LUNG TRANSPLANTATION Pediatric Recipients ISHLT 2002 J Heart





























- Slides: 29

LUNG TRANSPLANTATION Pediatric Recipients ISHLT 2002 J Heart Lung Transplant 2002; 21: 827 -840.

AGE DISTRIBUTION OF PEDIATRIC LUNG RECIPIENTS ISHLT 2002 J Heart Lung Transplant 2002; 21: 827 -840.

AGE DISTRIBUTION FOR DONORS OF PEDIATRIC LUNG RECIPIENTS (1986 -2001) ISHLT 2002 J Heart Lung Transplant 2002; 21: 827 -840.

Number of Transplants AGE DISTRIBUTION OF PEDIATRIC LUNG RECIPIENTS By Year of Transplant 85 86 82 72 47 50 66 67 57 45 42 20 1 3 ISHLT 4 6 * Numbers may be low due to delayed reporting. 2002 J Heart Lung Transplant 2002; 21: 827 -840.

NUMBER OF CENTERS REPORTING PEDIATRIC LUNG TRANSPLANTS ISHLT * Numbers may be low due to delayed reporting. 2002 J Heart Lung Transplant 2002; 21: 827 -840.

PEDIATRIC LUNG TRANSPLANTATION: Indications (1991 -2001) DIAGNOSIS AGE: < 1 Year Cystic Fibrosis PPH Congenital Heart Disease AGE: 1 -10 Years 55 34. 2% 7 16. 7% 24 14. 9% 14 33. 3% 17 10. 6% 12 7. 5% IPF Pulmonary Vascular Disease 6 14. 3% 6 3. 7% Re-TX: Non-OB 3 7. 1% 8 5. 0% Re-TX: OB 9 5. 6% OB (Non-Re. TX) 6 3. 7% Bronchiectasis 2 1. 2% COPD/Emphysema 2 1. 2% 17 10. 6% Other 11 ISHLT 2002 J Heart Lung Transplant 2002; 21: 827 -840. 26. 2%

PEDIATRIC LUNG TRANSPLANTATION Indications by Age (1991 -2001) Age <1 Year ISHLT Age 1 -10 Years 2002 J Heart Lung Transplant 2002; 21: 827 -840.

DIAGNOSIS IN PEDIATRIC LUNG RECIPIENTS Age: 11 -17 Years ISHLT 2002 J Heart Lung Transplant 2002; 21: 827 -840.

PEDIATRIC LUNG TRANSPLANTATION Actuarial Survival by Procedure Type (1990 -2001) P = 0. 006 ISHLT 2002 J Heart Lung Transplant 2002; 21: 827 -840.

PEDIATRIC LUNG TRANSPLANTATION Actuarial Survival by Age Group (1990 -2001) <1 Year: ½-life = 3. 5 Years 1 -10 Years: ½-life = 3. 5 Years 11 -17 Years: ½-life = 3. 2 Years ISHLT 2002 J Heart Lung Transplant 2002; 21: 827 -840.

PEDIATRIC LUNG TRANSPLANTATION Conditional Actuarial Survival by Age Group (1990 -2001) <1 Year: ½-life = 7. 1 Years 1 -10 Years: ½-life = 5. 9 Years 11 -17 Years: ½-life = 5. 4 Years ISHLT 2002 J Heart Lung Transplant 2002; 21: 827 -840.

Survival (%) PEDIATRIC LUNG TRANSPLANTATION Actuarial Survival by Era (1988 -2001) ISHLT 2002 J Heart Lung Transplant 2002; 21: 827 -840.

PEDIATRIC LUNG TRANSPLANTATION Actuarial Survival by Procedure Type Diagnosis: PPH (1990 -2001) P = 0. 002 ISHLT 2002 J Heart Lung Transplant 2002; 21: 827 -840.

PEDIATRIC LUNG RECIPIENTS Functional Status (April 1994 -December 2001) ISHLT 2002 J Heart Lung Transplant 2002; 21: 827 -840.

PEDIATRIC LUNG RECIPIENTS Rehospitalization Post-transplant ISHLT 2002 J Heart Lung Transplant 2002; 21: 827 -840. (April 1994 - December 2001)

PEDIATRIC LUNG RECIPIENTS Induction Immunosuppression For follow-ups between October 1999 and December 2001 ISHLT 2002 J Heart Lung Transplant 2002; 21: 827 -840.

PEDIATRIC LUNG RECIPIENTS Maintenance Immunosuppression at Any Time During Follow-up Period For follow-ups between October 1999 and December 2001 ISHLT 2002 J Heart Lung Transplant 2002; 21: 827 -840.

PEDIATRIC LUNG RECIPIENTS Maintenance Immunosuppression at Time of Follow-up For follow-ups between October 1999 and December 2001 ISHLT 2002 J Heart Lung Transplant 2002; 21: 827 -840.

PEDIATRIC LUNG RECIPIENTS Maintenance Immunosuppression at Time of Follow-up For follow-ups between October 1999 and December 2001 1 Year Follow-up (N = 76) ISHLT 5 Year Follow-up (N = 39) 2002 J Heart Lung Transplant 2002; 21: 827 -840.

PEDIATRIC LUNG RECIPIENTS Maintenance Immunosuppression at Time of Follow-up Report For follow-ups between October 1999 and December 2001 ISHLT 2002 J Heart Lung Transplant 2002; 21: 827 -840.

POST-LUNG TRANSPLANT MORBIDITY For Pediatric Recipients (April 1994 -December 2000) ISHLT 2002 J Heart Lung Transplant 2002; 21: 827 -840.

Freedom from Bronchiolitis Obliterans For Pediatric Lung Recipients (April 1994 -December 2000) ISHLT 2002 J Heart Lung Transplant 2002; 21: 827 -840.

Freedom from Renal Dysfunction* For Pediatric Lung Recipients (April 1994 -December 2000) * Renal dysfunction = Creatinine > 2. 5 mg/dl, dialysis or renal transplant ISHLT 2002 J Heart Lung Transplant 2002; 21: 827 -840.

MALIGNANCY POST-LUNG TRANSPLANTATION FOR PEDIATRICS Cumulative Incidence for Survivors (April 1994 -December 2001) Malignancy/Type 1 -Year Survivors No Malignancy 288 (93. 5%) 45 (91. 8%) Malignancy (all types combined) 20 (6. 5%) 4 (8. 2%) Malignancy Type ISHLT Lymph 18 Other 2 2002 J Heart Lung Transplant 2002; 21: 827 -840. 5 -Year Survivors 4

Freedom from Malignancy For Pediatric Lung Recipients (April 1994 -December 2000) ISHLT 2002 J Heart Lung Transplant 2002; 21: 827 -840.

PEDIATRIC LUNG TRANSPLANTATION Actuarial Survival Based on Rejection within 1 st Year (1994 -2000) Survival (%) P= 0. 01 ISHLT 2002 J Heart Lung Transplant 2002; 21: 827 -840.

PEDIATRIC LUNG RECIPIENTS Relationship of Diabetes and Cystic Fibrosis Transplants: April 1994 – December 2000 Diagnosis Report of Diabetes Developing Between Transplant and 1 st Year* Transplant and 3 rd Year** No Yes Cystic Fibrosis 103 70. 1% 44 29. 9% 29 55. 8% 23 44. 2% Other Diagnosis 137 97. 3% 4 2. 8% 53 94. 6% 3 5. 4% *p < 0. 0001 ISHLT 2002 J Heart Lung Transplant 2002; 21: 827 -840. **p < 0. 0001

PEDIATRIC LUNG RECIPIENTS: Time Of Death (1988 -2001) ISHLT 2002 J Heart Lung Transplant 2002; 21: 827 -840.

PEDIATRIC LUNG TRANSPLANT RECIPIENTS: Cause of Death (1982 -2001) ISHLT Timing of Death 2002 J Heart Lung Transplant 2002; 21: 827 -840.
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