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HEART TRANSPLANTATION Pediatric Recipients ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982.

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Presentation on theme: "HEART TRANSPLANTATION Pediatric Recipients ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982."— Presentation transcript:

1 HEART TRANSPLANTATION Pediatric Recipients ISHLT 2005 J Heart Lung Transplant 2005;24:

2 AGE DISTRIBUTION OF PEDIATRIC HEART RECIPIENTS (Transplants: January June 2004) Number of Transplants ISHLT 2005 J Heart Lung Transplant 2005;24:

3 AGE DISTRIBUTION FOR DONORS OF PEDIATRIC HEART RECIPIENTS (Transplants: January June 2004) Number of Transplants ISHLT 2005 J Heart Lung Transplant 2005;24:

4 AGE DISTRIBUTION OF PEDIATRIC HEART RECIPIENTS By Year of Transplant Number of Transplants 355 ISHLT 2005 J Heart Lung Transplant 2005;24:

5 NUMBER OF CENTERS REPORTING PEDIATRIC HEART TRANSPLANTS Number of Pediatric Cases Reporting ISHLT 2005 J Heart Lung Transplant 2005;24:

6 DIAGNOSIS IN PEDIATRIC HEART TRANSPLANT RECIPIENTS (Age: < 1 Year) /1996-6/2004 % of Cases ISHLT 2005 J Heart Lung Transplant 2005;24:

7 DIAGNOSIS IN PEDIATRIC HEART TRANSPLANT RECIPIENTS (Age: 1-10 Years) /1996-6/2004 % of Cases ISHLT 2005 J Heart Lung Transplant 2005;24:

8 DIAGNOSIS IN PEDIATRIC HEART TRANSPLANT RECIPIENTS (Age: Years) /1996-6/2004 % of Cases ISHLT 2005 J Heart Lung Transplant 2005;24:

9 PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival (1/1982-6/2003) Survival (%) ISHLT 2005 J Heart Lung Transplant 2005;24:

10 PEDIATRIC HEART TRANSPLANTATION Conditional Kaplan-Meier Survival (1/1982-6/2003) Survival (%) ISHLT 2005 J Heart Lung Transplant 2005;24:

11 PEDIATRIC HEART TRANSPLANTATION Conditional 5-year Kaplan-Meier Survival (1/1982-6/2003) Survival (%) ISHLT 2005 J Heart Lung Transplant 2005;24:

12 PEDIATRIC HEART TRANSPLANTATION Conditional Kaplan-Meier Survival for Recent Era (1/1999-6/2003) Survival (%) ISHLT 2005 J Heart Lung Transplant 2005;24:

13 PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival by Era (1/1982-6/2003) Survival (%) ISHLT 2005 J Heart Lung Transplant 2005;24:

14 PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival by Era (1/1982-6/2003) Age: < 1 Year Survival (%) ISHLT 2005 J Heart Lung Transplant 2005;24:

15 PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival by Era (1/1982-6/2003) Age: 1-10 Years Survival (%) ISHLT 2005 J Heart Lung Transplant 2005;24:

16 PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival by Era (1/1982-6/2003) Age: Years Survival (%) ISHLT 2005 J Heart Lung Transplant 2005;24:

17 PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival Based on Rejection within 1 st Year (Transplants: April June 2002) p = Survival (%) ISHLT 2005 J Heart Lung Transplant 2005;24:

18 PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival Based on Rejection within 1 st Year (Transplants: January 1998 – June 2002) p = Survival (%) ISHLT 2005 J Heart Lung Transplant 2005;24:

19 PEDIATRIC HEART TRANSPLANTS (1/1995-6/2003) Risk Factors For 1 Year Mortality N=3,014 ISHLT 2005 J Heart Lung Transplant 2005;24:

20 PEDIATRIC HEART TRANSPLANTS (1/1995-6/2003) Borderline Significant Risk Factors For 1 Year Mortality N=3,014 ISHLT 2005 J Heart Lung Transplant 2005;24:

21 PEDIATRIC HEART TRANSPLANTS (1/1995-6/2003) Risk Factors for 1 Year Mortality ISHLT 2005 J Heart Lung Transplant 2005;24:

22 PEDIATRIC HEART TRANSPLANTS (1/1995-6/2003) Risk Factors for 1 Year Mortality Donor Age ISHLT 2005 J Heart Lung Transplant 2005;24:

23 PEDIATRIC HEART TRANSPLANTS (1/1995-6/2003) Risk Factors for 1 Year Mortality Pre-Transplant Bilirubin ISHLT 2005 J Heart Lung Transplant 2005;24:

24 PEDIATRIC HEART TRANSPLANTS (1/1995-6/2003) Risk Factors for 1 Year Mortality Pre-Transplant Creatinine ISHLT 2005 J Heart Lung Transplant 2005;24:

25 PEDIATRIC HEART TRANSPLANTS (1/1995-6/2003) Risk Factors for 1 Year Mortality Weight Ratio ISHLT 2005 J Heart Lung Transplant 2005;24:

26 PEDIATRIC HEART TRANSPLANTS (1/1995-6/2003) Factors Not Significant for 1 Year Mortality Recipient Factors: IV inotropes, sternotomy, thoracotomy, history of malignancy, height, recent infection, age, PA pressure, cardiac output, pulmonary vascular resistance, PRA ISHLT 2005 J Heart Lung Transplant 2005;24:

27 PEDIATRIC HEART TRANSPLANTS (1/1995-6/2003) Factors Not Significant for 1 Year Mortality Donor Factors: Gender, history of hypertension, height, clinical infection, cause of death, history of diabetes Transplant Factors: CMV mismatch, ABO identical/compatible, ischemia time, HLA mismatch, transplant center volume ISHLT 2005 J Heart Lung Transplant 2005;24:

28 PEDIATRIC HEART TRANSPLANTS (1/1995-6/2003) 1-Year Predicted Survival – Hypothetical Cases #1 and #2 ISHLT 2005 J Heart Lung Transplant 2005;24:

29 PEDIATRIC HEART TRANSPLANTS (1/1995-6/2003) 1-Year Predicted Survival – Hypothetical Case #3 ISHLT 2005 J Heart Lung Transplant 2005;24:

30 PEDIATRIC HEART TRANSPLANTS (1/1995-6/2003) 1-Year Predicted Survival – Hypothetical Cases #4 and #5 ISHLT 2005 J Heart Lung Transplant 2005;24:

31 PEDIATRIC HEART TRANSPLANTS (1/1995-6/1999) Risk Factors For 5 Year Mortality N=1,598 ISHLT 2005 J Heart Lung Transplant 2005;24:

32 PEDIATRIC HEART TRANSPLANTS (1/1995-6/1999) Risk Factors for 5 Year Mortality ISHLT 2005 J Heart Lung Transplant 2005;24:

33 PEDIATRIC HEART TRANSPLANTS (1/1995-6/1999) Risk Factors for 5 Year Mortality Pre-Transplant Recipient Weight ISHLT 2005 J Heart Lung Transplant 2005;24:

34 PEDIATRIC HEART TRANSPLANTS (1/1995-6/1999) Risk Factors for 5 Year Mortality Pre-Transplant Creatinine ISHLT 2005 J Heart Lung Transplant 2005;24:

35 PEDIATRIC HEART TRANSPLANTS (1/1995-6/1999) Factors Not Significant for 5 Year Mortality Recipient Factors: History of malignancy, recent infection, bilirubin, age, hospitalized at time of transplant, PRA, pulmonary vascular resistance, gender, PA pressures, cardiac output, sternotomy, height ISHLT 2005 J Heart Lung Transplant 2005;24:

36 PEDIATRIC HEART TRANSPLANTS (1/1995-6/1999) Factors Not Significant for 5 Year Mortality Donor Factors: Cause of death, history of hypertension, weight, height, age Transplant Factors: Donor/recipient weight ratio, year of transplant, CMV mismatch, ischemia time, HLA mismatch, transplant center volume ISHLT 2005 J Heart Lung Transplant 2005;24:

37 PEDIATRIC HEART TRANSPLANTS (1/1995-6/1999) 5-Year Predicted Survival – Hypothetical Cases #1,2 and 3 ISHLT 2005 J Heart Lung Transplant 2005;24:

38 PEDIATRIC HEART TRANSPLANTS (1/1995-6/1999) 5-Year Predicted Survival – Hypothetical Cases #4 and 5 ISHLT 2005 J Heart Lung Transplant 2005;24:

39 PEDIATRIC HEART TRANSPLANTS (1/1995-6/1999) Risk Factors For 5 Year Mortality Conditional on 1 Year Survival N=1,276 ISHLT 2005 J Heart Lung Transplant 2005;24:

40 PEDIATRIC HEART TRANSPLANTS (1/1995-6/1999) Risk Factors For 5 Year Mortality Conditional on 1 Year Survival ISHLT 2005 J Heart Lung Transplant 2005;24:

41 PEDIATRIC HEART TRANSPLANTS (1/1995-6/1999) Risk Factors For 5 Year Mortality Conditional on 1 Year Survival Recipient Weight ISHLT 2005 J Heart Lung Transplant 2005;24:

42 PEDIATRIC HEART TRANSPLANTS (1/1995-6/1999) Risk Factors For 5 Year Mortality Conditional on 1 Year Survival Ischemia Time ISHLT 2005 J Heart Lung Transplant 2005;24:

43 PEDIATRIC HEART TRANSPLANTS (1/1995-6/1999) Factors Not Significant for Conditional 5 Year Mortality Recipient Factors: History of malignancy, recent infection, hospitalized at time of transplant, bilirubin, creatinine, cardiac output, pulmonary vascular resistance, PRA, sternotomy, ventilator, VAD, age, PA pressures ISHLT 2005 J Heart Lung Transplant 2005;24:

44 PEDIATRIC HEART TRANSPLANTS (1/1995-6/1999) Factors Not Significant for Conditional 5 Year Mortality Donor Factors: Cause of death, history of hypertension, weight, height, age, gender, clinical infection at donation Transplant Factors: Donor/recipient weight ratio, year of transplant, CMV mismatch, transplant center volume, induction use, treated for infection prior to discharge, dialysis prior to discharge ISHLT 2005 J Heart Lung Transplant 2005;24:

45 PEDIATRIC HEART TRANSPLANTS (1/1995-6/1999) 5-Year Predicted Survival Conditional on Survival to 1 Year – Hypothetical Case #1 ISHLT 2005 J Heart Lung Transplant 2005;24:

46 PEDIATRIC HEART TRANSPLANTS (1/1995-6/1999) 5-Year Predicted Survival Conditional on Survival to 1 Year – Hypothetical Case #2 ISHLT 2005 J Heart Lung Transplant 2005;24:

47 PEDIATRIC HEART TRANSPLANTS (1/1995-6/1999) 5-Year Predicted Survival Conditional on Survival to 1 Year – Hypothetical Case #3 ISHLT 2005 J Heart Lung Transplant 2005;24:

48 PEDIATRIC HEART TRANSPLANTS (1/1995-6/1999) 5-Year Predicted Survival Conditional on Survival to 1 Year – Hypothetical Case #4 ISHLT 2005 J Heart Lung Transplant 2005;24:

49 PEDIATRIC HEART TRANSPLANTS (1/1995-6/1999) 5-Year Predicted Survival Conditional on Survival to 1 Year – Hypothetical Case #5 ISHLT 2005 J Heart Lung Transplant 2005;24:

50 PEDIATRIC HEART RECIPIENTS Functional Status of Surviving Recipients (Follow-ups: April June 2004) ISHLT 2005 J Heart Lung Transplant 2005;24:

51 PEDIATRIC HEART RECIPIENTS Rehospitalization Post-transplant of Surviving Recipients (Follow-ups: April June 2004) ISHLT 2005 J Heart Lung Transplant 2005;24:

52 PEDIATRIC HEART RECIPIENTS Induction Immunosuppression (Follow-ups: January June 2004) % of Patients ISHLT 2005 J Heart Lung Transplant 2005;24:

53 PEDIATRIC HEART RECIPIENTS Induction Immunosuppression (Follow-ups: January June 2004) ISHLT 2005 J Heart Lung Transplant 2005;24:

54 PEDIATRIC HEART RECIPIENTS Maintenance Immunosuppression at Time of Follow-up (Follow-ups: January June 2004) NOTE: Different patients are analyzed in Year 1 and Year 5 % of Patients ISHLT 2005 J Heart Lung Transplant 2005;24:

55 PEDIATRIC HEART RECIPIENTS Maintenance Immunosuppression Drug Combinations at Time of Follow-up (Follow-ups: January June 2004) NOTE: Different patients are analyzed in Year 1 and Year 5 % of Patients ISHLT 2005 J Heart Lung Transplant 2005;24:

56 PERCENTAGE OF PEDIATRIC HEART TRANSPLANT RECIPIENTS TREATED FOR REJECTION IN 1ST YEAR Stratified by Induction (Transplants: January June 2003) % treated for rejection within 1year No within age group or gender comparisons were significant. ISHLT 2005 J Heart Lung Transplant 2005;24:

57 NUMBER OF REJECTION EPISODES FOR PEDIATRIC HEART TRANSPLANT RECIPIENTS TREATED FOR REJECTION IN 1ST YEAR Stratified by Induction (Transplants: January June 2003) Average number of rejection episodes ISHLT 2005 J Heart Lung Transplant 2005;24:

58 PERCENTAGE OF PEDIATRIC HEART TRANSPLANT RECIPIENTS TREATED FOR REJECTION IN 1ST YEAR Stratified by Type of Induction (Transplants: January June 2003) % treated for rejection within 1year Overall: No induction vs. OKT3 (p = ); polyclonal vs. OKT3 (p = ); IL2 vs. OKT3 (p = ). 1-10: No induction vs. polyclonal (p = 0.04); 11-17: No induction vs. OKT3 (p = 0.003); polyclonal vs. OKT3 (p = 0.007); IL2R vs. OKT3 (p = 0.002) Female: No induction vs. OKT3 (p = 0.003); polyclonal vs. OKT3 (p = 0.01); IL2R vs. OTK3 (p = 0.03) Male: No induction vs. OKT3 (p=0.03); polyclonal vs. OKT3 (p < 0.05); IL2R vs. OKT3 (p = 0.01) ISHLT 2005 J Heart Lung Transplant 2005;24:

59 NUMBER OF REJECTION EPISODES FOR PEDIATRIC HEART TRANSPLANT RECIPIENTS TREATED FOR REJECTION IN 1ST YEAR Stratified by Type of Induction (Transplants: January June 2003) Average number of rejection episodes ISHLT 2005 J Heart Lung Transplant 2005;24:

60 PERCENTAGE OF PEDIATRIC HEART TRANSPLANT RECIPIENTS TREATED FOR REJECTION IN 1ST YEAR Stratified by Maintenance Immunosuppression and Induction (Transplants: January June 2003) % treated for rejection within 1year Overall: CyA + no induction vs. TAC + no induction: p = ; CyA + induction vs. TAC + induction: p = ; CyA + induction vs. TAC + no induction: p = ; CyA + no induction vs. TAC +induction: p = ; 1-10 years: CyA + no induction vs. TAC + no induction: p = ; CyA + induction vs. TAC + induction: p = ; CyA + induction vs. TAC + no induction: p = Female: CyA + no induction vs. TAC + no induction: p=0.008; CyA + induction vs. TAC + induction: p = ; CyA + induction vs. TAC + no induction: p = ; CyA + no induction vs. TAC + induction: p = No other age group or gender differences were significant. ISHLT 2005 J Heart Lung Transplant 2005;24:

61 NUMBER OF REJECTION EPISODES FOR PEDIATRIC HEART TRANSPLANT RECIPIENTS TREATED FOR REJECTION IN 1ST YEAR Stratified by Maintenance Immunosuppression and Induction (Transplants: January June 2003) Average number of rejection episodes ISHLT 2005 J Heart Lung Transplant 2005;24:

62 PERCENTAGE OF PEDIATRIC HEART TRANSPLANT RECIPIENTS TREATED FOR REJECTION IN 1ST YEAR Stratified by Maintenance Immunosuppression (Transplants: January June 2003) % treated for rejection within 1 year Overall: CyA+MMF vs. TAC+MMF (p = ); CyA +MMF vs. TAC + AZA (p = ); CyA + AZA vs. TAC + MMF (p = ); CyA + AZA vs. TAC + AZA (p = ). <1: CyA + MMF vs. TAC + MMF ( p = 0.03); CyA + AZA vs. TAC + MMF (p = 0.005). 1-10: Cya + MMF vs. TAC + AZA (p = 0.005); CyA + AZA vs. TAC + AZA (p = 0.004) : CyA + AZA vs. TAC + MMF (p = 0.01). Female: CyA + MMF vs. TAC + AZA (p = 0.002); CyA + AZA vs. TAC + MMF (p = 0.01); CyA + AZA vs. TAC + AZA (p=0.0006); TAC + MMF vs. TAC + AZA (p = 0.03). Male: CyA + MMF vs. TAC + MMF (p < 0.05) ISHLT 2005 J Heart Lung Transplant 2005;24:

63 NUMBER OF REJECTION EPISODES FOR PEDIATRIC HEART TRANSPLANT RECIPIENTS TREATED FOR REJECTION IN 1ST YEAR Stratified by Maintenance Immunosuppression (Transplants: January June 2003) Average number of rejection episodes <1 years: CyA + AZA vs. TAC + MMF (p=0.004). No other age group or gender comparisons were significant. ISHLT 2005 J Heart Lung Transplant 2005;24:

64 PERCENTAGE OF PEDIATRIC HEART TRANSPLANT RECIPIENTS TREATED FOR REJECTION IN 1ST YEAR Stratified by Tacrolimus vs. Cyclosporine Use at Discharge Conditional on Survival to 14 Days (Transplants: January June 2003) % treated for rejection within 1year <1: CyA vs. TAC (p = ) 1-10: CyA vs. TAC (p = ) Females: CyA vs. TAC (p = ) ISHLT 2005 J Heart Lung Transplant 2005;24:

65 NUMBER OF REJECTION EPISODES FOR PEDIATRIC HEART TRANSPLANT RECIPIENTS TREATED FOR REJECTION IN 1ST YEAR Stratified by Tacrolimus vs. Cyclosporine Use at Discharge Conditional on Survival to 14 Days (Transplants: January June 2003) Average number of rejection episodes ISHLT 2005 J Heart Lung Transplant 2005;24:

66 POST-HEART TRANSPLANT MORBIDITY FOR PEDIATRICS Cumulative Prevalence in Survivors within 1 Year Post-Transplant (Follow-ups: April June 2004) ISHLT 2005 J Heart Lung Transplant 2005;24:

67 POST-HEART TRANSPLANT MORBIDITY FOR PEDIATRICS Cumulative Prevalence in Survivors within 5 Years Post-Transplant (Follow-ups: April June 2004) ISHLT 2005 J Heart Lung Transplant 2005;24:

68 POST-HEART TRANSPLANT MORBIDITY FOR PEDIATRICS Cumulative Prevalence in Survivors within 7 Years Post-Transplant (Follow-ups: April June 2004) ISHLT 2005 J Heart Lung Transplant 2005;24:

69 FREEDOM FROM CORONARY ARTERY VASCULOPATHY For Pediatric Heart Recipients (Follow-ups: April June 2004) % Freedom from CAV ISHLT 2005 J Heart Lung Transplant 2005;24:

70 FREEDOM FROM CORONARY ARTERY VASCULOPATHY For Pediatric Heart Recipients (Follow-ups: April June 2004) Stratified by Induction % Freedom from CAV p = 0.43 ISHLT 2005 J Heart Lung Transplant 2005;24:

71 FREEDOM FROM CORONARY ARTERY VASCULOPATHY For Pediatric Heart Recipients (Follow-ups: April June 2004) Stratified by Age Group % Freedom from CAV ISHLT 2005 J Heart Lung Transplant 2005;24:

72 GRAFT SURVIVAL FOLLOWING REPORT OF CORONARY ARTERY VASCULOPATHY For Pediatric Heart Recipients (Follow-ups: April June 2004) Stratified by Age Group Survival since Report of CAV (%) ISHLT 2005 J Heart Lung Transplant 2005;24:

73 FREEDOM FROM SEVERE RENAL DYSFUNCTION* For Pediatric Heart Recipients (Follow-ups: April June 2004) * Severe renal dysfunction = Creatinine > 2.5 mg/dl, dialysis or renal transplant % Freedom from Severe Renal Dysfunction ISHLT 2005 J Heart Lung Transplant 2005;24:

74 MALIGNANCY POST-HEART TRANSPLANTATION FOR PEDIATRICS Cumulative Prevalence in Survivors (Follow-ups: April June 2004) Malignancy/Type1-Year Survivors 5-Year Survivors 7-Year Survivors No Malignancy 2230 (98.0%)716 (95.9%) 365 (93.8%) Malignancy (all types combined) 45 (2.0%)31 (4.1%)24 (6.2%) Malignancy Type Lymph Other33 Type Not Reported1 Other types: Ewings, Large cell lymphoma ISHLT 2005 J Heart Lung Transplant 2005;24:

75 FREEDOM FROM MALIGNANCY For Pediatric Heart Recipients (Follow-ups: April June 2004) % Freedom from Malignancy ISHLT 2005 J Heart Lung Transplant 2005;24:

76 PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival Based on Prednisone Use (Transplants: April June 2003) p = Survival (%) ISHLT 2005 J Heart Lung Transplant 2005;24:

77 PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival Based on Prednisone Use (Transplants: January 1998 – June 2003) p = Survival (%) ISHLT 2005 J Heart Lung Transplant 2005;24:

78 PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival by Induction Group (Transplants: January 2000 – June 2003) Conditional on Survival to 14 Days Survival (%) No comparisons were statistically significant. ISHLT 2005 J Heart Lung Transplant 2005;24:

79 PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival by Induction Group (Transplants: January 2000 – June 2003) Conditional on Survival to 14 Days Age: < 1 Year Survival (%) ISHLT 2005 J Heart Lung Transplant 2005;24:

80 PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival by Induction Group (Transplants: January 2000 – June 2003) Conditional on Survival to 14 Days Age: 1-10 Years Survival (%) ISHLT 2005 J Heart Lung Transplant 2005;24:

81 PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival by Induction Group (Transplants: January 2000 – June 2003) Conditional on Survival to 14 Days Age: Years Survival (%) ISHLT 2005 J Heart Lung Transplant 2005;24:

82 PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier Survival Stratified by Tacrolimus vs. Cyclosporine Use at Discharge (Transplants: January June 2003) Conditional on Survival to 14 Days Survival (%) ISHLT 2005 J Heart Lung Transplant 2005;24:

83 PEDIATRIC HEART RECIPIENTS Incidence of Hypertension between 1 and 3 Years (Transplants: April June 2001) Maintenance Immunosuppression at discharge and 1 year % HTN reported between 1 and 3 years P-value For Patients on drug For Patients not on drug Azathioprine21.6%22.1%0.9 Cyclosporine20.5%21.4%0.8 MMF19.9%21.0%0.8 Prednisone28.9%6.6%< Rapamycin.20.6% Tacrolimus24.8%19.5%0.2 ISHLT 2005 J Heart Lung Transplant 2005;24:

84 PEDIATRIC HEART RECIPIENTS Relationship of Rejection and Coronary Artery Vasculopathy (Follow-ups: April 1994 – June 2004) Rejection During 1 st Year Reported CAV between 1 st and 3 rd years post-transplant Reported CAV between 3 rd and 5 th years post-transplant YesNoAllYesNoAll Yes36 8.1% % % % % % No13 3.0% % % 9 4.6% % % p = p = NOTE: Only those recipients without CAV prior to 3 years were included in the last set of columns ISHLT 2005 J Heart Lung Transplant 2005;24:

85 PEDIATRIC HEART RECIPIENTS Growth Following Transplantation: Height Stratified by Prednisone Use at Discharge and at 1 Year ISHLT 2005 J Heart Lung Transplant 2005;24:

86 PEDIATRIC HEART RECIPIENTS Growth Following Transplantation: Weight Stratified by Prednisone Use at Discharge and at 1 Year ISHLT 2005 J Heart Lung Transplant 2005;24:

87 PEDIATRIC HEART TRANSPLANT RECIPIENTS: Cause of Death (Deaths: January June 2004) CAUSE OF DEATH 0-30 Days (N = 335) 31 Days - 1 Year (N = 281) >1 Year - 3 Years (N = 198) >3 Years - 5 Years (N = 139) >5 Years (N = 252) CORONARY ARTERY VASCULOPATHY 3 (0.9%)26 (9.3%)36 (18.2%)52 (37.4%)72 (28.6%) ACUTE REJECTION 27 (8.1%)76 (27.0%)54 (27.3%)18 (12.9%)32 (12.7%) LYMPHOMA 6 (2.1%)10 (5.1%)3 (2.2%)21 (8.3%) MALIGNANCY, OTHER 4 (1.4%)2 (1.0%)1 (0.7%)9 (3.6%) CMV 1 (0.3%)7 (2.5%)1 (0.5%) INFECTION, NON-CMV 47 (14.0%)46 (16.4%)17 (8.6%)6 (4.3%)16 (6.3%) PRIMARY FAILURE 58 (17.3%)11 (3.9%)6 (3.0%)8 (5.8%)12 (4.8%) GRAFT FAILURE 79 (23.6%)31 (11.0%)35 (17.7%)27 (19.4%)49 (19.4%) TECHNICAL 21 (6.3%)2 (0.7%)2 (1.0%)1 (0.7%)1 (0.4%) OTHER 15 (4.5%)16 (5.7%)16 (8.1%)14 (10.1%)24 (9.5%) MULTIPLE ORGAN FAILURE 36 (10.7%)29 (10.3%)3 (1.5%)2 (1.4%)6 (2.4%) RENAL FAILURE 1 (0.3%)4 (1.4%)1 (0.5%) PULMONARY 24 (7.2%)16 (5.7%)9 (4.5%)6 (4.3%)7 (2.8%) CEREBROVASCULAR 23 (6.9%)7 (2.5%)6 (3.0%)1 (0.7%)3 (1.2%) ISHLT 2005 J Heart Lung Transplant 2005;24:


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