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2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 HEART-LUNG TRANSPLANTATION Overall.

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Presentation on theme: "2004 ISHLT J Heart Lung Transplant 2004; 23: 804-15 HEART-LUNG TRANSPLANTATION Overall."— Presentation transcript:

1 2004 ISHLT J Heart Lung Transplant 2004; 23: HEART-LUNG TRANSPLANTATION Overall

2 2004 ISHLT J Heart Lung Transplant 2004; 23: NUMBER OF HEART-LUNG TRANSPLANTS REPORTED BY YEAR

3 2004 ISHLT J Heart Lung Transplant 2004; 23: AVERAGE CENTER VOLUME Heart-Lung Transplants: January 1, June 30, 2003

4 2004 ISHLT J Heart Lung Transplant 2004; 23: DISTRIBUTION OF HEART-LUNG TRANSPLANTS BY LUNG CENTER VOLUME Heart-Lung Transplants: January 1, June 30, 2003

5 2004 ISHLT J Heart Lung Transplant 2004; 23: HEART-LUNG TRANSPLANTATION Kaplan-Meier SURVIVAL (Transplants: January June 2002) N=2,973 Half-life = 2.8 years Conditional Half-life = 8.3 years Survival (%)

6 2004 ISHLT J Heart Lung Transplant 2004; 23: HEART-LUNG TRANSPLANTATION Adult Recipients

7 2004 ISHLT J Heart Lung Transplant 2004; 23: DIAGNOSIS IN ADULT HEART-LUNG TRANSPLANTS (1/1982-6/2003) Other includes cancer, LAM, OB, sarcoidosis, bronchiectasis

8 2004 ISHLT J Heart Lung Transplant 2004; 23: DIAGNOSIS IN ADULT HEART-LUNG TRANSPLANTS (Transplants: January June 2003) Diagnosis N (%) Congenital Heart Disease726 (32.1%) PPH550 (24.3%) CF355 (15.7%) Acquired Heart Disease98 ( 4.3%) COPD/Emphysema89 ( 3.9%) IPF63 ( 2.8%) Alpha-157 ( 2.5%) Re-TX: Non-OB30 ( 1.3%) Sarcoidosis26 ( 1.1%) Re-TX: OB24 ( 1.1%) Bronchiectasis14 ( 0.6%) OB (not Re-TX)8 ( 0.4%) Other225 ( 9.9%)

9 2004 ISHLT J Heart Lung Transplant 2004; 23: DIAGNOSIS IN ADULT HEART-LUNG TRANSPLANTS BY ERA /1996-6/2003 Other includes OB (non-ReTX), Bronchiectasis, Sarcoidosis

10 2004 ISHLT J Heart Lung Transplant 2004; 23: HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival for Adult Recipients (Transplants: January June 2002) N=2,389 Half-life = 3.1 years Conditional Half-life = 8.8 years Survival (%)

11 2004 ISHLT J Heart Lung Transplant 2004; 23: ADULT HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival By Diagnosis (Transplants: January 1990 – June 2002)

12 2004 ISHLT J Heart Lung Transplant 2004; 23: ADULT HEART-LUNG RECIPIENTS Functional Status (Follow-ups: April 1994 – June 2003)

13 2004 ISHLT J Heart Lung Transplant 2004; 23: ADULT HEART-LUNG RECIPIENTS Employment Status (Follow-ups: April 1994 – June 2003)

14 2004 ISHLT J Heart Lung Transplant 2004; 23: ADULT HEART-LUNG RECIPIENTS: Rehospitalization Post-transplant (Follow-ups: April June 2003)

15 2004 ISHLT J Heart Lung Transplant 2004; 23: ADULT HEART-LUNG RECIPIENTS Induction Immunosuppression For follow-ups between January 2001 through June 2003

16 2004 ISHLT J Heart Lung Transplant 2004; 23: ADULT HEART-LUNG RECIPIENTS Induction Immunosuppression (Follow-ups: January June 2003)

17 2004 ISHLT J Heart Lung Transplant 2004; 23: ADULT HEART-LUNG RECIPIENTS Maintenance Immunosuppression at Time of Follow-up For follow-ups between January 2001 through June 2003 NOTE: Different patients are analyzed in Year 1 and Year 5

18 2004 ISHLT J Heart Lung Transplant 2004; 23: ADULT HEART-LUNG RECIPIENTS Maintenance Immunosuppression Drug Combinations at Time of Follow-up For follow-ups between January 2001 through June 2003 NOTE: Different patients are analyzed in Year 1 and Year 5

19 2004 ISHLT J Heart Lung Transplant 2004; 23: POST-HEART-LUNG TRANSPLANT MORBIDITY FOR ADULTS Cumulative Prevalence in Survivors within 1 Year Post-Transplant (Follow-ups: April June 2003)

20 2004 ISHLT J Heart Lung Transplant 2004; 23: POST-HEART-LUNG TRANSPLANT MORBIDITY FOR ADULTS Cumulative Prevalence in Survivors within 5 Years Post-Transplant (Follow-ups: April June 2003)

21 2004 ISHLT J Heart Lung Transplant 2004; 23: Freedom from CAV For Adult Heart-Lung Recipients (Follow-ups: April 1994-June 2003)

22 2004 ISHLT J Heart Lung Transplant 2004; 23: Freedom from Bronchiolitis Obliterans For Adult Heart-Lung Recipients (Follow-ups: April 1994-June 2003)

23 2004 ISHLT J Heart Lung Transplant 2004; 23: Freedom from Severe Renal Dysfunction* For Adult Heart-Lung Recipients (Follow-ups: April 1994-June 2003) *Severe renal dysfunction = Creatinine > 2.5 mg/dl, dialysis or renal transplant

24 2004 ISHLT J Heart Lung Transplant 2004; 23: MALIGNANCY POST-HEART-LUNG TRANSPLANT FOR ADULTS Cumulative Prevalence in Survivors (Follow-ups: April 1994-June 2003) Malignancy/Type1-Year Survivors5-Year Survivors No Malignancy 245 (91.4%)68 (86.1%) Malignancy (all types combined) 23 (8.6%)11 (13.9%) Malignancy Type Skin23 Lymph165 Other11 Type Not Reported42

25 2004 ISHLT J Heart Lung Transplant 2004; 23: Freedom from Malignancy For Adult Heart-Lung Recipients (Follow-ups: April June 2003)

26 2004 ISHLT J Heart Lung Transplant 2004; 23: ADULT HEART-LUNG TRANSPLANT RECIPIENTS: Cause of Death (Deaths: January June 2003) CAUSE OF DEATH 0-30 Days (N = 181) 31 Days - 1 Year (N = 117) >1 Year - 3 Years (N = 96) >3 Years - 5 Years (N = 56) >5 Years (N = 82) BRONCHIOLITIS. (.%)4 (3.4%)25 (26.0%)21 (37.5%)17 (20.7%) ACUTE REJECTION 3 (1.7%)3 (2.6%)1 (1.0%)1 (1.8%)1 (1.2%) LYMPHOMA. (.%)3 (2.6%)4 (4.2%)3 (5.4%)1 (1.2%) MALIGNANCY, OTHER. (.%)1 (0.9%)6 (6.3%)2 (3.6%)5 (6.1%) CMV. (.%)1 (0.9%). (.%)1 (1.8%). (.%) INFECTION, NON-CMV 37 (20.4%)52 (44.4%)31 (32.3%)3 (5.4%)11 (13.4%) GRAFT FAILURE 57 (31.5%)23 (19.7%)17 (17.7%)8 (14.3%)20 (24.4%) CARDIOVASCULAR 17 (9.4%)7 (6.0%)5 (5.2%)8 (14.3%)7 (8.5%) TECHNICAL 35 (19.3%)2 (1.7%)1 (1.0%). (.%) OTHER 32 (17.7%)21 (17.9%)6 (6.3%)9 (16.1%)20 (24.4%)

27 2004 ISHLT J Heart Lung Transplant 2004; 23: HEART-LUNG TRANSPLANTATION Pediatric Recipients

28 2004 ISHLT J Heart Lung Transplant 2004; 23: AGE DISTRIBUTION OF PEDIATRIC HEART-LUNG RECIPIENTS (Transplants: January June 2003)

29 2004 ISHLT J Heart Lung Transplant 2004; 23: AGE DISTRIBUTION FOR DONORS OF PEDIATRIC HEART- LUNG RECIPIENTS (Transplants: January June 2003)

30 2004 ISHLT J Heart Lung Transplant 2004; 23: AGE DISTRIBUTION OF PEDIATRIC HEART-LUNG RECIPIENTS By Year of Transplant Number of Transplants

31 2004 ISHLT J Heart Lung Transplant 2004; 23: NUMBER OF CENTERS REPORTING PEDIATRIC HEART-LUNG TRANSPLANTS

32 2004 ISHLT J Heart Lung Transplant 2004; 23: DIAGNOSIS IN PEDIATRIC HEART –LUNG TRANSPLANT RECIPIENTS (Age: Years) Other includes Alpha-1, Bronchiectasis, IPF and OB (non-ReTX)

33 2004 ISHLT J Heart Lung Transplant 2004; 23: PEDIATRIC HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival By Diagnosis (Transplants: January 1990 – June 2002)

34 2004 ISHLT J Heart Lung Transplant 2004; 23: PEDIATRIC HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival (Transplants: January June 2002) 1-10 years vs years p = 0.9

35 2004 ISHLT J Heart Lung Transplant 2004; 23: PEDIATRIC HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival by Era (Transplants: January June 2002) Survival (%)

36 2004 ISHLT J Heart Lung Transplant 2004; 23: PEDIATRIC HEART-LUNG TRANSPLANT RECIPIENTS: Cause of Death (Deaths: January June 2003) CAUSE OF DEATH0-30 Days (N = 25) 31 Days - 1 Year (N = 27) >1 Year - 3 Years (N = 25) >3 Years - 5 Years (N = 16) >5 Years (N = 17) BRONCHIOLITIS 1 (3.7%)13 (52.0%)8 (50.0%)5 (29.4%) ACUTE REJECTION 2 (7.4%) INFECTION, NON-CMV 5 (20.0%)9 (33.3%)5 (20.0%)1 (6.3%)5 (29.4%) GRAFT FAILURE 12 (48.0%)2 (7.4%)5 (20.0%)4 (25.0%)3 (17.6%) CARDIOVASCULAR 1 (4.0%)3 (11.1%)1 (6.3%)2 (11.8%) TECHNICAL 3 (12.0%)1 (3.7%) OTHER 4 (16.0%)9 (33.3%)2 (8.0%)2 (12.5%)2 (11.8%)


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