survival by Induction Usage Conditional on Survival to 14 Days (Transplants: January 2000 – June 2012) 100 p < 0. 0001 Survival (%) 75 50 N at risk = 141 No induction (N = 7, 722) 25 N at risk = 120 Induction (N = 8, 398) 0 0 1 2 3 4 5 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 6 7 8 9 10 11

Adult Lung Transplants Maintenance Immunosuppression at Time of Follow-up Analysis limited to patients receiving prednisone (Follow-ups: January 2002 – June 2013) 100 Year 1 (N = 12, 803) Year 5 (N = 5, 397) % of patients 80 60 40 20 0 Cyclosporine Tacrolimus Sirolimus/ Everolimus MMF/MPA Azathioprine NOTE: Different patients are analyzed in Year 1 and Year 5 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 Analysis is limited to patients who were alive at the time of the follow-up

Adult Lung Transplants Maintenance Immunosuppression at Time of Follow-up 100 Analysis limited to patients receiving prednisone (Follow-ups: January 2002 – June 2013) Consecutive bars within each drug type represent follow-ups in years from 2002 through 06/2013 % of patients 80 60 40 20 0 Cy. A TAC Sirolimus/ MMF/ Everolimus MPA AZA 1 -Year Follow-Up Cy. A TAC Sirolimus/ MMF/ Everolimus MPA 5 -Year Follow-Up NOTE: Different patients are analyzed in Year 1 and Year 5 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 Analysis is limited to patients who were alive at the time of the discharge AZA

Adult Lung Transplants Maintenance Immunosuppression at Time of 1 Year Follow-up Analysis limited to patients receiving prednisone (Follow-ups: 2002, 2006 and July 2011 – June 2013) 100 2002 (N = 726) 2006 (N = 1, 101) 7/2012 -6/2013 (N = 1, 514) % of patients 80 60 40 20 0 Cyclosporine Tacrolimus Sirolimus/ Everolimus MMF/ MPA Azathioprine NOTE: Different patients are analyzed in each time frame 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 Analysis is limited to patients who were alive at the time of the follow-up

Adult Lung Transplants Maintenance Immunosuppression at Time of Follow-up Analysis limited to patients receiving prednisone (Follow-ups: January 2002 – June 2013) 100 % of patients 80 60 Tac MMF/ MPA Tac MMF 40 20 AZA Cy. A AZA 0 Calcineurin Cell. Cycle Sirolimus/ Inhibitor Everolimus 1 Year Follow-up (N = 12, 803) Calcineurin Cell. Cycle Sirolimus/ Inhibitor Everolimus 5 Year Follow-up (N = 5, 397) NOTE: Different patients are analyzed in Year 1 and Year 5 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 Analysis is limited to patients who were alive at the time of the follow-up

Adult Lung Transplants Maintenance Immunosuppression Drug Combinations at Time of Follow-up (Follow-ups: January 2002 – June 2013) Analysis limited to patients receiving prednisone 100% Other Sirolimus/Everolimus + Calcineurin + Cellcycle Sirolimus/Everolimus + Cellcycle % of Patients 80% Sirolimus/Everolimus + Calcineurin 60% Tacrolimus Alone Tacrolimus + MMF/MPA 40% Tacrolimus + AZA 20% Cyclosporine + MMF/MPA Cyclosporine + AZA 0% Year 1 (N = Year 5 (N = 5, 397) 12, 803) NOTE: Different patients are analyzed in Year 1 and Year 5 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 Analysis is limited to patients who were alive at the time of the follow-up

Adult Lung Transplants Kaplan-Meier Survival by Maintenance Immunosuppression Combinations Conditional on Survival to 1 Year (Transplants: January 2000 – June 2012) Analysis limited to patients receiving prednisone 100 p < 0. 0001 Survival (%) 75 50 Tacrolimus + MMF/MPA use at discharge and 1 year (N=4, 702) Tacrolimus + AZA use at discharge and 1 year (N=1, 725) 25 Cyclosporine + MM/MPA use at discharge and 1 year (N=504) Cyclosporine + AZA use at discharge and 1 year (N=551) 0 0 1 2 3 4 5 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 6 7 8 9 10 11

Adult Lung Transplants Kaplan-Meier Survival by Maintenance Immunosuppression Combinations Conditional on Survival to 1 Year (Transplants: January 2000 – June 2012) Analysis limited to patients receiving prednisone Diagnosis: COPD/Emphysema 100 p = 0. 0088 Survival (%) 75 50 Tacrolimus + MMF/MPA use at discharge and 1 year (N=1, 363) 25 Tacrolimus + AZA use at discharge and 1 year (N=566) Cyclosporine + MM/MPA use at discharge and 1 year (N=213) Cyclosporine + AZA use at discharge and 1 year (N=243) 0 0 1 2 3 4 5 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 6 7 8 9 10 11

Adult Lung Transplants Kaplan-Meier Survival by Maintenance Immunosuppression Combinations Conditional on Survival to 1 Year (Transplants: January 2000 – June 2012) Analysis limited to patients receiving prednisone Diagnosis: Idiopathic Pulmonary Fibrosis 100 p = 0. 0019 Survival (%) 75 50 Tacrolimus + MMF/MPA use at discharge and 1 year (N=1, 543) 25 Tacrolimus + AZA use at discharge and 1 year (N=518) Cyclosporine + MM/MPA use at discharge and 1 year (N=127) Cyclosporine + AZA use at discharge and 1 year (N=105) 0 0 1 2 3 4 5 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 6 7 8 9 10

Adult Lung Transplants Kaplan-Meier Survival by Maintenance Immunosuppression Combinations Conditional on Survival to 1 Year (Transplants: January 2000 – June 2012) Analysis limited to patients receiving prednisone Diagnosis: Cystic Fibrosis 100 p = 0. 5040 Survival (%) 75 50 Tacrolimus + MMF/MPA use at discharge and 1 year (N=683) Tacrolimus + AZA use at discharge and 1 year (N=236) Cyclosporine + MM/MPA use at discharge and 1 year (N=42) Cyclosporine + AZA use at discharge and 1 year (N=78) 25 0 0 1 2 3 4 5 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 6 7 8 9

Adult Lung Transplants % experiencing treated rejection within 1 year Percentage Experiencing Treated Rejection between Discharge and 1 Year Follow-Up by Type of Induction (Follow-ups: July 2004 – June 2013) 60 50 40 No induction (N=5, 486) IL-2 R Antagonist (N=4, 431) Polyclonal (N=1, 144) Alemtuzumab (N=804) No pair-wise comparisons were significant at p < 0. 05 except No induction vs. IL 2 R and IL-2 R vs. Alemtuzumab 30 20 10 0 Analysis is limited to patients who were alive at the time of the follow-up 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 Treated rejection = Recipient was reported to (1) have at least one acute rejection episode that was treated with an anti-rejection agent; or (2) have been hospitalized for rejection.

Adult Lung Transplants Percentage Experiencing Any Rejection between Discharge and 1 -Year Follow-Up by Type of Induction (Follow-ups: July 2004 – June 2013) % experiencing rejection within 1 year 60 No induction (N=5, 486) IL-2 R Antagonist (N=4, 431) Polyclonal (N=1, 144) Alemtuzumab (N=804) 50 No pair-wise comparisons were significant at p < 0. 05 except No induction vs. IL 2 R and IL-2 R vs. Alemtuzumab 40 30 20 10 0 Analysis is limited to patients who were alive at the time of the follow-up 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 No rejection = Recipient had (i) no acute rejection episodes and (ii) was reported either as not hospitalized for rejection or did not receive anti-rejection agents.

Adult Lung Transplants % experiencing treated rejection within 1 year Percentage Experiencing Treated Rejection between Discharge and 1 Year Follow-Up by Type of Induction (Follow-ups: July 2004 – June 2013) 60 No induction Polyclonal IL-2 R Antagonist Alemtuzumab 50 40 30 20 10 0 18 -34 (N=1, 566) 35 -49 (N=1, 919) 50 -59 (N=3, 598) 60 -65 (N=3, 192) >65 (N=1, 590) Female (N=5, 096) Male (N=6, 769) No induction vs. IL-2 R (male), Polyclonal vs. Alemtuzumab (50 -69) and IL-2 R vs. Alemtuzumab (50 -59 years and female) were significant at p < 0. 05. No other pair-wise comparisons were significant at p<0. 05 Analysis is limited to patients who were alive at the time of the follow-up Treated rejection = Recipient was reported to (1) have 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 at least one acute rejection episode that was treated with an anti-rejection agent; or (2) have been hospitalized for rejection.

Adult Lung Transplants Percentage Experiencing Any Rejection between Discharge and 1 -Year Follow-Up by Type of Induction (Follow-ups: July 2004 – June 2012) % experiencing rejection within 1 year 60 No induction Polyclonal IL-2 R Antagonist Alemtuzumab 50 40 30 20 10 0 18 -34 (N=1, 566) 35 -49 (N=1, 919) 50 -59 (N=3, 598) 60 -65 (N=3, 192) >65 (N=1, 590) Female (N=5, 096) Male (N=6, 769) Polyclonal vs. IL-2 R (>65 years), Polyclonal vs. Alemtuzumab (50 -59 years) and IL-2 R vs. Alemtuzumab (50 -59 years and female) were significant at p < 0. 05. No other pair-wise comparisons were significant at p<0. 05 Analysis is limited to patients who were alive at the time of the follow-up 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 No rejection = Recipient had (i) no acute rejection episodes and (ii) was reported either as not hospitalized for rejection or did not receive antirejection agents.

Adult Lung Transplants Percentage Experiencing Treated Rejection between Discharge and 1 - Year Follow-Up by Maintenance Immunosuppression % experiencing treated rejection within 1 year (Follow-ups: July 2004 – June 2013) 70 60 Cy. A + MMF/MPA (N=551) Cy. A + AZA (N=804) TAC + MMF/MPA (N=6, 514) TAC + AZA (N=2, 685) All pair-wise comparisons were significant at p < 0. 05 except Cy. A + MMF/MPA vs. TAC + AZA 50 40 30 20 10 0 Analysis is limited to patients who were alive at the time of the follow-up 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 Treated rejection = Recipient was reported to (1) have at least one acute rejection episode that was treated with an anti-rejection agent; or (2) have been hospitalized for rejection.

Adult Lung Transplants Percentage Experiencing Rejection between Discharge and 1 -Year Follow-Up by Maintenance Immunosuppression (Follow-ups: July 2004 – June 2013) % experiencing rejection within 1 year 70 Cy. A + MMF/MPA (N=551) Cy. A + AZA (N=804) TAC + MMF/MPA (N=6, 514) TAC + AZA (N=2, 685) 60 All pair-wise comparisons were significant at p < 0. 05 except Cy. A + MMF/MPA vs. TAC + AZA 50 40 30 20 10 0 Analysis is limited to patients who were alive at the time of the follow-up 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 No rejection = Recipient had (i) no acute rejection episodes and (ii) was reported either as not hospitalized for rejection or did not receive anti-rejection agents.

Adult Lung Transplants Percentage Experiencing Treated Rejection between Discharge and 1 -Year Follow-Up by Maintenance Immunosuppression % experiencing treated rejection within 1 year (Follow-ups: July 2004 – June 2012) 70 Cy. A + MMF/MPA Cy. A + AZA TAC + MMF/MPA TAC + AZA 60 50 40 30 20 10 0 18 -34 35 -49 50 -59 60 -65 >65 (N=1, 384) (N=1, 699) (N=3, 194) (N=2, 869) (N=1, 408) Female Male (N=4, 519) (N=6, 035) Cy. A + MMF/MPA vs. Cy. A + AZA (except >65 years), Cy. A + MMF/MPA vs. TAC + MMF/MPA (female), Cy. A + AZA vs. TAC + MMF/MPA, Cy. A + AZA vs. TAC + AZA (except >65 years), and TAC + MMF/MPA vs. TAC + AZA (>65 years and female) were significant at p < 0. 05. No other pair-wise comparisons were significant. Analysis is limited to patients who were alive at the time of the follow-up Treated rejection = Recipient was reported to (1) have 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 at least one acute rejection episode that was treated with an anti-rejection agent; or (2) have been hospitalized for rejection.

Adult Lung Transplants Percentage Experiencing Rejection between Discharge and 1 -Year Follow-Up by Maintenance Immunosuppression % experiencing rejection within 1 year (Follow-ups: July 2004 – June 2013) 70 Cy. A + MMF/MPA Cy. A + AZA TAC + MMF/MPA TAC + AZA 60 50 40 30 20 10 0 18 -34 (N=1, 384) 35 -49 (N=1, 699) 50 -59 (N=3, 194) 60 -65 (N=2, 869) >65 (N=1, 408) Female (N=4, 519) Male (N=6, 035) Cy. A + MMF/MPA vs. Cy. A + AZA (except 35 -49 and >65 years), Cy. A + MMF/MPA vs. TAC + MMF/MPA (female), Cy. A + AZA vs. TAC + MMF/MPA, Cy. A + AZA vs. TAC + AZA (except >65 years), and TAC + MMF/MPA vs. TAC + AZA (except 18 -34, 34 -49 and >65 years) were significant at p < 0. 05. No other pair-wise comparisons were significant. Analysis is limited to patients who were alive at the time of the follow-up No rejection = Recipient had (i) no acute rejection 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 episodes and (ii) was reported either as not hospitalized for rejection or did not receive antirejection agents.

Post Transplant Morbidities 2014 JHLT. 2014 Oct; 33(10): 1009 -1024

Adult Lung Transplants Cumulative Morbidity Rates in Survivors within 1 Year Post Transplant (Follow-ups: April 1994 – June 2013) Follow-ups: April 1994 – June 2003 Total number Within 1 Year with known response Outcome Follow-ups: July 2003– June 2013 Total number Within 1 Year with known response Hypertension 50. 8% (N = 5, 982) 52. 3% (N = 10, 503) Renal Dysfunction 26. 1% (N = 5, 991) 21. 6% (N = 12, 890) Abnormal Creatinine ≤ 2. 5 mg/dl 15. 8% 16. 1% Creatinine > 2. 5 mg/dl 8. 3% 3. 8% Chronic Dialysis 2. 0% 1. 7% Renal Transplant 0. 0% 0. 1% Hyperlipidemia 16. 3% (N = 6, 264) 31. 3% (N = 10, 937) Diabetes 20. 1% (N = 5, 959) 25. 6% (N = 12, 856) Bronchiolitis Obliterans Syndrome 9. 4% (N = 5, 592) 9. 4% (N = 12, 169) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024

Adult Lung Transplants Cumulative Morbidity Rates in Survivors within 1 Year Post Transplant by Transplant Type (Follow-ups: April 1994 – June 2013) Primary First Retransplant Within 1 Year Total number with known response Hypertension 51. 5% (N = 15, 962) 58. 1% (N = 516) Renal Dysfunction 22. 9% (N = 18, 269) 27. 2% (N = 604) Outcome Abnormal Creatinine ≤ 2. 5 mg/dl 16. 0% 16. 4% Creatinine > 2. 5 mg/dl 5. 1% 7. 0% Chronic Dialysis 1. 7% 3. 1% Renal Transplant 0. 1% 0. 7% Hyperlipidemia 25. 8% (N = 16, 653) 26. 6% (N = 541) Diabetes 23. 9% (N = 18, 206) 22. 8% (N = 601) Bronchiolitis Obliterans Syndrome 9. 2% (N = 17, 185) 16. 7% (N = 568) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024

Adult Lung Transplants Cumulative Morbidity Rates in Survivors within 1 and 5 Years Post Transplant (Follow-ups: April 1994 – June 2013) Within 1 Year Total number with known response Within 5 Years Total number with known response Hypertension 51. 8% (N = 16, 485) 81. 7% (N = 4, 866) Renal Dysfunction 23. 1% (N = 18, 881) 54. 8% (N = 6, 278) Outcome Abnormal Creatinine ≤ 2. 5 mg/dl 16. 0% 36. 3% Creatinine > 2. 5 mg/dl 5. 2% 14. 6% Chronic Dialysis 1. 8% 3. 2% Renal Transplant 0. 1% 0. 7% Hyperlipidemia 25. 9% (N = 17, 201) 58. 7% (N = 5, 222) Diabetes 23. 8% (N = 18, 815) 40. 2% (N = 6, 175) Bronchiolitis Obliterans Syndrome 9. 4% (N = 17, 761) 40. 6% (N = 5, 328) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024

Adult Lung Retransplants Cumulative Morbidity Rates in Survivors within 1 and 5 Years Post First Retransplant (Follow-ups: April 1994 – June 2013) Within 1 Year Total number with known response Within 5 Years Total number with known response Hypertension 58. 1% (N = 516) 83. 9% (N = 87) Renal Dysfunction 27. 2% (N = 604) 61. 6% (N = 146) Outcome Abnormal Creatinine ≤ 2. 5 mg/dl 16. 4% 34. 9% Creatinine > 2. 5 mg/dl 7. 0% 16. 4% Chronic Dialysis 3. 1% 7. 5% Renal Transplant 0. 7% 2. 7% Hyperlipidemia 26. 6% (N = 541) 59. 0% (N = 100) Diabetes 22. 8% (N = 601) 39. 9% (N = 138) Bronchiolitis Obliterans Syndrome 16. 7% (N = 568) 53. 4% (N = 118) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024

Adult Lung Transplants Cumulative Morbidity Rates in Survivors within 10 Years Post-Transplant (Follow-ups: April 1994 – June 2013) Outcome Renal Dysfunction Within 10 Years Total number with known response 73. 5% (N = 1, 270) Abnormal Creatinine ≤ 2. 5 mg/dl 41. 1% Creatinine > 2. 5 mg/dl 19. 4% Chronic Dialysis 7. 8% Renal Transplant 5. 3% Bronchiolitis Obliterans Syndrome 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 63. 4% (N = 946)

Adult Lung Transplants Freedom from Bronchiolitis Obliterans Syndrome % Free from Bronchiolitis Obliterans Syndrome Conditional on Survival to 14 days (Follow-ups: April 1994 – June 2013) 100 Freedom from Bronchiolitis Obliterans Syndrome (N = 17, 811) 80 60 40 N at risk = 12 20 0 0 1 2 3 4 5 6 7 8 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 9 10 11 12 13 14 15

Adult Lung Transplants Freedom from Bronchiolitis Obliterans Syndrome by Diagnosis Conditional on Survival to 14 days % Free from Bronchiolitis Obliterans Syndrome (Follow-ups: April 1994 – June 2013) 100 No pair-wise comparisons were significant at p < 0. 05 except CF vs. COPD 80 60 40 20 Alpha-1 (N=955) CF (N=2, 468) COPD (N=6, 163) IPF (N=4, 743) IPAH (N=478) Sarcoidosis (N=521) 0 0 1 2 3 4 5 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 6 7 8 9 10

Adult Lung Transplants Freedom from Bronchiolitis Obliterans Syndrome by Induction Use Conditional on Survival to 14 days % Free from Bronchiolitis Obliterans Syndrome (Follow-ups: April 1994 – June 2013) 100 No induction (N = 8, 749) Induction (N = 7, 990) 80 60 40 N at risk = 20 20 p = 0. 0002 N at risk = 40 0 0 1 2 3 4 5 6 7 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 8 9 10 11 12 13

Adult Lung Transplants Freedom from Bronchiolitis Obliterans Syndrome by Induction Use Conditional on Survival to 1 Year % Free from Bronchiolitis Obliterans Syndrome (Follow-ups: April 1994 – June 2013) 100 No induction (N = 7, 891) Induction (N = 7, 262) 80 60 40 N at risk = 20 20 N at risk = 40 p = 0. 0003 0 0 1 2 3 4 5 6 7 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 8 9 10 11 12 13

Adult Lung Transplants % Free from Bronchiolitis Obliterans Syndrome Freedom from Bronchiolitis Obliterans Syndrome by Donor/Recipient CMV Status Conditional on Survival to 14 Days (Follow-ups: April 1994 – June 2013) 100 D(-)/R(-) (N = 2, 806) D(-)/R(+) (N = 3, 667) 80 D(+)/R(-) (N = 3, 670) D(+)/R(+) (N = 6, 045) 60 N at risk = 14 40 N at risk = 25 20 No pair-wise comparisons were significant at p < 0. 05 except D(+)/R(-) vs. D(+)/R(+): p = 0. 0113 N at risk = 15 N at risk = 11 0 0 1 2 3 4 5 6 7 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 8 9 10 11 12 13

Adult Lung Transplants Freedom from Bronchiolitis Obliterans Syndrome by Donor/Recipient CMV Status % Free from Bronchiolitis Obliterans Syndrome Conditional on Survival to 1 Year (Follow-ups: April 1994 – June 2013) 100 80 D(-)/R(-) (N = 2, 346) D(-)/R(+) (N = 3, 071) D(+)/R(-) (N = 2, 869) D(+)/R(+) (N = 4, 915) 60 N at risk = 21 40 N at risk = 31 20 N at risk = 21 N at risk = 18 No p-values were significant at p < 0. 05 0 0 1 2 3 4 5 6 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 7 8 9 10 11 12

Adult Lung Transplants Freedom from Severe Renal Dysfunction* (Follow-ups: April 1994 – June 2013) % Free from Severe Renal Dysfunction 100 Freedom from Severe Renal Dysfunction (N=18, 897). . . 80 60 N at risk = 33 40 * Severe renal dysfunction = Creatinine > 2. 5 mg/dl (221 μmol/L), dialysis or renal transplant 20 0 0 1 2 3 4 5 6 7 8 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 9 10 11 12 13 14 15

Adult Lung Transplants Freedom from Severe Renal Dysfunction* Conditional on Survival to 1 Year (Follow-ups: April 1994 – June 2013) % Free from Severe Renal Dysfunction 100 Freedom from Severe Renal Dysfunction (N=16, 952). . . 80 60 N at risk = 33 40 * Severe renal dysfunction = Creatinine > 2. 5 mg/dl (221 μmol/L), dialysis or renal transplant 20 0 0 1 2 3 4 5 6 7 8 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 9 10 11 12 13 14 15

Adult Lung Transplants Freedom from Severe Renal Dysfunction* by Maintenance Immunosuppression Combinations at Discharge Conditional on Survival to 14 Days (Transplants: January 2000 – June 2012) Analysis limited to patients receiving prednisone % Free from Severe Renal Dysfunction 100 80 60 * Severe renal dysfunction = Creatinine > 2. 5 mg/dl (221 μmol/L), dialysis or renal transplant 40 All pair-wise comparisons with Cy. A + MMF/MPA were significant at p < 0. 001. No other pair-wise comparisons were significant at p < 0. 05. 20 TAC+MMF/MPA (N = 6, 903) TAC+AZA (N = 3, 219) Cy. A+MMF/MPA (N = 1, 032) Cy. A+AZA (N = 1, 585) 1 5 0 0 2 3 4 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 6 Years 7 8 9 10 11

Adult Lung Transplants Cumulative Post Transplant Malignancy Rates in Survivors(Follow-ups: April 1994 – June 2013) 1 -Year Survivors 5 -Year Survivors 10 -Year Survivors 18, 644 (96. 4%) 5, 600 (84. 3%) 1, 049 (72. 2%) 701 (3. 6%) 1, 042 (15. 7%) 403 (27. 8%) Malignancy/Type No Malignancy (all types combined) Malignancy Type* Skin 237 724 284 Lymphoma 261 101 43 Other 176 263 113 Type Not Reported 27 9 0 Other malignancies reported include: adenocarcinoma (2; 2; 1), bladder (2; 1; 0), lung (2; 4; 0), breast (1; 5; 2); prostate (0; 5; 1), cervical (1; 1; 0); liver (1; 1; 1); colon (1; 1; 0). Numbers in parentheses represent the number of reported cases within each time period. * Recipients may have experienced more than one type of malignancy so sum of individual malignancy types may be greater than total number with malignancy. 2014 JHLT. 2014 Oct; 33(10): 1009 -1024

Adult Lung Transplants Freedom from Malignancy (Follow-ups: April 1994 – June 2013) % Free from Malignancy 100 80 60 40 20 All malignancy Lymphoma Skin Other 0 0 1 2 3 4 5 6 7 8 9 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 10 11 12 13 14 15 16 17

Adult Lung Transplants Freedom from Malignancy Conditional on Survival to 1 Year (Follow-ups: April 1994 – June 2013) % Free from Malignancy 100 80 60 40 20 All malignancy Lymphoma Skin Other 0 0 1 2 3 4 5 6 7 8 9 Years 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 10 11 12 13 14 15 16 17

Adult Lung Transplants Cause of Death (Deaths: January 1992 – June 2013) 0 -30 Days (N = 2, 905) 31 Days - 1 Year (N = 5, 098) >1 Year - 3 Years (N = 4, 797) Bronchiolitis 8 (0. 3%) 233 (4. 6%) 1, 230 (25. 6%) 804 (29. 3%) 806 (24. 7%) 219 (20. 1%) Acute Rejection 96 (3. 3%) 93 (1. 8%) 75 (1. 6%) 17 (0. 6%) 18 (0. 6%) 2 (0. 2%) Lymphoma 1 (0. 0%) 114 (2. 2%) 84 (1. 8%) 42 (1. 5%) 60 (1. 8%) 35 (3. 2%) Malignancy, Non-Lymphoma 5 (0. 2%) 144 (2. 8%) 380 (7. 9%) 300 (10. 9%) 448 (13. 7%) 135 (12. 4%) 0 116 (2. 3%) 48 (1. 0%) 7 (0. 3%) 4 (0. 1%) 1 (0. 1%) Cause of Death CMV >3 Years - 5 >5 Years – 10 >10 Years (N Years = 1, 092) (N = 2, 746) (N = 3, 263) Infection, Non-CMV 550 (18. 9%) 1, 803 (35. 4%) 1, 041 (21. 7%) 506 (18. 4%) 586 (18. 0%) 182 (16. 7%) Graft Failure 702 (24. 2%) 844 (16. 6%) 906 (18. 9%) 493 (18. 0%) 558 (17. 1%) 181 (16. 6%) Cardiovascular 329 (11. 3%) 257 (5. 0%) 210 (4. 4%) 138 (5. 0%) 182 (5. 6%) 83 (7. 6%) Technical 330 (11. 4%) 180 (3. 5%) 45 (0. 9%) 14 (0. 5%) 28 (0. 9%) 8 (0. 7%) Other 884 (30. 4%) 1, 314 (25. 8%) 778 (16. 2%) 425 (15. 5%) 573 (17. 6%) 246 (22. 5%) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 Percentages represent % of deaths in the respective time period

Adult Lung Retransplants Cause of Death (Deaths: January 1992 – June 2013) 0 -30 Days (N = 226) 31 Days - 1 Year (N = 306) >1 Year - 3 Years (N = 215) Bronchiolitis 4 (1. 8%) 26 (8. 5%) 78 (36. 3%) 30 (37. 5%) 22 (25. 0%) 6 (33. 3%) Acute Rejection 6 (2. 7%) 8 (2. 6%) 0 0 Lymphoma 0 4 (1. 3%) 4 (1. 9%) 2 (2. 5%) 3 (3. 4%) 0 Malignancy, Non-Lymphoma 0 3 (1. 0%) 11 (5. 1%) 5 (6. 3%) 6 (6. 8%) 2 (11. 1%) CMV 0 5 (1. 6%) 3 (1. 4%) 0 0 0 Infection, Non-CMV 39 (17. 3%) 102 (33. 3%) 39 (18. 1%) 16 (20. 0%) 13 (14. 8%) 0 Graft Failure 56 (24. 8%) 49 (16. 0%) 45 (20. 9%) 15 (18. 8%) 20 (22. 7%) 2 (11. 1%) Cardiovascular 24 (10. 6%) 16 (5. 2%) 10 (4. 7%) 2 (2. 5%) 3 (3. 4%) 1 (5. 6%) Technical 31 (13. 7%) 7 (2. 3%) 1 (0. 5%) 0 1 (1. 1%) 1 (5. 6%) Other 66 (29. 2%) 86 (28. 1%) 24 (11. 2%) 10 (12. 5%) 20 (22. 7%) 6 (33. 3%) Cause of Death 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 >3 Years - 5 >5 Years – 10 >10 Years (N Years = 18) (N = 80) (N = 88) Percentages represent % of deaths in the respective time period

Adult Lung Transplants Cause of Death Stratified by Transplant Type (Deaths: January 1992 – June 2013) Transplant Type Primary Cause of Death 0 -30 Days 31 Days - 1 Year >1 Year - 3 >3 Years - 5 Years Bronchiolitis 4 (0. 1%) 207 (4. 3%) 1, 152 (25. 1%) 774 (29. 0%) 997 (23. 5%) Malignancy 6 (0. 2%) 251 (5. 2%) 449 (9. 8%) 335 (12. 6%) 667 (15. 7%) 497 (18. 6%) 760 (17. 9%) >5 Years Infection 511 (19. 1%) Graft Failure 646 (24. 1%) 795 (16. 6%) 861 (18. 8%) 478 (17. 9%) 717 (16. 9%) Cardiovascular 305 (11. 4%) 241 (5. 0%) 200 (4. 4%) 136 (5. 1%) 261 (6. 1%) Technical 299 (11. 2%) 173 (3. 6%) 44 (1. 0%) 14 (0. 5%) 34 (0. 8%) 2, 679 4, 792 4, 582 2, 666 4, 249 4 (1. 8%) 26 (8. 5%) 78 (36. 3%) 30 (37. 5%) 28 (26. 4%) 0 7 (2. 3%) 15 (7. 0%) 7 (8. 8%) 11 (10. 4%) 39 (17. 3%) 107 (35. 0%) 42 (19. 5%) 16 (20. 0%) 13 (12. 3%) 56 (24. 8%) 49 (16. 0%) 45 (20. 9%) 15 (18. 8%) 22 (20. 8%) Cardiovascular 24 (10. 6%) 16 (5. 2%) 10 (4. 7%) 2 (2. 5%) 4 (3. 8%) Technical 31 (13. 7%) 7 (2. 3%) 1 (0. 5%) 0 2 (1. 9%) 226 306 215 80 106 All known causes Bronchiolitis Malignancy Infection Retransplant Graft Failure All known causes 1, 812 (37. 8%) 1, 047 (22. 9%) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 Acute rejection and other causes of death are not shown on the slide

Adult Lung Transplants Relative Incidence of Leading Causes of Death (Deaths: January 1992 – June 2013) 50 Bronchiolitis Infection (non-CMV) Cardiovascular Malignancy (non-Lymph/PTLD) Graft Failure % of Deaths 40 30 20 10 0 0 -30 Days (N=2, 905) 31 Days – 1 >1 Year – 3 >3 Years – 5 >5 Years – 10 Year (N=5, 098) Years (N=4, 797) Years (N=2, 746) Years (N=3, 263) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 >10 Years (N=1, 092)

Adult Lung Retransplants Relative Incidence of Leading Causes of Death (Deaths: January 1992 – June 2013) 50 Bronchiolitis Infection (non-CMV) Cardiovascular Malignancy (non-Lymph/PTLD) Graft Failure % of Deaths 40 30 20 10 0 0 -30 Days (N=226) 31 Days – 1 Year >1 Year – 3 Years >3 Years – 5 Years >5 Years (N=106) (N=306) (N=215) (N=80) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024

Multivariable Analyses 2014 JHLT. 2014 Oct; 33(10): 1009 -1024

Adult Lung Transplants (January 2000 – June 2012) Risk Factors For 1 Year Mortality N = 16, 785 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 * Retransplant includes those with a retransplant diagnosis or a previous transplant was reported. ** Other = All diagnoses other than COPD, IPAH, IPF, cystic fibrosis, sarcoidosis, pulmonary fibrosis, bronchiectasis, alpha-1 antitrypsin deficiency, retransplant , LAM and Connective Tissue Disease.

Adult Lung Transplants (January 2000 – June 2012) Risk Factors For 1 Year Mortality Continuous Factors (see figures) Recipient age Recipient oxygen required at rest Transplant center volume Cardiac output Height difference Recipient FVC % predicted Bilirubin Creatinine 2014 JHLT. 2014 Oct; 33(10): 1009 -1024

Adult Lung Transplants (January 2000 – June 2012) Risk Factors For 1 Year Mortality with 95% Confidence Limits Recipient Age Hazard Ratio of 1 Year Mortality 2. 0 1. 5 1. 0 0. 5 p < 0. 0001 0. 0 20 25 30 35 40 45 Recipient Age 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 50 55 60 65

Adult Lung Transplants (January 2000 – June 2012) Risk Factors For 1 Year Mortality with 95% Confidence Limits Center Volume Hazard Ratio of 1 Year Mortality 2. 0 1. 5 1. 0 0. 5 p < 0. 0001 0. 0 5 10 15 20 25 30 35 Center Volume (cases per year) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 40 45 50

Adult Lung Transplants (January 2000 – June 2012) Risk Factors For 1 Year Mortality with 95% Confidence Limits Height Difference Hazard Ratio of 1 Year Mortality 2. 0 1. 5 1. 0 0. 5 p = 0. 0037 0. 0 -15 -10 -5 0 5 10 Donor Height - Recipient Height (cm) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 15 20

Adult Lung Transplants (January 2000 – June 2012) Risk Factors For 1 Year Mortality with 95% Confidence Limits Recipient Pre-Transplant Bilirubin Hazard Ratio of 1 Year Mortality 2. 0 1. 5 1. 0 0. 5 p = 0. 0002 0. 0 0. 5 1. 0 Recipient Bilirubin (mg/dl) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 1. 5 2. 0

Adult Lung Transplants (January 2000 – June 2012) Risk Factors For 1 Year Mortality with 95% Confidence Limits Recipient Oxygen Required at Rest Hazard Ratio of 1 Year Mortality 2. 0 1. 5 1. 0 0. 5 p < 0. 0001 0. 0 0 1 2 3 4 Oxygen Required at Rest (L/min) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 5 6

Adult Lung Transplants (January 2000 – June 2012) Risk Factors For 1 Year Mortality with 95% Confidence Limits Recipient Pre-Transplant Cardiac Output Hazard Ratio of 1 Year Mortality 2. 0 1. 5 1. 0 0. 5 p = 0. 0011 0. 0 3 4 5 6 Cardiac output 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 7 8

Adult Lung Transplants (January 2000 – June 2012) Risk Factors For 1 Year Mortality with 95% Confidence Limits Recipient FVC (% predicted) Hazard Ratio of 1 Year Mortality 2. 0 1. 5 1. 0 0. 5 p < 0. 0001 0. 0 25 30 35 40 45 50 55 60 Recipient FVC (% predicted) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 65 70 75 80

Adult Lung Transplants (January 2000 – June 2012) Hazard Ratio of 1 Year Mortality Risk Factors For 1 Year Mortality with 95% Confidence Limits Recipient Creatinine at Transplant 2. 0 1. 5 1. 0 p = 0. 0022 0. 5 0. 0 0. 50 0. 75 1. 00 Creatinine 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 1. 25 1. 50

Adult Lung Transplants (January 2000 – June 2012) Diagnosis = COPD/Emphysema Risk Factors For 1 Year Mortality 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 N = 5, 314

Adult Lung Transplants (January 2000 – June 2012) Diagnosis = COPD/Emphysema Risk Factors For 1 Year Mortality Continuous Factors (see figures) Recipient age Cardiac output Transplant center volume Recipient FVC % predicted Donor height Recipient FEV 1 % predicted Recipient oxygen required at rest 2014 JHLT. 2014 Oct; 33(10): 1009 -1024

Adult Lung Transplants (January 2000 – June 2012) Hazard Ratio of 1 Year Mortality Diagnosis = COPD/Emphysema Risk Factors For 1 Year Mortality with 95% Confidence Limits Recipient Age 2. 0 1. 5 1. 0 0. 5 p < 0. 0001 0. 0 25 30 35 40 45 Recipient Age 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 50 55 60 65

Adult Lung Transplants (January 2000 – June 2012) Hazard Ratio of 1 Year Mortality Diagnosis = COPD/Emphysema Risk Factors For 1 Year Mortality with 95% Confidence Limits Center Volume 2. 0 1. 5 1. 0 0. 5 p = 0. 0016 0. 0 5 10 15 20 25 30 35 Center Volume (cases per year) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 40 45 50

Adult Lung Transplants (January 2000 – June 2012) Hazard Ratio of 1 Year Mortality Diagnosis = COPD/Emphysema Risk Factors For 1 Year Mortality with 95% Confidence Limits Donor Height 2. 0 1. 5 1. 0 0. 5 p = 0. 0321 0. 0 155 160 165 170 Donor Height (cm) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 175 180 185

Adult Lung Transplants (January 2000 – June 2012) Hazard Ratio of 1 Year Mortality Diagnosis = COPD/Emphysema Risk Factors For 1 Year Mortality with 95% Confidence Limits Recipient Oxygen Required at Rest 2. 0 1. 5 1. 0 0. 5 p = 0. 0192 0. 0 0 1 2 Oxygen Required at Rest (L/min) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 3 4

Adult Lung Transplants (January 2000 – June 2012) Diagnosis = COPD/Emphysema Risk Factors For 1 Year Mortality with 95% Confidence Limits Recipient Pre-Transplant Cardiac Output Hazard Ratio of 1 Year Mortality 2. 5 p = 0. 0063 2. 0 1. 5 1. 0 0. 5 0. 0 3 4 5 6 Cardiac output 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 7 8

Adult Lung Transplants (January 2000 – June 2012) Diagnosis = COPD/Emphysema Risk Factors For 1 Year Mortality with 95% Confidence Limits Recipient FVC (% predicted) Hazard Ratio of 1 Year Mortality 2. 0 1. 5 1. 0 0. 5 p = 0. 0310 0. 0 25 30 35 40 45 50 55 60 Recipient FVC (% predicted) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 65 70 75 80

Adult Lung Transplants (January 2000 – June 2012) Hazard Ratio of 1 Year Mortality Diagnosis = COPD/Emphysema Risk Factors For 1 Year Mortality with 95% Confidence Limits Recipient FEV 1 (% predicted) 2. 0 1. 5 1. 0 p = 0. 0262 0. 5 0. 0 25 30 35 40 Recipient FEV 1 (% predicted) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 45 50

Adult Lung Transplants (January 2000 – June 2012) Diagnosis = IPF Risk Factors For 1 Year Mortality 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 N = 5, 004

Adult Lung Transplants (January 2000 – June 2012) Diagnosis = IPF Risk Factors For 1 Year Mortality Continuous Factors (see figures) Recipient age Recipient oxygen required at rest Transplant center volume Bilirubin Donor height Creatinine 2014 JHLT. 2014 Oct; 33(10): 1009 -1024

Adult Lung Transplants (January 2000 – June 2012) Diagnosis = IPF Hazard Ratio of 1 Year Mortality Risk Factors For 1 Year Mortality with 95% Confidence Limits Recipient Age 2. 0 1. 5 1. 0 0. 5 p < 0. 0001 0. 0 35 40 45 50 Recipient Age 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 55 60 65

Adult Lung Transplants (January 2000 – June 2012) Hazard Ratio of 1 Year Mortality Diagnosis = IPF Risk Factors For 1 Year Mortality with 95% Confidence Limits Center Volume 2. 5 2. 0 1. 5 1. 0 0. 5 p < 0. 0001 0. 0 5 10 15 20 25 30 35 Center Volume (cases per year) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 40 45 50

Adult Lung Transplants (January 2000 – June 2012) Hazard Ratio of 1 Year Mortality Diagnosis = IPF Risk Factors For 1 Year Mortality with 95% Confidence Limits Donor Height 2. 0 1. 5 1. 0 0. 5 p < 0. 0001 0. 0 150 160 170 Donor Height (cm) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 180 190

Adult Lung Transplants (January 2000 – June 2012) Hazard Ratio of 1 Year Mortality Diagnosis = IPF Risk Factors For 1 Year Mortality with 95% Confidence Limits Recipient Oxygen Required at Rest 2. 0 1. 5 1. 0 0. 5 p = 0. 0020 0. 0 0 1 2 3 4 Oxygen Required at Rest (L/min) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 5 6

Adult Lung Transplants (January 2000 – June 2012) Hazard Ratio of 1 Year Mortality Diagnosis = IPF Risk Factors For 1 Year Mortality with 95% Confidence Limits Recipient Bilirubin 2. 0 1. 5 1. 0 p < 0. 0001 0. 5 0. 0 0. 5 1. 0 Bilirubin (mg/dl) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 1. 5

Adult Lung Transplants (January 2000 – June 2012) Hazard Ratio of 1 Year Mortality Diagnosis = IPF Risk Factors For 1 Year Mortality with 95% Confidence Limits Recipient Creatinine at Transplant 2. 0 1. 5 1. 0 p = 0. 0037 0. 5 0. 0 0. 50 0. 75 1. 00 Creatinine 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 1. 25 1. 50

Adult Lung Transplants (January 2000 – June 2008) Risk Factors For 5 Year Mortality 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 N = 9, 930 * Retransplant includes those with a retransplant diagnosis or a previous transplant was reported

Adult Lung Transplants (January 2000 – June 2008) Risk Factors For 5 Year Mortality Continuous Factors (see figures) Recipient age Recipient oxygen required at rest Transplant center volume Cardiac output Height difference 2014 JHLT. 2014 Oct; 33(10): 1009 -1024

Adult Lung Transplants (January 2000 – June 2008) Risk Factors For 5 Year Mortality with 95% Confidence Limits Recipient Age Hazard Ratio of 5 Year Mortality 2. 0 1. 5 1. 0 0. 5 p < 0. 0001 0. 0 20 25 30 35 40 45 Recipient Age 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 50 55 60 65

Adult Lung Transplants (January 2000 – June 2008) Risk Factors For 5 Year Mortality with 95% Confidence Limits Center Volume Hazard Ratio of 5 Year Mortality 2. 0 1. 5 1. 0 0. 5 p < 0. 0001 0. 0 5 10 15 20 25 30 35 Center Volume (cases per year) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 40 45 50

Adult Lung Transplants (January 2000 – June 2008) Risk Factors For 5 Year Mortality with 95% Confidence Limits Height Difference Hazard Ratio of 5 Year Mortality 2. 0 1. 5 1. 0 0. 5 p = 0. 0260 0. 0 -15 -10 -5 0 5 10 Donor Height - Recipient Height (cm) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 15 20

Adult Lung Transplants (January 2000 – June 2008) Risk Factors For 5 Year Mortality with 95% Confidence Limits Recipient Oxygen Required at Rest Hazard Ratio of 5 Year Mortality 2. 0 1. 5 1. 0 0. 5 p = 0. 0013 0. 0 0 1 2 3 4 Oxygen Required at Rest (L/min) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 5 6

Adult Lung Transplants (January 2000 – June 2008) Risk Factors For 5 Year Mortality with 95% Confidence Limits Recipient Pre-Transplant Cardiac Output Hazard Ratio of 5 Year Mortality 2. 0 1. 5 1. 0 0. 5 p < 0. 0001 0. 0 3 4 5 6 Cardiac output 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 7 8

Adult Lung Transplants (January 2000 – June 2008) Risk Factors For 5 Year Mortality Conditional on Survival to 1 Year 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 N = 7, 890

Adult Lung Transplants (January 2000 – June 2008) Risk Factors For 5 Year Mortality Conditional on Survival to 1 Year Continuous Factors (see figures) Recipient age Recipient oxygen required at rest Transplant center volume Cardiac output BMI difference PVR 2014 JHLT. 2014 Oct; 33(10): 1009 -1024

Adult Lung Transplants (January 2000 – June 2008) Hazard Ratio of 5 Year Mortality Risk Factors For 5 Year Mortality with 95% Confidence Limits Conditional on Survival to 1 Year Recipient Age 3. 0 2. 5 2. 0 1. 5 1. 0 0. 5 p < 0. 0001 0. 0 20 25 30 35 40 45 Recipient Age 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 50 55 60 65

Adult Lung Transplants (January 2000 – June 2008) Risk Factors For 5 Year Mortality with 95% Confidence Limits Conditional on Survival to 1 Year Center Volume Hazard Ratio of 5 Year Mortality 2. 0 1. 5 1. 0 0. 5 p = 0. 0003 0. 0 5 10 15 20 25 30 35 Center Volume (cases per year) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 40 45 50

Adult Lung Transplants (January 2000 – June 2008) Risk Factors For 5 Year Mortality with 95% Confidence Limits Conditional on Survival to 1 Year BMI Difference Hazard Ratio of 5 Year Mortality 2. 0 1. 5 1. 0 0. 5 p = 0. 0087 0. 0 -8 -6 -4 -2 0 2 4 Donor BMI - Recipient BMI (kg/m 2) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 6 8

Adult Lung Transplants (January 2000 – June 2008) Risk Factors For 5 Year Mortality with 95% Confidence Limits Conditional on Survival to 1 Year Recipient Oxygen Required at Rest Hazard Ratio of 5 Year Mortality 2. 0 1. 5 1. 0 0. 5 p = 0. 0082 0. 0 0 1 2 3 4 Oxygen Required at Rest (L/min) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 5 6

Adult Lung Transplants (January 2000 – June 2008) Hazard Ratio of 5 Year Mortality Risk Factors For 5 Year Mortality with 95% Confidence Limits Conditional on Survival to 1 Year Recipient Pre-Transplant Cardiac Output 2. 5 p = 0. 0142 2. 0 1. 5 1. 0 0. 5 0. 0 3 4 5 6 Cardiac output 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 7 8

Adult Lung Transplants (January 2000 – June 2008) Hazard Ratio of 5 Year Mortality Risk Factors For 5 Year Mortality with 95% Confidence Limits Conditional on Survival to 1 Year Recipient PVR 2. 0 p = 0. 0018 1. 5 1. 0 0. 5 0. 0 1 2 3 4 Recipient PVR 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 5 6

Adult Lung Transplants (January 1997 – June 2003) Risk Factors For 10 Year Mortality 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 N = 5, 776

Adult Lung Transplants (January 1997 – June 2003) Risk Factors For 10 Year Mortality Continuous Factors (see figures) Recipient age Recipient oxygen required at rest Transplant center volume Cardiac output Donor Age Creatinine BMI difference 2014 JHLT. 2014 Oct; 33(10): 1009 -1024

Adult Lung Transplants (January 1997 – June 2003) Risk Factors For 10 Year Mortality with 95% Confidence Limits Recipient Age Hazard Ratio of 10 Year Mortality 2. 0 1. 5 1. 0 0. 5 p < 0. 0001 0. 0 20 25 30 35 40 45 Recipient Age 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 50 55 60 65

Adult Lung Transplants (January 1997 – June 2003) Risk Factors For 10 Year Mortality with 95% Confidence Limits Center Volume Hazard Ratio of 10 Year Mortality 2. 0 1. 5 1. 0 0. 5 p < 0. 0001 0. 0 5 10 15 20 25 30 35 Center Volume (cases per year) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 40 45 50

Adult Lung Transplants (January 1997 – June 2003) Risk Factors For 10 Year Mortality with 95% Confidence Limits Donor Age Hazard Ratio of 10 Year Mortality 2. 0 1. 5 1. 0 0. 5 p = 0. 0009 0. 0 15 20 25 30 35 Donor Age 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 40 45 50 55

Adult Lung Transplants (January 1997 – June 2003) Risk Factors For 10 Year Mortality with 95% Confidence Limits BMI Difference Hazard Ratio of 10 Year Mortality 2. 0 1. 5 1. 0 0. 5 p < 0. 0001 0. 0 -8 -6 -4 -2 0 2 4 Donor BMI - Recipient BMI (kg/m 2) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 6 8

Adult Lung Transplants (January 1997 – June 2003) Risk Factors For 10 Year Mortality with 95% Confidence Limits Recipient Oxygen Required at Rest Hazard Ratio of 10 Year Mortality 2. 0 1. 5 1. 0 0. 5 p = 0. 0057 0. 0 0 1 2 3 4 Oxygen Required at Rest (L/min) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 5 6

Adult Lung Transplants (January 1997 – June 2003) Risk Factors For 10 Year Mortality with 95% Confidence Limits Recipient Pre-Transplant Cardiac Output Hazard Ratio of 10 Year Mortality 2. 5 p = 0. 0326 2. 0 1. 5 1. 0 0. 5 0. 0 3 4 5 6 Cardiac output 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 7 8

Adult Lung Transplants (January 1997 – June 2003) Hazard Ratio of 10 Year Mortality Risk Factors For 10 Year Mortality with 95% Confidence Limits Recipient Creatinine at Transplant 2. 0 1. 5 1. 0 p = 0. 0242 0. 5 0. 0 0. 50 0. 75 1. 00 Creatinine 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 1. 25 1. 50

Adult Lung Transplants (January 1995 – June 2008) Risk Factors For Retransplantation within 5 Years N = 13, 778 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 * Other = All diagnoses other than COPD, IPAH, IPF, cystic fibrosis, sarcoidosis, pulmonary fibrosis, bronchiectasis, alpha-1 antitrypsin deficiency, retransplant , LAM and Connective Tissue Disease.

Adult Lung Transplants (January 1995 – June 2008) Risk Factors For Retransplantation within 5 Years Continuous Factors (see figures) Recipient age Recipient height Donor age BMI ratio 2014 JHLT. 2014 Oct; 33(10): 1009 -1024

Adult Lung Transplants (January 1995 – June 2008) Risk Factors For Retransplantation within 5 Years with 95% Confidence Limits Recipient Age Hazard Ratio of Retransplantation within 5 Years 7. 0 6. 0 p < 0. 0001 5. 0 4. 0 3. 0 2. 0 1. 0 0. 0 25 30 35 40 45 Recipient Age 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 50 55 60 65

Adult Lung Transplants (January 1995 – June 2008) Risk Factors For Retransplantation within 5 Years with 95% Confidence Limits Donor Age Hazard Ratio of Retransplantation within 5 Years 2. 0 p = 0. 0048 1. 5 1. 0 0. 5 0. 0 15 20 25 30 35 Donor Age 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 40 45 50 55

Adult Lung Transplants (January 1995 – June 2008) Risk Factors For Retransplantation within 5 Years with 95% Confidence Limits Recipient Height Hazard Ratio of Retransplantation within 5 Years 3. 0 2. 5 p < 0. 0001 2. 0 1. 5 1. 0 0. 5 0. 0 155 160 165 170 175 Recipient Height (cm) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 180 185

Adult Lung Retransplants (January 1995 – June 2012) Retransplant recipients Risk Factors For 1 Year Mortality 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 N = 731

Adult Lung Retransplants (January 1995 – June 2012) Retransplant recipients Risk Factors For 1 Year Mortality Continuous Factors (see figures) Transplant center volume Creatinine Donor height 2014 JHLT. 2014 Oct; 33(10): 1009 -1024

Adult Lung Retransplants (January 1995 – June 2012) Hazard Ratio of 1 Year Mortality Retransplant recipients Risk Factors For 1 Year Mortality with 95% Confidence Limits Center Volume 2. 5 2. 0 1. 5 1. 0 0. 5 p = 0. 0170 0. 0 10 15 20 25 30 35 Center Volume (cases per year) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 40 45 50

Adult Lung Retransplants (January 1995 – June 2012) Hazard Ratio of 1 Year Mortality Retransplant recipients Risk Factors For 1 Year Mortality with 95% Confidence Limits Donor Height 3. 0 2. 5 2. 0 1. 5 1. 0 0. 5 p = 0. 0133 0. 0 155 160 165 170 Donor Height (cm) 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 175 180 185

Adult Lung Retransplants (January 1995 – June 2012) Hazard Ratio of 1 Year Mortality Retransplant recipients Risk Factors For 1 Year Mortality with 95% Confidence Limits Recipient Creatinine at Transplant 2. 0 1. 5 1. 0 p = 0. 0054 0. 5 0. 0 0. 50 0. 75 1. 00 Creatinine 2014 JHLT. 2014 Oct; 33(10): 1009 -1024 1. 25 1. 50