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2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 LUNG TRANSPLANTATION Pediatric Recipients.

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Presentation on theme: "2004 ISHLT J Heart Lung Transplant 2004; 23: 933-947 LUNG TRANSPLANTATION Pediatric Recipients."— Presentation transcript:

1 2004 ISHLT J Heart Lung Transplant 2004; 23: LUNG TRANSPLANTATION Pediatric Recipients

2 2004 ISHLT J Heart Lung Transplant 2004; 23: AGE DISTRIBUTION OF PEDIATRIC LUNG RECIPIENTS (Transplants: January June 2003)

3 2004 ISHLT J Heart Lung Transplant 2004; 23: AGE DISTRIBUTION OF PEDIATRIC LUNG RECIPIENTS (Transplants: January June 2003)

4 2004 ISHLT J Heart Lung Transplant 2004; 23: AGE DISTRIBUTION FOR DONORS OF PEDIATRIC LUNG RECIPIENTS (Transplants: January June 2003)

5 2004 ISHLT J Heart Lung Transplant 2004; 23: AGE DISTRIBUTION FOR DONORS OF PEDIATRIC LUNG RECIPIENTS (Transplants: January June 2003)

6 2004 ISHLT J Heart Lung Transplant 2004; 23: AGE DISTRIBUTION OF PEDIATRIC LUNG RECIPIENTS By Year of Transplant Number of Transplants

7 2004 ISHLT J Heart Lung Transplant 2004; 23: NUMBER OF CENTERS REPORTING PEDIATRIC LUNG TRANSPLANTS

8 2004 ISHLT J Heart Lung Transplant 2004; 23: PEDIATRIC LUNG TRANSPLANTATION: Indications (Transplants: January June 2003) DIAGNOSISAGE: < 1 YearAGE: 1-10 Years Cystic Fibrosis6635.9% PPH714.3%2513.6% Congenital Heart Disease2346.9%2010.9% IPF137.1% Pulmonary Vascular Disease612.2%63.0% Re-TX: Non-OB36.1%84.3% Re-TX: OB116.0% OB (Non-ReTX)73.8% Bronchiectasis21.1% COPD/Emphysema21.1% Other1020.0%2413.0%

9 2004 ISHLT J Heart Lung Transplant 2004; 23: DIAGNOSIS IN PEDIATRIC LUNG RECIPIENTS Age: Years

10 2004 ISHLT J Heart Lung Transplant 2004; 23: PEDIATRIC LUNG TRANSPLANTATION Kaplan-Meier Survival for Congenital Diagnosis (Transplants: January 1990 – June 2002)

11 2004 ISHLT J Heart Lung Transplant 2004; 23: PEDIATRIC LUNG TRANSPLANTATION Kaplan-Meier Survival by Procedure Type (Transplants: January June 2002) P =

12 2004 ISHLT J Heart Lung Transplant 2004; 23: PEDIATRIC LUNG TRANSPLANTATION Kaplan-Meier Survival by Procedure Type Diagnosis: PPH (Transplants: January June 2002) P =

13 2004 ISHLT J Heart Lung Transplant 2004; 23: PEDIATRIC LUNG TRANSPLANTATION Kaplan-Meier Survival by Procedure Type Diagnosis: PPH (Transplants: January June 2002) P =

14 2004 ISHLT J Heart Lung Transplant 2004; 23: PEDIATRIC LUNG TRANSPLANTATION Kaplan-Meier Survival by Age Group (Transplants: January June 2002)

15 2004 ISHLT J Heart Lung Transplant 2004; 23: PEDIATRIC LUNG TRANSPLANTATION Conditional Kaplan-Meier Survival by Age Group (Transplants: January June 2002) HALF-LIFE <1 Year: ½-life = 7.1 Years 1-10 Years: ½-life = 6.7 Years Years: ½-life = 6.1 Years

16 2004 ISHLT J Heart Lung Transplant 2004; 23: PEDIATRIC LUNG TRANSPLANTATION Kaplan-Meier Survival by Era (Transplants: January June 2002)

17 2004 ISHLT J Heart Lung Transplant 2004; 23: PEDIATRIC LUNG RECIPIENTS Functional Status (Follow-ups: April 1994-June 2003)

18 2004 ISHLT J Heart Lung Transplant 2004; 23: PEDIATRIC LUNG RECIPIENTS Rehospitalization Post-transplant (Follow-ups: April June 2003)

19 2004 ISHLT J Heart Lung Transplant 2004; 23: PEDIATRIC LUNG RECIPIENTS Induction Immunosuppression For follow-ups between January 2001 and June 2003

20 2004 ISHLT J Heart Lung Transplant 2004; 23: PEDIATRIC LUNG RECIPIENTS Induction Immunosuppression (Follow-ups: January June 2003)

21 2004 ISHLT J Heart Lung Transplant 2004; 23: PEDIATRIC LUNG RECIPIENTS Induction Immunosuppression (Follow-ups: January June 2003)

22 2004 ISHLT J Heart Lung Transplant 2004; 23: PEDIATRIC LUNG RECIPIENTS Maintenance Immunosuppression at Time of Follow-up For follow-ups between January 2001 and June 2003 NOTE: Different patients are analyzed in Year 1 and Year 5

23 2004 ISHLT J Heart Lung Transplant 2004; 23: PEDIATRIC LUNG RECIPIENTS Maintenance Immunosuppression at Time of Follow-up For follow-ups between January 2001 and June Year Follow-up (N = 78)5 Year Follow-up (N = 45) NOTE: Different patients are analyzed in Year 1 and Year 5

24 2004 ISHLT J Heart Lung Transplant 2004; 23: PEDIATRIC LUNG RECIPIENTS Maintenance Immunosuppression Drug Combinations at Time of Follow-up Report For follow-ups between January 2001 and June 2003 NOTE: Different patients are analyzed in Year 1 and Year 5

25 2004 ISHLT J Heart Lung Transplant 2004; 23: POST-LUNG TRANSPLANT MORBIDITY FOR PEDIATRICS Cumulative Prevalence in Survivors within 1 Year Post-Transplant (Follow-ups: April June 2003)

26 2004 ISHLT J Heart Lung Transplant 2004; 23: POST-LUNG TRANSPLANT MORBIDITY FOR PEDIATRICS Cumulative Prevalence in Survivors within 5 Years Post-Transplant (Follow-ups: April June 2003)

27 2004 ISHLT J Heart Lung Transplant 2004; 23: Freedom from Bronchiolitis Obliterans For Pediatric Lung Recipients (Follow-ups: April June 2003)

28 2004 ISHLT J Heart Lung Transplant 2004; 23: Freedom from Severe Renal Dysfunction* For Pediatric Lung Recipients (Follow-ups: April June 2003) * Severe renal dysfunction = Creatinine > 2.5 mg/dl, dialysis or renal transplant

29 2004 ISHLT J Heart Lung Transplant 2004; 23: MALIGNANCY POST-LUNG TRANSPLANTATION FOR PEDIATRICS Cumulative Incidence for Survivors (Follow-ups: April June 2003) Malignancy/Type1-Year Survivors5-Year Survivors No Malignancy345 (94.3%)63 (91.3%) Malignancy (all types combined)21 (5.7%)6 (8.7%) Malignancy Type Lymph196 Other2

30 2004 ISHLT J Heart Lung Transplant 2004; 23: Freedom from Malignancy For Pediatric Lung Recipients (Follow-ups: April June 2003)

31 2004 ISHLT J Heart Lung Transplant 2004; 23: PEDIATRIC LUNG TRANSPLANT RECIPIENTS: Cause Of Death (Deaths: January June 2003) CAUSE OF DEATH 0-30 Days (N = 45) 31 Days - 1 Year (N = 75) >1 Year - 3 Years (N = 81) >3 Years - 5 Years (N = 35) >5 Years (N = 11) BRONCHIOLITIS5 (6.7%)30 (37.0%)16 (45.7%)5 (45.5%) ACUTE REJECTION3 (4.0%)1 (2.9%) LYMPHOMA3 (4.0%)4 (4.9%)1 (2.9%)2 (18.2%) CMV5 (6.7%) INFECTION, NON- CMV 6 (13.3%)31 (41.3%)17 (21.0%)8 (22.9%)1 (9.1%) GRAFT FAILURE20 (44.4%)14 (18.7%)16 (19.8%)3 (8.6%)2 (18.2%) CARDIOVASCULAR6 (13.3%)2 (2.7%)2 (2.5%) TECHNICAL6 (13.3%)1 (1.3%) OTHER7 (15.6%)11 (14.7%)12 (14.8%)6 (17.1%)1 (9.1%)


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