HEART TRANSPLANTATION Overall ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095.

HEART TRANSPLANTATION Overall ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

NUMBER OF HEART TRANSPLANTS BY YEAR NOTE: This figure includes only the heart transplants that are reported to the ISHLT Transplant Registry. As such, the presented data may not mirror the changes in the number of heart transplants performed worldwide. ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

NUMBER OF HEART TRANSPLANTS BY YEAR AND LOCATION NOTE: This figure includes only the heart transplants that are reported to the ISHLT Transplant Registry. As such, the presented data may not mirror the changes in the number of heart transplants performed worldwide. ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

AVERAGE CENTER VOLUME Heart Transplants: January 2006 – June 2011 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

HEART TRANSPLANTS Donor Age by Year of Transplant ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

HEART TRANSPLANTS Median Donor Age by Location ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

AGE DISTRIBUTION OF HEART TRANSPLANT RECIPIENTS BY ERA ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

HEART TRANSPLANTS Kaplan-Meier Survival (Transplants: January 1982 - June 2010) ISHLT 2012 Survival is based on adult and pediatric transplant recipients N = 96,273 N at risk at 25 years = 112 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

HEART TRANSPLANTATION Adult Recipients ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

DIAGNOSIS IN ADULT HEART TRANSPLANTS ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Diagnosis: Cardiomyopathy vs. CAD by Location ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Diagnosis by Location (Transplants: January 2006 – June 2011) ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Donor and Recipient Characteristics ISHLT 2012 1992-2000 (N = 36,507) 2001-2005 (N = 16,352) 2006-6/2011 (N = 17,868) p-value Recipient age (years) 54.0 (28.0-65.0)54.0 (26.0-66.0)54.0 (24.0-67.0)0.0064 Donor age (years) 31.0 (15.0-54.0)33.0 (16.0-55.0)34.0 (17.0-56.0)<0.0001 Donor and Recipient Age Difference (years) -19.0 (-44.0-7.0)-17.0 (-43.0-10.0)-16.0 (-43.0-12.0)<0.0001 Recipient weight (kg) 75.0 (51.0-101.6)77.6 (53.0-106.6)79.4 (53.1-110.2)<0.0001 Recipient height (cm) 173.0 (157.0-188.0)174.0 (157.5-188.0)175.0 (157.5-188.0)<0.0001 Recipient BMI 25.0 (18.9-32.7)25.6 (19.2-33.8)26.0 (19.2-34.9)<0.0001 Donor weight (kg) 74.8 (52.0-103.0) 1 76.7 (55.0-108.6)79.4 (56.7-113.0)<0.0001 Donor height (cm) 175.0 (155.0-188.0) 1 175.0 (157.0-189.0)175.0 (158.0-190.0)<0.0001 Donor BMI 24.2 (18.8-32.9) 1 24.8 (19.5-34.3)25.5 (19.9-36.2)<0.0001 Continuous factors are expressed as median (5 th -95 th percentiles) 1 Based on 4/1994-2000 transplants. J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Donor and Recipient Characteristics ISHLT 2012 1992-2000 (N = 36,507) 2001-2005 (N = 16,352) 2006-6/2011 (N = 17,868) p-value Recipient/donor gender (% male) 80.7%/ 68.4%77.7%/ 69.0%76.3%/ 69.4%<0.0001/ 0.0545 Male recipient/ female donor 21.2%18.4%16.6%<0.0001 Female recipient/ male donor 9.1%9.7% 0.0327 Recipient/donor diabetes mellitus 17.8% 1 / 1.6% 1 20.2%/ 2.0%25.4%/ 2.8%<0.0001/ <0.0001 Recipient amiodarone use (US only) 21.7% 1 29.0%30.2%<0.0001 Recipient/donor cigarette history -/ 38.0% 1 46.6% 2 / 29.1%46.5%/ 19.2%0.9848/ <0.0001 Recipient/donor hypertension 34.2% 1 / 10.8% 1 38.1%/ 11.4%44.1%/ 13.4%<0.0001/ <0.0001 Recipient prior cardiac surgery -38.9% 2 45.4%<0.0001 Recipient Peripheral Vascular Disease 3.8% 1 3.2%2.9%0.0002 Recipient previous malignancy 3.2% 1 4.5%6.4%<0.0001 Recipient COPD 3.2% 1 3.2%4.2%0.0001 Ischemic time (hours) 2.6 (0.0-4.5)2.9 (0.0-4.9)3.1 (0.0-5.0)<0.0001 Continuous factors are expressed as median (5 th -95 th percentiles) 1 Based on 4/1994-2000 transplants. 2 Based on 7/2004-2005 transplants. (Cont’d) J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Donor and Recipient Characteristics ISHLT 2012 1992-2000 (N = 36,507) 2001-2005 (N = 16,352) 2006-6/2011 (N = 17,868) p-value Most recent PRA > 10% 1 Overall 7.7%8.8% 2 12.7% 3 <0.0001 Class I - -14.2% 4 - Class II - -9.1% 4 - Creatinine at time of transplant 1.2 (0.7-2.5)1.2 (0.7-2.4)1.2 (0.7-2.3)<0.0001 Pulmonary vascular resistance (Wood units) 2.2 (0.4-6.1) 5 2.0 (0.3-5.6)2.1 (0.3-5.4)<0.0001 HLA Mismatches 0-2 4.3%4.4%3.8% 0.0051 3-4 40.2%40.0%38.9% 5-6 55.5% 57.4% Continuous factors are expressed as median (5 th -95 th percentiles) 2 Based on US 2001-6/2004 transplants and non US 2001 - 2005 transplants. 3 Based on non US transplants. 4 Based on US transplants. 5 Based on 4/1994-2000 transplants. 1 PRA was collected as a single percentage outside of US. Until mid-2004 PRA was collected in US as a single percentage. After this date, PRA was collected separately for Class I and Class II. (Cont’d) J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Donor and Recipient Characteristics ISHLT 2012 1992-2000 (N = 36,507) 2001-2005 (N = 16,352) 2006-6/2011 (N = 17,868) p-value Diagnosis Cardiomyopathy 46.4%48.5%53.8% <0.0001 Coronary artery disease 45.8%42.6%37.1% Valvular 3.8%3.3%2.6% Retransplant 1.9%2.2%2.6% Congenital 1.8%2.7%3.0% Other causes 0.4%0.6%0.9% Donor cause of death Head trauma 44.6%54.5%46.6% <0.0001 Stroke 28.2%33.0%24.8% Other 27.2%12.5%28.6% (Cont’d) J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Donor and Recipient Characteristics ISHLT 2012 1992-2000 (N = 36,507) 2001-2005 (N = 16,352) 2006-6/2011 (N = 17,868) p-value Pre-operative support (multiple items may be reported) Hospitalized at time of transplant 60.2%47.8%44.6%<0.0001 On IV inotropes 55.8% 1 47.3%42.6%<0.0001 LVAD 12.1 2 17.0%27.3%<0.0001 IABP 6.8%6.9%6.2%0.0731 RVAD -5.0% 3 3.8%0.0125 Ventilator 3.5%3.3%2.9%0.0141 TAH 0.1% 2 0.1%0.9%<0.0001 ECMO 0.3% 4 0.5%1.0%<0.0001 1 Based on 4/1994-2000 transplants. 2 Based on 11/1999-2000 transplants. 3 Based on 2005 transplants. 4 Based on 5/1995-2000 transplants. (Cont’d) J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Donor and Recipient Age (Transplants: January 2006 – June 2011) ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS PRA Distribution (Transplants: January 2006 – June 2011) ISHLT 2012 If Class I and Class II values were reported separately, the higher of the two values was used. J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS % of Patients Bridged with Mechanical Circulatory Support* (Transplants: January 2000 – December 2010) ISHLT 2012 * LVAD, RVAD, TAH J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS % of Patients Bridged with Mechanical Circulatory Support* by Year and Device Type ISHLT 2012 * LVAD, RVAD, TAH J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Number of Combined Organ Transplants Reported By Year and Type of Transplant ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS % of Combined Organ Transplants Reported By Year ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Donor Age Distribution By Location (Transplants: January 2006 – June 2011) ISHLT 2012 Mean/median donor age: Europe = 40.2/42.0 North America = 31.6/29.0 Other = 32.2/30.0 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Recipient Age Distribution By Location (Transplants: January 2006 – June 2011) ISHLT 2012 Mean/median recipient age: Europe = 49.6/52.0 North America = 52.0/55.0 Other = 48.5/51.0 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Recipient BMI Distribution By Location (Transplants: January 2006 – June 2011) ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Recipient BMI Distribution By Diagnosis (Transplants: January 2006 – June 2011) ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Recipient Diabetes Mellitus Distribution By Location (Transplants: January 2006 – June 2011) ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Recipient Diabetes Mellitus Distribution By Diagnosis (Transplants: January 2006 – June 2011) ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Recipient Cigarette History By Location (Transplants: January 2006 – June 2011) ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Recipient Cigarette History By Diagnosis (Transplants: January 2006 – June 2011) ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Kaplan-Meier Survival by Era (Transplants: January 1982 - June 2010) 1982-1992 vs. 1993-2002: p < 0.0001 1982-1992 vs. 2003-6/2010: p <0.0001 1993-2002 vs. 2003-6/2010: p <0.0001 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Conditional Kaplan-Meier Survival by Era (Transplants: January 1982 - June 2010) 1982-1992 vs. 1993-2002: p < 0.0001 1982-1992 vs. 2003-6/2010: p <0.0001 1993-2002 vs. 2003-6/2010: p = 0.3073 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Kaplan-Meier Survival by Age Group (Transplants: January 1982 - June 2010) All pair-wise comparisons are statistically significant at p < 0.01 except 18-29 vs. 30-39 (p=0.8452) ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Kaplan-Meier Survival by Age Group (Transplants: January 2003 - June 2010) All pair-wise comparisons are statistically significant at p < 0.05 except 18-29 vs. 60-69; 18-29 vs. 70+, 30-39 vs. 40-49 and 60-69 vs. 70+ ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Kaplan-Meier Survival by Diagnosis (Transplants: January 1982 - June 2010) All pair-wise comparisons are statistically significant at < 0.001 except cardiomyopathy vs. congenital (p=0.6340). ISHLT 2012 HALF-LIFE Cardiomyopathy: 11.4 years; CAD: 9.4 years; Congenital: 13.7 years; Retransplant: 6.0 years; Valvular: 10.9 years J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Kaplan-Meier Survival by Diagnosis Conditional on Survival to 1 Year (Transplants: January 1982 - June 2010) All pair-wise comparisons are significant at p < 0.05 except cardiomyopathy vs. valvular ISHLT 2012 HALF-LIFE Cardiomyopathy: 14.0 years; CAD: 11.7 years; Congenital: 20.4 years; Retransplant: 10.7 years; Valvular: 14.3 years J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Kaplan-Meier Survival by Era (Transplants: January 1982 - June 2010) Diagnosis: Cardiomyopathy All comparisons are significant at p < 0.0001 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Kaplan-Meier Survival by Era (Transplants: January 1982 - June 2010) Diagnosis: Coronary Artery Disease ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Kaplan-Meier Survival by Era (Transplants: January 1982 - June 2010) Diagnosis: Congenital No comparisons are significant at < 0.05 except 1993-2002 vs. 2003-6/2010: p = 0.0489 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Kaplan-Meier Survival by Era (Transplants: January 1982 - June 2010) Diagnosis: Retransplant ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Kaplan-Meier Survival by Era (Transplants: January 1982 - June 2010) Diagnosis: Valvular All comparisons are significant at < 0.05 except 1993-2002 vs. 2003-6/2010 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Kaplan-Meier 1 Year Survival by Diagnosis (Transplants: January 2003 – June 2010) All pair-wise comparisons are significant at p < 0.05 except CAD vs. retransplant, valvular vs. congenital, valvular vs. retransplant and congenital vs. retransplant ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Kaplan-Meier Survival by Diagnosis (Transplants: January 2003 – June 2010) All pair-wise comparisons are significant at p < 0.05 except CAD vs. congenital, valvular vs. congenital, valvular vs. retransplant and congenital vs. retransplant ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Kaplan-Meier Survival by Diagnosis Conditional on Survival to 1 Year (Transplants: January 2003 – June 2010) No pair-wise comparisons are significant at < 0.05 except cardiomyopathy vs. CAD, cardiomyopathy vs. retransplant, CAD vs. congenital and congenital vs. retransplant ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Kaplan-Meier Survival by PVR (Transplants: January 2003 – June 2010) 1-<3 vs. 3-<5: p < 0.0001 1-<3 vs. 5+: p = 0.3483 3-<5 vs. 5+: p = 0.1762 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Kaplan-Meier Survival by Donor/Recipient Weight Ratio (Transplants: January 2003 – June 2010) For recipients with PVR: 1–<3 wood units No pair-wise comparisons are statistically significant at p < 0.05 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Kaplan-Meier Survival by Donor/Recipient Weight Ratio (Transplants: January 2003 – June 2010) For recipients with PVR: 3–<5 wood units No pair-wise comparisons are statistically significant at p < 0.05 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Kaplan-Meier Survival by Donor/Recipient Weight Ratio (Transplants: January 2003 – June 2010) For recipients with PVR: 5+ wood units No pair-wise comparisons are statistically significant at p < 0.05 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Kaplan-Meier Survival by BMI Group (Transplants: January 2003 – June 2010) p = 0.0007 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Kaplan-Meier Survival by Recipient Diabetes Mellitus (Transplants: January 2003 – June 2010) p = 0.0007 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Kaplan-Meier Survival by Recipient Cigarette History (Transplants: July 2004 – June 2010) p = 0.1663 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Kaplan-Meier Survival by VAD usage (Transplants: April 1994 – June 2010) Pulsatile vs. Continuous: p=0.0207 Pulsatile vs. No LVAD/No Inotropes: p = 0.0005 Pulsatile vs. No LVAD/Inotropes: p = 0.0187 No other pair-wise comparisons are statistically significant at p < 0.05 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Kaplan-Meier Survival by VAD usage (Transplants: January 2003 – June 2010) Pulsatile vs. No LVAD/No Inotropes: p = 0.0012 Pulsatile vs. No LVAD/Inotropes: p = 0.0008 Continuous vs. No LVAD/No Inotropes: p = 0.0027 Continuous vs. No LVAD/Inotropes: p = 0.0006 No other pair-wise comparisons are statistically significant at p < 0.05 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Kaplan-Meier Survival by VAD usage Conditional on Survival to 6 Months (Transplants: January 1999 – June 2010) Continuous vs. No LVAD/No Inotropes: p = 0.0038 No other pair-wise comparisons are statistically significant at p < 0.05 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Kaplan-Meier Survival by VAD usage (Transplants: January 2005 – June 2010) All pair-wise comparisons with LVAD+RVAD Pulsatile are statistically significant at p < 0.001. LVAD Continuous vs. No LVAD/ Inotropes: p= 0.0239 No other pair-wise comparisons are statistically significant at p < 0.05. ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART RE-TRANSPLANTS 1 Year Survival ISHLT 2012 Time between previous and current transplant Comparison of survival for interval ≤ 12 months vs. > 12 months: p < 0.0001 Comparison of survival for interval ≤ 12 months vs. > 12 months for 1/2003-6/2010: p < 0.0001 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART RECIPIENTS Cross-Sectional Analysis Functional Status of Surviving Recipients (Follow-ups: January 2000 – June 2011) ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART RECIPIENTS Functional Status of Surviving Recipients US Recipients Only (Follow-ups: January 2006 – June 2011) ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART RECIPIENTS Employment Status of Surviving Recipients (Follow-ups: January 2000 – June 2011) ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART RECIPIENTS Employment Status of Surviving Recipients Age at Follow-up: 25-55 Years (Follow-ups: January 2000 – June 2011) ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART RECIPIENTS Rehospitalization Post-transplant of Surviving Recipients (Follow-ups: January 2000 – June 2011) ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART RECIPIENTS Induction Immunosuppression (Transplants: January 2005 – June 2011) Analysis is limited to patients who were alive at the time of the discharge ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART RECIPIENTS Induction Immunosuppression by Location (Transplants: January 2005 – June 2011) Analysis is limited to patients who were alive at the time of the discharge ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART RECIPIENTS Induction Immunosuppression (Transplants: 2002, 2007 and 1/2011–6/2011) Analysis is limited to patients who were alive at the time of the follow-up ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART RECIPIENTS Kaplan-Meier Survival by Induction Type Conditional on Survival to 14 Days (Transplants: January 2001 – June 2010) No induction vs. IL-2R: p = 0.0002 Polyclonal vs. IL-2R: p = 0.0131 IL-2R vs. OKT3: p = 0.0368 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART RECIPIENTS Maintenance Immunosuppression at Time of Follow-up (Follow-ups: January 2008 – June 2011) Analysis is limited to patients who were alive at the time of the follow-up ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART RECIPIENTS Maintenance Immunosuppression at Time of 1 Year Follow-up Analysis is limited to patients who were alive at the time of the follow-up NOTE: Different patients are analyzed in each time frame ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART RECIPIENTS Maintenance Immunosuppression Drug Combinations at Time of Follow-up For the Same Patients (Follow-ups: January 2001 – June 2011) Analysis is limited to patients who were alive at the time of the follow-up ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART RECIPIENTS Maintenance Immunosuppression Drug Combinations at Time of Follow-up (Follow-ups: January 2006 – June 2011) Analysis is limited to patients who were alive at the time of the follow-up NOTE: Different patients are analyzed in Year 1 and Year 5 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART RECIPIENTS Maintenance Immunosuppression Drug Combinations at Time of Follow-up by Location (Follow-ups: January 2006 – June 2011) Analysis is limited to patients who were alive at the time of the follow-up NOTE: Different patients are analyzed in Year 1 and Year 5 ISHLT 2012 Year 1Year 5 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

PERCENTAGE OF ADULT HEART RECIPIENTS Rejection between Transplant Discharge and 1-Year Follow-Up by Year Analysis is limited to patients who were alive at the time of the follow-up 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. 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. ISHLT 2012 Transplant Year Rejection, TreatedRejection, Untreated No RejectionTotal N%N%N%N% 200439925.51066.81,05867.71,563100.0 200538623.1965.71,19271.21,674100.0 200637521.61579.11,20269.31,734100.0 200731117.919911.41,23070.71,740100.0 200825815.619611.81,20272.61,656100.0 200927616.024214.01,20870.01,726100.0 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

PERCENTAGE OF ADULT HEART RECIPIENTS Experiencing Rejection between Transplant Discharge and 1-Year Follow-Up Stratified by Type of Induction (Follow-ups: January 2005 – June 30, 2011) Analysis is limited to patients who were alive at the time of the follow-up 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. 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. ISHLT 2012 No induction: N=5,192 Polyclonal: N=2,161 IL-2R antagonist: N=3,094 OKT3: N=168 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

PERCENTAGE OF ADULT HEART RECIPIENTS Experiencing Rejection between Transplant Discharge and 1-Year Follow-Up Stratified by Maintenance Immunosuppression (Follow-ups: 2005 – June 30, 2011) Analysis is limited to patients who were alive at the time of the follow-up 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. 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. ISHLT 2012 Cyclosporine + MMF/MPA: N = 2,966 Tacrolimus + MMF/MPA: N = 6,493 NOTE: There were 138 patients with cyclosporine + AZA and 62 with tacrolimus+AZA. These groups were excluded due to small numbers. J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Kaplan-Meier Survival Stratified by Treatment for Rejection Within 1 st Year Conditional on survival to 1 year (1 Year follow-ups: 2005 – 6/2010) ISHLT 2012 p < 0.0001 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. 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. J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

FREEDOM FROM HOSPITALIZATION FOR REJECTION BY ERA For Adult Heart Recipients (Transplants: April 1994 – June 2010) ISHLT 2012 All pair-wise comparisons are statistically significant at p < 0.0001 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

POST-HEART TRANSPLANT MORBIDITY FOR ADULTS Cumulative Morbidity Rates in Survivors within 1, 5 and 10 Years Post- Transplant (Follow-ups: January 1995 – June 2011) Outcome Within 1 Year Total N with known response Within 5 Years Total N with known response Within 10 Years Total N with known response Hypertension*72.8%(N = 25,542)92.6%(N = 11,853) – Renal Dysfunction26.7%(N = 27,478)53.0%(N = 13,481)68.2%(N = 4,339) Abnormal Creatinine < 2.5 mg/dl18.3% 33.2% 37.5% Creatinine > 2.5 mg/dl6.6% 15.8% 21.1% Chronic Dialysis1.5% 2.9% 6.1% Renal Transplant0.3% 1.2% 3.6% Hyperlipidemia*60.2%(N = 26,810)88.0%(N = 13,191) – Diabetes*26.5%(N = 27,474)38.0%(N = 13,306) – Cardiac Allograft Vasculopathy7.9%(N = 24,790)30.4%(N = 9,819)49.7%(N = 2,482) ISHLT 2012 * Data are not available 10 years post transplant J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

POST-HEART TRANSPLANT MORBIDITY FOR ADULTS Cumulative Morbidity Rates in Survivors within 1, 5 and 10 Years Post- Transplant (Follow-ups: January 1995 – June 2001) For the Same Patients Outcome Within 1 Year Total N with known response Within 5 Years Total N with known response Within 10 Years Total N with known response Renal Dysfunction21.3%(N = 1,902)48.6%(N = 1,902)65.4%(N = 1,902) Abnormal Creatinine < 2.5 mg/dl14.7% 33.1% 39.2% Creatinine > 2.5 mg/dl6.3% 13.7% 18.7% Chronic Dialysis0.1% 0.9% 4.0% Renal Transplant0.3% 0.9% 3.5% Cardiac Allograft Vasculopathy6.8%(N = 1,902)29.6%(N = 1,902)48.9%(N = 1,902) ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

POST-HEART TRANSPLANT MORBIDITY FOR ADULTS Cumulative Morbidity Rates in Survivors within 1 and 5 Years Post-Transplant (Follow-ups: January 2001 - June 2006) For the Same Patients OutcomeWithin 1 Year Total N with known response Within 5 Years Total N with known response Hypertension73.0%(N = 3,000)88.3%(N = 3,000) Renal Dysfunction26.4%(N = 3,000)50.6%(N = 3,000) Abnormal Creatinine < 2.5 mg/dl22.2% 38.1% Creatinine > 2.5 mg/dl3.5% 9.7% Chronic Dialysis0.5% 1.8% Renal Transplant0.2% 0.9% Hyperlipidemia72.4%(N = 3,000)89.9%(N = 3,000) Diabetes29.3%(N = 3,000)40.6%(N = 3,000) Cardiac Allograft Vasculopathy5.4%(N = 3,000)26.7%(N = 3,000) ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS Kaplan-Meier Survival Stratified by Renal Dysfunction Within 1 st Year Conditional on survival to 1 year (1 Year follow-ups: April 1994-June 2010) ISHLT 2012 p < 0.0001 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

FREEDOM FROM CARDIAC ALLOGRAFT VASCULOPATHY For Adult Heart Recipients (Transplants: April 1994 – June 2010) ISHLT 2012 p < 0.0001 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

FREEDOM FROM CARDIAC ALLOGRAFT VASCULOPATHY Stratified by Ischemia Time For Adult Heart Recipients (Transplants: April 1994 – June 2010) ISHLT 2012 p = 0.5705 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

FREEDOM FROM CARDIAC ALLOGRAFT VASCULOPATHY Stratified by Recipient Age Group For Adult Heart Recipients (Transplants: April 1994 – June 2010) ISHLT 2012 p = 0.5938 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

FREEDOM FROM SEVERE RENAL DYSFUNCTION BY ERA* For Adult Heart Recipients (Transplants: April 1994 – June 2010) ISHLT 2012 p < 0.0001 * Severe renal dysfunction = Creatinine > 2.5 mg/dl (221 μmol/L), dialysis or renal transplant J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

FREEDOM FROM SEVERE RENAL DYSFUNCTION* Stratified by Ischemia Time For Adult Heart Recipients (Transplants: April 1994 – June 2010) ISHLT 2012 p = 0.5729 * Severe renal dysfunction = Creatinine > 2.5 mg/dl (221 μmol/L), dialysis or renal transplant J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

FREEDOM FROM SEVERE RENAL DYSFUNCTION* Stratified by Age Group For Adult Heart Recipients (Transplants: April 1994 – June 2010) ISHLT 2012 p < 0.0001 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

Patient Survival After Report of CAV Within 3 Years of Transplant and Patient Survival In Patients Without CAV* (Transplants: April 1994 – June 2010) ISHLT 2012 p < 0.0001 * Survival for patients without CAV within 3 years after transplant was conditioned on survival to median time of CAV development (501 days). Median time to CAV development is based on patients who developed CAV within 3 years of transplant. J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

Patient Survival After Report of CAV Within 3 Years of Transplant and Patient Survival In Patients Without CAV* by Era (Transplants: April 1994 – June 2010) ISHLT 2012 4/1994-2002: No CAV vs. CAV p < 0.0001 2003-6/2010: No CAV vs. CAV p < 0.0001 No CAV: 4/1994-2002 vs. 2003-6/2010 p = 0.5210 CAV: 4/1994-2002 vs. 2003-6/2010 p = 0.0154 * Survival for patients without CAV within 3 years after transplant was conditioned on survival to median time of CAV development (501 days). Median time to CAV development is based on patients who developed CAV within 3 years of transplant. J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

MALIGNANCY POST-HEART TRANSPLANT FOR ADULTS Cumulative Morbidity Rates in Survivors (Follow-ups: April 1994 – June 2011) Malignancy/Type 1-Year Survivors 5-Year Survivors 10-Year Survivors No Malignancy 29,101 (97.3%)12,750 (85.8%)3,565 (71.2%) Malignancy (all types combined) 795 (2.7%)2,102 (14.2%)1,439 (28.8%) Malignancy Type* Skin 3901,4021,020 Lymphoma 16516297 Other 185608455 Type Not Reported 554216 * Recipients may have experienced more than one type of malignancy so sum of individual malignancy types may be greater than total number with malignancy. “Other” includes: prostate (11, 35, 21), adenocarcinoma (7, 7, 4), lung (6, 4, 1), bladder (4, 5, 4), Kaposi's sarcoma (0, 3, 1), breast (2, 7, 2), cervical (2, 5, 2), colon (2, 4, 2), and renal (2, 7, 2). Numbers in parentheses are those reported within 1 year, 5 years and 10 years, respectively. ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

FREEDOM FROM MALIGNANCY For Adult Heart Recipients (Follow-ups: April 1994 – June 2011) ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

FREEDOM FROM MALIGNANCY by Maintenance Immunosuppression Combinations at Discharge For Adult Heart Recipients (Transplants: January 2001 - June 2010) Conditional on Survival to 14 days ISHLT 2012 p = 0.0015 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

FREEDOM FROM MALIGNANCY For Adult Heart Recipients (Transplants: April 1994 – June 2010) ISHLT 2012 p < 0.0001 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

FREEDOM FROM SKIN MALIGNANCY For Adult Heart Recipients (Transplants: April 1994 – June 2010) ISHLT 2012 p < 0.0001 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

FREEDOM FROM LYMPHOMA For Adult Heart Recipients (Transplants: April 1994 – June 2010) ISHLT 2012 p < 0.0001 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

FREEDOM FROM LYMPHOMA By Recipient Age Group For Adult Heart Recipients (Follow-ups: April 1994 – June 2011) ISHLT 2012 p = 0.0074 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

FREEDOM OTHER MALIGNANCY For Adult Heart Recipients (Transplants: April 1994 – June 2010) ISHLT 2012 p < 0.0001 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

FREEDOM FROM NON SKIN MALIGNANCY By Recipient Age Group For Adult Heart Recipients (Follow-ups: April 1994 – June 2011) ISHLT 2012 p < 0.0001 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANT RECIPIENTS: Cause of Death (Deaths: January 1994 – June 2011) CAUSE OF DEATH 0-30 Days (N = 4,092) 31 Days – 1 Year (N = 3,801) >1 Year – 3 Years (N = 2,846) >3 Years – 5 Years (N = 2,547) >5 Years – 10 Years (N = 6,617) >10 Years – 15 Years (N =4,221) >15 Years (N =1,937) Cardiac Allograft Vasculopathy 71 (1.7%)161 (4.2%)373 (13.1%)369 (14.5%)951 (14.4%)619 (14.7%)248 (12.8%) Acute Rejection222 (5.4%)394 (10.4%)296 (10.4%)127 (5.0%)127 (1.9%)42 (1.0%)13 (0.7%) Lymphoma3 (0.1%)59 (1.6%)81 (2.8%)105 (4.1%)283 (4.3%)163 (3.9%)66 (3.4%) Malignancy, Other1 (0.0%)91 (2.4%)326 (11.5%)472 (18.5%)1,344 (20.3%)847 (20.1%)345 (17.8%) CMV3 (0.1%)42 (1.1%)14 (0.5%)6 (0.2%)6 (0.1%)2 (0.0%)0 Infection, Non-CMV548 (13.4%)1,155 (30.4%)354 (12.4%)241 (9.5%)703 (10.6%)432 (10.2%)226 (11.7%) Graft Failure1,522 (37.2%)631 (16.6%)688 (24.2%)543 (21.3%)1,150 (17.4%)670 (15.9%)305 (15.7%) Technical307 (7.5%)53 (1.4%)21 (0.7%)24 (0.9%)78 (1.2%)59 (1.4%)27 (1.4%) Other199 (4.9%)305 (8.0%)253 (8.9%)201 (7.9%)547 (8.3%)311 (7.4%)167 (8.6%) Multiple Organ Failure716 (17.5%)533 (14.0%)164 (5.8%)155 (6.1%)455 (6.9%)345 (8.2%)175 (9.0%) Renal Failure31 (0.8%)39 (1.0%)45 (1.6%)85 (3.3%)392 (5.9%)359 (8.5%)175 (9.0%) Pulmonary142 (3.5%)158 (4.2%)123 (4.3%)126 (4.9%)282 (4.3%)173 (4.1%)88 (4.5%) Cerebrovascular327 (8.0%)180 (4.7%)108 (3.8%)93 (3.7%)299 (4.5%)199 (4.7%)102 (5.3%) ISHLT 2012 Percentages represent % of deaths in the respective time period J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART RECIPIENTS Cause of Death from Leading Causes by Time since Transplant and Era (Deaths: January 1994 - June 2011) ISHLT 2012 Deaths 1994 – 2001Deaths 2002 – 6/2011 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANT RECIPIENTS Relative Incidence of Leading Causes of Death (Deaths: January 1994 - June 2011) ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANT RECIPIENTS Cumulative Incidence of Leading Causes of Death (Transplants: January 1994 - June 2010) ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANT RECIPIENTS Relative Incidence of Leading Causes of Death (Deaths: January 2004 - June 2011) ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANT RECIPIENTS Cumulative Incidence of Leading Causes of Death (Transplants: January 2003 - June 2010) ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2005-6/2010) Risk Factors For 1 Year Mortality VARIABLE NRelative Risk P-value95% Confidence Interval Temporary circulatory support*1753.05<.00012.26-4.10 Diagnosis: Congenital vs. cardiomyopathy2742.11<.00011.56-2.86 Total artificial heart771.900.01371.14-3.16 Temporary continuous flow device491.840.02611.08-3.15 Recipient history of dialysis2311.72<.00011.33-2.23 Recipient on ventilator at time of transplant 3001.630.00021.26-2.09 Chronic continuous flow device12411.53<.00011.25-1.88 Previous transplant2971.530.0041.14-2.04 Chronic pulsatile flow device12371.380.00121.14-1.68 N = 10,288 ISHLT 2012 * Temporary circulatory support includes ECMO and temporary pulsatile flow devices. J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2005-6/2010) Risk Factors For 1 Year Mortality (continued) VARIABLE NRelative Risk P-value95% Confidence Interval Prior transfusion22021.35<.00011.17-1.57 Recipient with infection requiring IV drug therapy within 2 weeks prior to transplant 10441.250.00931.06-1.49 Ventricular remodeling15560.760.00330.64-0.91 Transplant year: 2006 vs. 2009/201019271.360.00071.14-1.63 Transplant year: 2007 vs. 2009/201018691.230.02851.02-1.47 Transplant year: 2005 vs. 2009/201018841.220.03721.01-1.46 N = 10,288 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2005-6/2010) Borderline Significant Risk Factors For 1 Year Mortality VARIABLE NRelative Risk P-value95% Confidence Interval Transplant year: 2008 vs. 2009/201017781.180.06960.99-1.42 Diagnosis: coronary artery disease vs. cardiomyopathy 41961.140.05611.00-1.30 Not hospitalized just prior to transplant55930.890.07170.78-1.01 N = 10,288 Reference group = Cardiomyopathy, year=2009/2010 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2005-6/2010) Risk Factors For 1 Year Mortality Continuous Factors (see figures) Recipient ageIschemia time Recipient heightRecipient pre-transplant bilirubin Recipient weightRecipient pre-transplant creatinine Donor agePRA Class II Donor BMIRecipient mean pulmonary artery pressure Transplant center volume ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2005-6/2010) Risk Factors For 1 Year Mortality with 95% Confidence Limits Recipient Age p < 0.0001 ISHLT 2012 (N = 10,288) J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2005-6/2010) Risk Factors For 1 Year Mortality with 95% Confidence Limits Donor Age p < 0.0001 ISHLT 2012 (N = 10,288) J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2005-6/2010) Risk Factors For 1 Year Mortality with 95% Confidence Limits Recipient Height p < 0.0001 ISHLT 2012 (N = 10,288) * The risk associated with recipient height should be considered in conjunction with the risk associated with recipient weight and donor BMI. J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2005-6/2010) Risk Factors For 1 Year Mortality with 95% Confidence Limits Recipient Weight p = 0.0051 ISHLT 2012 (N = 10,288) * The risk associated with recipient weight should be considered in conjunction with the risk associated with recipient height and donor BMI. J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2005-6/2010) Risk Factors For 1 Year Mortality with 95% Confidence Limits Donor BMI p = 0.0182 ISHLT 2012 (N = 10,288) * The risk associated with donor BMI should be considered in conjunction with the risk associated with recipient weight and recipient height. J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2005-6/2010) Risk Factors For 1 Year Mortality with 95% Confidence Limits Ischemia Time p < 0.0001 ISHLT 2012 (N = 10,288) J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2005-6/2010) Risk Factors For 1 Year Mortality with 95% Confidence Limits Center Volume p = 0.0256 ISHLT 2012 (N = 10,288) J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2005-6/2010) Risk Factors For 1 Year Mortality with 95% Confidence Limits Recipient Pre-Transplant Bilirubin p = 0.0026 ISHLT 2012 (N = 10,288) J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2005-6/2010) Risk Factors For 1 Year Mortality with 95% Confidence Limits Recipient Pre-Transplant Creatinine p < 0.0001 ISHLT 2012 (N = 10,288) J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2005-6/2010) Risk Factors For 1 Year Mortality with 95% Confidence Limits PRA Class II (%) p = 0.0028 ISHLT 2012 (N = 10,288) J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2005-6/2010) Risk Factors For 1 Year Mortality with 95% Confidence Limits Mean Pulmonary Artery Pressure p = 0.0073 ISHLT 2012 (N = 10,288) J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Risk Factors For 5 Year Mortality VARIABLE NRelative Risk P-value95% Confidence Interval Temporary circulatory support*1752.49<.00011.96-3.16 Total artificial heart451.700.04201.02-2.82 Recipient history of dialysis3281.67<.00011.40-2.00 Diagnosis: Congenital vs. cardiomyopathy 2921.470.00081.17-1.84 Recipient on ventilator at time of transplant 3141.410.00081.15-1.72 Number of HLA mismatches at A locus (per locus) 0 A MM (N=665) 1 A MM (N=5089) 2 A MM (N=4753) 1.290.00031.13-1.49 N = 10,507 ISHLT 2012 * Temporary circulatory support includes ECMO and temporary pulsatile flow devices. J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Risk Factors For 5 Year Mortality (continued) VARIABLE NRelative Risk P-value95% Confidence Interval Female recipient with prior pregnancy/ male donor vs. male recipient/male donor 7801.220.02861.02-1.45 PRA > 10%7661.210.00661.06-1.40 Recipient with infection requiring IV drug therapy within 2 weeks prior to transplant 11611.180.00821.04-1.33 Recipient history of diabetes21771.140.00621.04-1.26 Diagnosis: coronary artery disease vs. cardiomyopathy 47921.140.00631.04-1.25 Not hospitalized just prior to transplant55160.920.04750.84 N = 10,507 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Borderline Significant Risk Factors For 5 Year Mortality VARIABLE NRelative Risk P-value95% Confidence Interval Recipient Hep B core (+)3971.200.060.99-1.44 Male recipient/female donor vs. male recipient/male donor 17631.110.07620.99-1.24 Not ABO identical14871.100.09680.98-1.22 N = 10,507 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Risk Factors For 5 Year Mortality Continuous Factors (see figures) Recipient ageTransplant center volume Recipient heightIschemia time Recipient BMIRecipient pre-transplant bilirubin Donor ageRecipient pre-transplant creatinine Donor weightRecipient PVR ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Risk Factors For 5 Year Mortality with 95% Confidence Limits Recipient Height p = 0.0018 ISHLT 2012 (N = 10,507) * The risk associated with recipient height should be considered in conjunction with the risk associated with recipient BMI and donor weight. J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Risk Factors For 5 Year Mortality with 95% Confidence Limits Recipient BMI p < 0.0001 ISHLT 2012 (N = 10,507) * The risk associated with recipient BMI should be considered in conjunction with the risk associated with recipient height and donor weight. J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Risk Factors For 5 Year Mortality with 95% Confidence Limits Donor Weight p = 0.0083 ISHLT 2012 (N = 10,507) * The risk associated with donor weight should be considered in conjunction with the risk associated with recipient weight and recipient BMI. J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Risk Factors For 5 Year Mortality with 95% Confidence Limits Center Volume p < 0.0001 ISHLT 2012 (N = 10,507) J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Risk Factors For 5 Year Mortality with 95% Confidence Limits Recipient Pre-Transplant Bilirubin p < 0.0001 ISHLT 2012 (N = 10,507) J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Risk Factors For 5 Year Mortality with 95% Confidence Limits Pulmonary Vascular Resistance p = 0.0003 ISHLT 2012 (N = 10,507) J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Risk Factors For 5 Year Mortality Conditional on Survival to 1 Year VARIABLE NRelative Risk P-value95% Confidence Interval Rejection between discharge and 1 st year24271.63<.00011.45-1.83 No AZA, MMF/MPA or Sirolimus at 1 year7261.59<.00011.31-1.95 No Cyclo, TAC or Sirolimus at 1 year3161.480.00521.13-1.96 Dialysis prior to discharge5311.430.00111.15-1.76 Recipient history of dialysis prior to transplant 2161.390.03341.03-1.87 Female recipient with prior pregnancy/ male donor vs. male recipient/male donor 6571.310.01171.06-1.61 Number of HLA mismatches at A locus (per mismatch) 0 A MM: N = 585 1 A MM: N = 4444 2 A MM: N = 3953 1.280.00971.06-1.55 N = 8,982 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Risk Factors For 5 Year Mortality Conditional on Survival to 1 Year (continued) VARIABLE NRelative Risk P-value95% Confidence Interval Treated for infection prior to discharge18791.230.0031.07-1.40 Recipient history of diabetes18391.210.00791.05-1.38 Diagnosis: Coronary artery disease vs. cardiomyopathy 40681.170.01871.03-1.34 IL-2R antagonist used for induction23341.150.02721.02-1.30 Not hospitalized at transplant48070.880.02590.78-0.98 Chronic pulsatile flow device15260.810.00840.69-0.95 N = 8,982 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Borderline Significant Risk Factors For 5 Year Mortality Conditional on Survival to 1 Year VARIABLE NRelative Risk P-value95% Confidence Interval Recipient Hep B core (+)3331.280.06660.98-1.66 Recipient history of malignancy4041.250.07410.98-1.60 Transplant year: 2004 vs. 2005/200615321.180.06020.99-1.40 Male recipient/female donor vs. male recipient/male donor 14701.140.09640.98-1.34 Diagnosis: Congenital vs. cardiomyopathy2230.720.09760.50-1.06 N = 8,982 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Risk Factors For 5 Year Mortality Conditional on Survival to 1 Year Continuous Factors (see figures) Recipient ageRecipient pre-transplant creatinine Recipient BMIRecipient TPG Donor age ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Risk Factors For 5 Year Mortality with 95% Confidence Limits Conditional on Survival to 1 Year Recipient Age p < 0.0001 ISHLT 2012 (N = 8,982) J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Risk Factors For 5 Year Mortality with 95% Confidence Limits Conditional on Survival to 1 Year Donor Age p = 0.0005 ISHLT 2012 (N = 8,982) J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Risk Factors For 5 Year Mortality with 95% Confidence Limits Conditional on Survival to 1 Year Recipient BMI p = 0.0026 ISHLT 2012 (N = 8,982) J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Risk Factors For 5 Year Mortality with 95% Confidence Limits Conditional on Survival to 1 Year Recipient Pre-Transplant Creatinine P = 0.0187 ISHLT 2012 (N = 8,982) J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Risk Factors For 5 Year Mortality with 95% Confidence Limits Conditional on Survival to 1 Year Transpulmonary Pressure Gradient p = 0.0033 ISHLT 2012 (N = 8,982) J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (1996-6/2001) Risk Factors For 10 Year Mortality VARIABLE NRelative Risk P-value95% Confidence Interval ECMO291.820.01071.15-2.87 Ventilator at time of transplant3461.65<.00011.43-1.92 Recipient on dialysis2331.50<.00011.26-1.78 Repeat transplant2831.43<.00011.21-1.70 Recipient history of diabetes19671.28<.00011.19-1.37 PRA > 20%5991.27<.00011.13-1.43 Transplant year: 1996 vs. 2000/200120541.23<.00011.12-1.34 Diagnosis: coronary artery disease vs. cardiomyopathy 57621.18<.00011.11-1.26 N = 11,531 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (1996-6/2001) Risk Factors For 10 Year Mortality (continued) VARIABLE NRelative Risk P-value95% Confidence Interval Recipient with infection requiring IV drug therapy within 2 weeks prior to transplant 10031.160.00411.05-1.28 Prior cerebrovascular event6031.150.02251.02-1.29 On VAD at time of transplant16051.130.0061.03-1.23 Year of transplant: 1997 vs. 2000/200120841.110.0161.02-1.21 Donor history of hypertension12931.110.02511.01-1.21 Year of transplant: 1998 vs. 2000/200121621.100.02631.01-1.20 Total HLA mismatches (per mismatch) 0/1 MM (N=67) 2 MM (N=304) 3 MM (N=1102) 4 MM (N=2520) 5 MM (N=5600) 6 MM (N=1938) 1.040.00481.01-1.07 Not hospitalized at transplant43370.930.03210.88-0.99 N = 11,531 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (1996-6/2001) Borderline Significant Risk Factors For 10 Year Mortality VARIABLE NRelative Risk P-value95% Confidence Interval Recipient Hep B core (+)3271.150.07920.98-1.35 Recipient prior pregnancy16171.090.06540.99-1.20 N = 11,531 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (1996-6/2001) Risk Factors For 10 Year Mortality Continuous Factors (see figures) Recipient ageTransplant center volume Recipient heightIschemia time Recipient weightRecipient pre-transplant bilirubin Donor ageRecipient pre-transplant creatinine Donor weight ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (1996-6/2001) Risk Factors For 10 Year Mortality with 95% Confidence Limits Recipient Height p < 0.0001 ISHLT 2012 (N = 11,531) * The risk associated with recipient height should be considered in conjunction with the risk associated with recipient weight and donor weight. J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (1996-6/2001) Risk Factors For 10 Year Mortality with 95% Confidence Limits Recipient Weight p = 0.0023 ISHLT 2012 (N = 11,531) * The risk associated with recipient BMI should be considered in conjunction with the risk associated with recipient height and donor weight. J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (1996-6/2001) Risk Factors For 10 Year Mortality with 95% Confidence Limits Donor Weight p = 0.0299 ISHLT 2012 (N = 11,531) * The risk associated with donor weight should be considered in conjunction with the risk associated with recipient weight and recipient height. J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (1996-6/2001) Risk Factors For 10 Year Mortality with 95% Confidence Limits Recipient Pre-Transplant Bilirubin p = 0.0006 ISHLT 2012 (N = 11,531) J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (1991-6/1996) Risk Factors For 15 Year Mortality VARIABLE NRelative Risk P-value95% Confidence Interval Retransplant2731.82<.00011.56-2.11 Diagnosis: not cardiomyopathy, coronary artery disease, congenital heart disease, valvular heart disease or retransplant vs. cardiomopathy 1131.350.01911.05-1.74 On ventilator3381.340.00021.15-1.56 Recipient Hep B Core (+)2441.330.00041.14-1.56 PR A> 20%4871.190.00211.07-1.33 Male recipient/female donor vs. male recipient/male donor 22531.19<.00011.09-1.30 N = 10,888 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (1991-6/1996) Risk Factors For 15 Year Mortality (continued) VARIABLE NRelative Risk P-value95% Confidence Interval On VAD at transplant5781.150.01241.03-1.29 Diagnosis: Coronary artery disease vs. cardiomyopathy 52951.14<.00011.08-1.20 Transplant year: 1991 vs. 1995/199618421.120.00381.04-1.21 Transplant year: 1992 vs. 1995/199618811.110.00821.03-1.20 Transplant year: 1993 vs. 1995/199620171.090.03081.01-1.18 0-3 vs. 4-6 total HLA mismatches14970.910.01030.85-0.98 N = 10,888 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (1991-6/1996) Borderline Significant Risk Factors For 15 Year Mortality VARIABLE NRelative Risk P-value95% Confidence Interval Female recipient/female donor vs. male recipient/male donor 10061.130.07580.99-1.29 Hospitalized (inc. ICU) at transplant64311.050.08990.99-1.10 N = 10,888 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (1991-6/1996) Risk Factors For 15 Year Mortality Continuous Factors (see figures) Recipient ageTransplant center volume Recipient heightIschemia time Recipient weightRecipient pre-transplant creatinine Donor age ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (1991-6/1996) Risk Factors For 15 Year Mortality with 95% Confidence Limits Recipient Height p = 0.0003 ISHLT 2012 (N = 11,531) * The risk associated with recipient height should be considered in conjunction with the risk associated with recipient weight. J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (1991-6/1996) Risk Factors For 15 Year Mortality with 95% Confidence Limits Recipient Weight p = 0.0009 ISHLT 2012 (N = 11,531) * The risk associated with recipient BMI should be considered in conjunction with the risk associated with recipient height. J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (1991-6/1996) Risk Factors For 15 Year Mortality with 95% Confidence Limits Center Volume p = 0.0015 ISHLT 2012 (N = 11,531) J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (1986-6/1991) Risk Factors For 20 Year Mortality VARIABLE NRelative Risk P-value95% Confidence Interval Retransplant2942.19<.00011.92-2.49 Diagnosis: not cardiomyopathy, coronary artery disease, congenital heart disease, valvular heart disease or retransplant vs. cardiomopathy 11701.39<.00011.29-1.50 Transplant year: 1986 vs. 1990/199120671.16<.00011.09-1.24 Transplant year: 1987 vs. 1990/199126341.15<.00011.08-1.21 Diagnosis: Coronary artery disease vs. cardiomyopathy 74441.11<.00011.06-1.16 Transplant year: 1988 vs. 1990/199130831.110.00021.05-1.17 Transplant year: 1989 vs. 1990/199132891.060.0211.01-1.12 Female recipient vs. male recipient26870.940.02250.89-0.99 Diagnosis: congenital vs. cardiomyopathy1940.780.01590.64-0.96 N = 10,888 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (1986-6/1991) Risk Factors For 20 Year Mortality Continuous Factors (see figures) Recipient ageTransplant center volume Donor ageIschemia time ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (1986-6/1991) Risk Factors For 20 Year Mortality with 95% Confidence Limits Ischemia Time p = 0.0068 ISHLT 2012 (N = 11,531) J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2005-6/2010) Risk Factors for Developing Severe Renal Dysfunction within 1 Year Limited to Recipients without Severe Renal Dysfunction* Pre-Transplant Conditional on Survival to Transplant Discharge VARIABLE NRelative Risk P-value95% Confidence Interval Dialysis prior to discharge4803.80<.00012.99-4.82 Continuous chronic device10901.610.00041.24-2.08 Infection requiring IV antibiotics within 2 weeks prior to transplant 8341.600.00051.23-2.08 Rejection prior to discharge8241.590.00131.20-2.12 Recipient history of malignancy5311.480.021.06-2.05 Female donor23521.430.00161.14-1.78 Cyclosporine vs. Tacrolimus at discharge24871.310.01151.06-1.61 Total number of HLA mismatches (per mismatch)1.100.04211.00-1.21 Diagnosis: Coronary artery disease vs. cardiomyopathy 35740.810.04860.66 N = 8,794 ISHLT 2012 *Severe renal dysfunction = creatinine > 2.5 mg/dl or dialysis J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2005-6/2010) Borderline Significant Risk Factors for Developing Severe Renal Dysfunction within 1 Year Limited to Recipients without Severe Renal Dysfunction* Pre-Transplant Conditional on Survival to Transplant Discharge VARIABLE NRelative Risk P-value95% Confidence Interval AZA vs. MMF/MPA at discharge1351.720.07980.94-3.15 Stroke prior to discharge1351.620.08330.94-2.79 Transplant year: 2006 vs. 2009/201016040.780.09570.57-1.05 N = 8,794 ISHLT 2012 *Severe renal dysfunction = creatinine > 2.5 mg/dl or dialysis J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2005-6/2010) Risk Factors for Developing Severe Renal Dysfunction within 1 Year Limited to Recipients without Severe Renal Dysfunction* Pre-Transplant Conditional on Survival to Transplant Discharge Continuous Factors (see figures) Recipient ageRecipient pre-transplant creatinine Recipient weightRecipient systolicpulmonary artery pressure (borderline) ISHLT 2012 *Severe renal dysfunction = creatinine > 2.5 mg/dl or dialysis J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2005-6/2010) Risk Factors for Developing Severe Renal Dysfunction within 1 Year Limited to Recipients without Severe Renal Dysfunction* Pre-Transplant Conditional on Survival to Transplant Discharge Recipient Age p = 0.0013 ISHLT 2012 (N = 8,794) *Severe renal dysfunction = creatinine > 2.5 mg/dl or dialysis J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2005-6/2010) Risk Factors for Developing Severe Renal Dysfunction within 1 Year Limited to Recipients without Severe Renal Dysfunction* Pre-Transplant Conditional on Survival to Transplant Discharge Recipient Weight p = 0.0043 ISHLT 2012 (N = 8,794) *Severe renal dysfunction = creatinine > 2.5 mg/dl or dialysis J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2005-6/2010) Risk Factors for Developing Severe Renal Dysfunction within 1 Year Limited to Recipients without Severe Renal Dysfunction* Pre-Transplant Conditional on Survival to Transplant Discharge Recipient Pre-Transplant Creatinine p < 0.0001 ISHLT 2012 (N = 8,794) *Severe renal dysfunction = creatinine > 2.5 mg/dl or dialysis J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2005-6/2010) Risk Factors for Developing Severe Renal Dysfunction within 1 Year Limited to Recipients without Severe Renal Dysfunction* Pre-Transplant Conditional on Survival to Transplant Discharge Systolic Pulmonary Artery Pressure p = 0.0952 ISHLT 2012 (N = 8,794) *Severe renal dysfunction = creatinine > 2.5 mg/dl or dialysis J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Risk Factors for Developing Severe Renal Dysfunction within 5 Years Limited to Recipients without Severe Renal Dysfunction* Pre-Transplant Conditional on Survival to Transplant Discharge VARIABLE NRelative Risk P-value95% Confidence Interval Dialysis prior to discharge4073.17<.00012.49-4.03 Donor cause of death: CNS tumor vs. head trauma 972.130.00461.26-3.59 Transplant year: 2001 vs. 2005/200615191.69<.00011.30-2.20 Transplant year: 2003 vs. 2005/200614691.580.00061.22-2.05 Transplant year: 2002 vs. 2005/200614121.560.00091.20-2.03 Pacemaker prior to discharge2781.520.02661.05-2.21 No AZA, MMF/MPA or Sirolimus at discharge 3921.500.0291.04-2.16 N = 8,168 ISHLT 2012 *Severe renal dysfunction = creatinine > 2.5 mg/dl or dialysis J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Risk Factors for Developing Severe Renal Dysfunction within 5 Years Limited to Recipients without Severe Renal Dysfunction* Pre-Transplant Conditional on Survival to Transplant Discharge (continued) VARIABLE NRelative Risk P-value95% Confidence Interval Cyclosporine vs. Tacrolimus at discharge43851.410.00041.17-1.71 Pulsatile chronic device13841.320.01131.06-1.63 Recipient history of diabetes16981.250.02161.03-1.51 Diagnosis: Coronary artery disease vs. cardiomyopathy 37520.810.02130.67-0.97 Polyclonal agent used for induction15700.790.04860.62 Diagnosis: Congenital vs. cardiomyopathy2050.360.04770.13-0.99 N = 8,168 ISHLT 2012 *Severe renal dysfunction = creatinine > 2.5 mg/dl or dialysis J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Borderline Significant Risk Factors for Developing Severe Renal Dysfunction within 5 Years Limited to Recipients without Severe Renal Dysfunction* Pre-Transplant Conditional on Survival to Transplant Discharge VARIABLE NRelative Risk P-value95% Confidence Interval Hospitalized (inc. ICU) at transplant37921.160.09310.98-1.37 N = 8,168 ISHLT 2012 *Severe renal dysfunction = creatinine > 2.5 mg/dl or dialysis J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Risk Factors for Developing Severe Renal Dysfunction within 5 Years Limited to Recipients without Severe Renal Dysfunction* Pre-Transplant Conditional on Survival to Transplant Discharge Continuous Factors (see figures) Recipient ageRecipient pre-transplant creatinine Donor/recipient height ratioTransplant center volume (borderline) ISHLT 2012 *Severe renal dysfunction = creatinine > 2.5 mg/dl or dialysis J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Risk Factors for Developing Severe Renal Dysfunction within 5 Years Limited to Recipients without Severe Renal Dysfunction* Pre-Transplant Conditional on Survival to Transplant Discharge Recipient Age p = 0.0017 ISHLT 2012 (N = 8,168) *Severe renal dysfunction = creatinine > 2.5 mg/dl or dialysis J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Risk Factors for Developing Severe Renal Dysfunction within 5 Years Limited to Recipients without Severe Renal Dysfunction* Pre-Transplant Conditional on Survival to Transplant Discharge Donor Height/Recipient Height Ratio p = 0.0313 ISHLT 2012 (N = 8,168) *Severe renal dysfunction = creatinine > 2.5 mg/dl or dialysis J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Risk Factors for Developing Severe Renal Dysfunction within 5 Years Limited to Recipients without Severe Renal Dysfunction* Pre-Transplant Conditional on Survival to Transplant Discharge Recipient Pre-Transplant Creatinine p < 0.0001 ISHLT 2012 (N = 8,168) *Severe renal dysfunction = creatinine > 2.5 mg/dl or dialysis J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Risk Factors for Developing Severe Renal Dysfunction within 5 Years Limited to Recipients without Severe Renal Dysfunction* Pre-Transplant Conditional on Survival to Transplant Discharge Center Volume p = 0.0985 ISHLT 2012 (N = 8,168) *Severe renal dysfunction = creatinine > 2.5 mg/dl or dialysis J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (1999-6/2003) Risk Factors for Developing Non-Skin Malignancy within 8 Years Limited to Recipients without Malignancy Pre-Transplant Conditional on Survival to Transplant Discharge VARIABLE NRelative Risk P-value95% Confidence Interval Diagnosis: Congenital vs. cardiomyopathy943.350.0071.39-8.07 Retransplant822.970.00061.60-5.52 Donor history of cancer892.83<.00011.72-4.65 Female recipient/female donor vs. male recipient/male donor 5851.710.0091.14-2.56 Transplant year: 1999 vs. 2002/200310181.470.0051.12-1.92 Transplant year: 2000 vs. 2002/200310461.390.01581.06-1.81 Implantable defibrillator prior to transplant17611.280.01451.05-1.56 N = 4,846 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (1999-6/2003) Borderline Significant Risk Factors for Developing Non-Skin Malignancy within 8 Years Limited to Recipients without Malignancy Pre-Transplant Conditional on Survival to Transplant Discharge VARIABLE NRelative Risk P-value95% Confidence Interval Pacemaker prior to discharge1891.480.07370.96-2.29 Male recipient/female donor vs. male recipient/male donor 8561.280.07250.98-1.68 Transplant year: 2001 vs. 2002/200310941.270.08650.97-1.67 Prior sternotomy22320.830.08650.67-1.03 N = 4,846 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (1999-6/2003) Risk Factors for Developing Non-Skin Malignancy within 8 Years Limited to Recipients without Malignancy Pre-Transplant Conditional on Survival to Transplant Discharge Continuous Factors (see figures) Recipient ageTransplant center volume Ischemia time (borderline) ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (1999-6/2003) Risk Factors for Developing Non-Skin Malignancy within 8 Years Limited to Recipients without Malignancy Pre-Transplant Conditional on Survival to Transplant Discharge Recipient Age p < 0.0001 ISHLT 2012 (N = 4,846) J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (1999-6/2003) Risk Factors for Developing Non-Skin Malignancy within 8 Years Limited to Recipients without Malignancy Pre-Transplant Conditional on Survival to Transplant Discharge Center Volume p = 0.0006 ISHLT 2012 (N = 4,846) J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (1999-6/2003) Risk Factors for Developing Non-Skin Malignancy within 8 Years Limited to Recipients without Malignancy Pre-Transplant Conditional on Survival to Transplant Discharge Ischemia Time p = 0.052 ISHLT 2012 (N = 4,846) J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Risk Factors for Developing CAV within 5 Years Conditional on Survival to Transplant Discharge VARIABLE NRelative Risk P-value95% Confidence Interval OTK3 used for induction3331.74<.00011.43-2.11 AZA vs. MMF/MPA at discharge4971.56<.00011.31-1.85 Pulmonary embolism prior to transplant1211.430.03621.02-1.99 Pacemaker prior to discharge2631.370.00741.09-1.73 Rejection prior to discharge10941.30<.00011.14-1.49 Cyclosporine vs. Tacrolimus at discharge42561.30<.00011.17-1.45 Donor history of hypertension8691.160.03811.01-1.33 Recipient CMV(-)/Donor CMV(+)14851.140.02381.02-1.28 N = 7,788 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Risk Factors for Developing CAV within 5 Years Conditional on Survival to Transplant Discharge (continued) VARIABLE NRelative Risk P-value95% Confidence Interval Transplant year: 2001 vs. 2005/200614270.840.02280.72-0.98 Male recipient/female donor vs. male recipient/male donor 12660.830.01090.72-0.96 Chronic pulsatile flow device13720.820.0030.72-0.93 Female recipient with prior pregnancy/female donor vs. male recipient/male donor 5910.780.00990.65-0.94 Recipient history of malignancy3530.720.01050.56-0.93 Diagnosis: Congenital vs. cardiomyopathy2050.590.0060.41-0.86 Female recipient without prior pregnancy/ female donor vs. male recipient/male donor3250.54<.00010.40-0.73 N = 7,788 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Borderline Significant Risk Factors for Developing CAV within 5 Years Conditional on Survival to Transplant Discharge VARIABLE NRelative Risk P-value95% Confidence Interval No Cyclosporine, Tacrolimus or Sirolimus at discharge 1951.350.08160.96-1.90 Donor history of cancer1361.330.0541.00-1.78 N = 7,788 ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Risk Factors for Developing CAV within 5 Years Conditional on Survival to Transplant Discharge Continuous Factors (see figures) Recipient BMIDonor age Donor/recipient height differenceIschemia time (borderline) ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Risk Factors for Developing CAV within 5 Years Conditional on Survival to Transplant Discharge Recipient BMI p = 0.0103 ISHLT 2012 (N = 7,788) J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Risk Factors for Developing CAV within 5 Years Conditional on Survival to Transplant Discharge Difference Between Donor Height and Recipient Height p = 0.0293 ISHLT 2012 (N = 7,788) J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Risk Factors for Developing CAV within 5 Years Conditional on Survival to Transplant Discharge Donor Age p < 0.0001 ISHLT 2012 (N = 7,788) J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

ADULT HEART TRANSPLANTS (2001-6/2006) Risk Factors for Developing CAV within 5 Years Conditional on Survival to Transplant Discharge Ischemia Time p = 0.0552 ISHLT 2012 (N = 7,788) J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

HEART TRANSPLANTATION Overall ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095.

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HEART TRANSPLANTATION Overall ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095.

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Presentation on theme: "HEART TRANSPLANTATION Overall ISHLT 2012 J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095."— Presentation transcript:

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