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HEART-LUNG TRANSPLANTATION Overall 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132.

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Presentation on theme: "HEART-LUNG TRANSPLANTATION Overall 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132."— Presentation transcript:

1 HEART-LUNG TRANSPLANTATION Overall 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

2 NUMBER OF HEART-LUNG TRANSPLANTS REPORTED BY YEAR NOTE: This figure includes only the heart-lung transplants that are reported to the ISHLT Transplant Registry. As such, this should not be construed as evidence that the number of heart-lung transplants worldwide has declined in recent years. ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

3 AVERAGE CENTER VOLUME Heart-Lung Transplants: January 1, June 30, 2010 ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

4 DISTRIBUTION OF HEART-LUNG TRANSPLANTS BY CENTER VOLUME Heart-Lung Transplants: January 1, June 30, 2010 ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

5 DISTRIBUTION OF HEART-LUNG TRANSPLANTS BY LUNG CENTER VOLUME Lung Transplants: January 1, June 30, 2010 ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

6 HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival for All Ages (Transplants: January June 2009) ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

7 HEART-LUNG TRANSPLANTATION Adult Recipients ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

8 DIAGNOSIS IN ADULT HEART-LUNG TRANSPLANTS (January June 2010) Other includes cancer, LAM, OB, sarcoidosis, bronchiectasis ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

9 DIAGNOSIS IN ADULT HEART-LUNG TRANSPLANTS (Transplants: January June 2010) Diagnosis N (%) Congenital Heart Disease1,116 (35.9%) Idiopathic Pulmonary Arterial Hypertension857 (27.5%) Cystic Fibrosis444 (14.3%) Acquired Heart Disease150 ( 4.8%) COPD/Emphysema132 ( 4.2%) Idiopathic Pulmonary Fibrosis113 ( 3.6%) Alpha-160 ( 1.9%) Sarcoidosis50 ( 1.6%) Re-Transplant: Not Obliterative Bronchiolitis36 ( 1.2%) Re-Transplant: Obliterative Bronchiolitis28 ( 0.9%) Bronchiectasis24 ( 0.8%) Obliterative Bronchiolitis (not Re-Transplant)22 ( 0.7%) Other80 ( 2.6%) ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

10 DIAGNOSIS IN ADULT HEART-LUNG TRANSPLANTS BY ERA (Transplants: January June 2010) Other includes OB (non-ReTX) and Bronchiectasis ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

11 ADULT HEART-LUNG TRANSPLANTATION Major Indications By Year (%) ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

12 ADULT HEART-LUNG TRANSPLANTATION Major Indications By Year (Number) ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

13 ADULT HEART-LUNG TRANSPLANTS: AGE DISTRIBUTION BY LOCATION Transplants between January 2000 and June 2010 ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

14 ADULT HEART-LUNG TRANSPLANTS: DIAGNOSIS DISTRIBUTION BY LOCATION Transplants between January 2000 and June 2010 ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

15 ADULT HEART-LUNG TRANSPLANTS: DONOR AGE DISTRIBUTION BY LOCATION Transplants between January 2000 and June 2010 ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

16 HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival for Adult Recipients (Transplants: January June 2009) ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

17 HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival for Adult Recipients by Era (Transplants: January June 2009) ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

18 ADULT HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival By Diagnosis (Transplants: January 1990 – June 2009) ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

19 ADULT HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival By Diagnosis Conditional on Survival to 1 Year (Transplants: January 1990 – June 2009) ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

20 ADULT HEART-LUNG RECIPIENTS Cross-Sectional Analysis Functional Status of Surviving Recipients (Follow-ups: April 1994 – June 2010) ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

21 ADULT HEART-LUNG RECIPIENTS Functional Status of Surviving Recipients US Recipients Only (Follow-ups: March June 2010) ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

22 ADULT HEART-LUNG RECIPIENTS Employment Status of Surviving Recipients (Follow-ups: April 1994 – June 2010) ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

23 ADULT HEART-LUNG RECIPIENTS: Rehospitalization Post-transplant of Surviving Recipients (Follow-ups: April June 2010) ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

24 ADULT HEART-LUNG RECIPIENTS Induction Immunosuppression For transplants between January 2001 through June 2010 ISHLT 2011 Analysis is limited to patients who were alive at the time of the discharge ISHLT J Heart Lung Transplant Oct; 30 (10):

25 ADULT HEART-LUNG RECIPIENTS Induction Immunosuppression (Transplants: January December 2009) ISHLT 2011 Analysis is limited to patients who were alive at the time of the discharge ISHLT J Heart Lung Transplant Oct; 30 (10):

26 ADULT HEART-LUNG RECIPIENTS Induction Immunosuppression (Transplants: January December 2009) Any Induction Polyclonal ALG/ATG OKT3 IL-2R Antagonist ISHLT 2011 Analysis is limited to patients who were alive at the time of the discharge ISHLT J Heart Lung Transplant Oct; 30 (10):

27 ADULT HEART-LUNG RECIPIENTS Maintenance Immunosuppression at Time of Follow-up For follow-ups between January 2001 through June 2010 NOTE: Different patients are analyzed in Year 1 and Year 5 Analysis is limited to patients who were alive at the time of the follow-up ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

28 ADULT HEART-LUNG RECIPIENTS Maintenance Immunosuppression Drug Combinations at Time of Follow-up For follow-ups between January 2001 through June 2010 NOTE: Different patients are analyzed in Year 1 and Year 5 Analysis is limited to patients who were alive at the time of the follow-up ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

29 POST-HEART-LUNG TRANSPLANT MORBIDITY FOR ADULTS Cumulative Prevalence in Survivors within 1 Year Post-Transplant (Follow-ups: April June 2010) ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

30 POST-HEART-LUNG TRANSPLANT MORBIDITY FOR ADULTS Cumulative Prevalence in Survivors within 5 Years Post-Transplant (Follow-ups: April June 2010) ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

31 Freedom from Coronary Artery Vasculopathy and Bronchiolitis Obliterans Syndrome For Adult Heart-Lung Recipients (Follow-ups: April 1994-June 2010) ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

32 Freedom from Coronary Artery Vasculopathy For Adult Heart-Lung Recipients By Diagnosis Type (Follow-ups: April 1994-June 2010) P-value comparing all = ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

33 Freedom from Bronchiolitis Obliterans Syndrome For Adult Heart-Lung Recipients By Diagnosis Type (Follow-ups: April 1994-June 2010) P-value comparing all = ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

34 Freedom from Severe Renal Dysfunction* For Adult Heart-Lung Recipients (Follow-ups: April 1994-June 2010) ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

35 MALIGNANCY POST-HEART-LUNG TRANSPLANT FOR ADULTS Cumulative Prevalence in Survivors (Follow-ups: April 1994-June 2010) Malignancy/Type1-Year Survivors 5-Year Survivors 10-Year Survivors No Malignancy 394 (93.8%)143 (88.8%)43 (86%) Malignancy (all types combined) 26 (6.2%)18 (11.2%)7 (14%) Malignancy Type* Skin257 Lymph1860 Other450 Type Not Reported220 * Recipients may have experienced more than one type of malignancy so sum of individual malignancy types may be greater than total number with malignancy. ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

36 Freedom from Malignancy For Adult Heart-Lung Recipients (Follow-ups: April June 2010) ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

37 ADULT HEART-LUNG TRANSPLANT RECIPIENTS: Cause of Death (Deaths: January June 2010) CAUSE OF DEATH 0-30 Days (N = 321) 31 Days - 1 Year (N = 249) >1 Year - 3 Years (N = 223) >3 Years - 5 Years (N = 151) >5 Years (N = 391) BRONCHIOLITIS 06 (2.4%)50 (22.4%)32 (21.2%)66 (16.9%) ACUTE REJECTION 3 (0.9%)8 (3.2%)4 (1.8%)1 (0.7%)2 (0.5%) LYMPHOMA 08 (3.2%)11 (4.9%)8 (5.3%)11 (2.8%) MALIGNANCY, OTHER 04 (1.6%)12 (5.4%)5 (3.3%)30 (7.7%) CMV 01 (0.4%)01 (0.7%)1 (0.3%) INFECTION, NON-CMV 52 (16.2%)80 (32.1%)67 (30.0%)42 (27.8%)96 (24.6%) GRAFT FAILURE 92 (28.7%)54 (21.7%)34 (15.2%)27 (17.9%)54 (13.8%) CARDIOVASCULAR 25 (7.8%)11 (4.4%)20 (9.0%)13 (8.6%)45 (11.5%) TECHNICAL 71 (22.1%)9 (3.6%)2 (0.9%)1 (0.7%)3 (0.8%) OTHER 78 (24.3%)68 (27.3%)23 (10.3%)21 (13.9%)83 (21.2%) ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

38 ADULT HEART-LUNG TRANSPLANT RECIPIENTS: Relative Incidence of Leading Causes of Death (Deaths: January June 2010) ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

39 HEART-LUNG TRANSPLANTATION Pediatric Recipients ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

40 AGE DISTRIBUTION OF PEDIATRIC HEART-LUNG RECIPIENTS (Transplants: January June 2010) ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

41 AGE DISTRIBUTION FOR DONORS OF PEDIATRIC HEART- LUNG RECIPIENTS (Transplants: January June 2010) ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

42 AGE DISTRIBUTION OF PEDIATRIC HEART-LUNG RECIPIENTS By Year of Transplant Number of Transplants NOTE: This figure includes only the heart-lung transplants that are reported to the ISHLT Transplant Registry. As such, this should not be construed as evidence that the number of pediatric heart-lung transplants worldwide has declined in recent years. ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

43 AGE DISTRIBUTION OF PEDIATRIC HEART-LUNG RECIPIENTS By Era of Transplant Percentage of Transplants ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

44 NUMBER OF CENTERS REPORTING PEDIATRIC HEART-LUNG TRANSPLANTS NEED TO UPDATE ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

45 NUMBER OF CENTERS REPORTING PEDIATRIC HEART-LUNG TRANSPLANTS Stratified by center volume ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

46 DIAGNOSIS IN PEDIATRIC HEART-LUNG TRANSPLANT RECIPIENTS (Transplants: ) Other includes Bronchiectasis, Alpha-1, and OB (non-ReTX) NOTE: Unknown diagnoses were excluded from this tabulation. ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

47 PEDIATRIC HEART-LUNG TRANSPLANTS: AGE DISTRIBUTION BY LOCATION Transplants between January 2000 and June 2010 ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

48 PEDIATRIC HEART-LUNG TRANSPLANTS: DIAGNOSIS DISTRIBUTION BY LOCATION Transplants between January 2000 and June 2010 ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

49 PEDIATRIC HEART-LUNG TRANSPLANTS: DONOR AGE DISTRIBUTION BY LOCATION Transplants between January 2000 and June 2010 ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

50 PEDIATRIC HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival By Diagnosis (Transplants: January 1990 – June 2009) ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

51 PEDIATRIC HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival (Transplants: January June 2009) ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

52 PEDIATRIC HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival by Era (Transplants: January June 2009) ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

53 PEDIATRIC HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival by Era (Transplants: January June 2009) Conditional on Survival to 1 Year ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

54 PEDIATRIC HEART-LUNG TRANSPLANT RECIPIENTS: Cause of Death (Deaths: January June 2010) CAUSE OF DEATH 0-30 Days (N = 43) 31 Days - 1 Year (N = 54 ) >1 Year - 3 Years (N = 51 ) >3 Years - 5 Years (N = 28 ) >5 Years (N = 66) BRONCHIOLITIS 02 (3.7%)23 (45.1%)10 (35.7%)13 (19.7%) ACUTE REJECTION 02 (3.7%)1 (2.0%)1 (3.6%)1 (1.5%) LYMPHOMA 02 (3.7%)2 (3.9%)1 (3.6%)2 (3.0%) MALIGNANCY, OTHER 02 (3.7%)01 (3.6%)4 (6.1%) CMV 02 (3.7%)000 INFECTION, NON-CMV 7 (16.3%)17 (31.5%)6 (11.8%)018 (27.3%) GRAFT FAILURE 18 (41.9%)10 (18.5%)14 (27.5%)12 (42.9%)11 (16.7%) CARDIOVASCULAR 2 (4.7%)3 (5.6%)1 (2.0%)2 (7.1%)5 (7.6%) TECHNICAL 9 (20.9%)0002 (3.0%) OTHER 7 (16.3%)14 (25.9%)4 (7.8%)1 (3.6%)10 (15.2%) ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

55 PEDIATRIC HEART-LUNG TRANSPLANT RECIPIENTS: Cause of Death (Deaths: April June 2010) CAUSE OF DEATH 0-30 Days (N = 35) 31 Days - 1 Year (N = 41) >1 Year - 3 Years (N = 44) >3 Years - 5 Years (N = 25) >5 Years (N = 66) BRONCHIOLITIS 01 (2.4%)19 (43.2%)9 (36.0%)13 (19.7%) ACUTE REJECTION 01 (2.4%)1 (2.3%)1 (4.0%)1 (1.5%) LYMPHOMA 02 (4.9%)2 (4.5%)1 (4.0%)2 (3.0%) MALIGNANCY, OTHER 02 (4.9%)01 (4.0%)4 (6.1%) CMV 01 (2.4%)000 INFECTION, NON-CMV 4 (11.4%)14 (34.1%)6 (13.6%)018 (27.3%) GRAFT FAILURE 15 (42.9%)7 (17.1%)11 (25.0%)11 (44.0%)11 (16.7%) CARDIOVASCULAR 2 (5.7%)2 (4.9%)1 (2.3%)1 (4.0%)5 (7.6%) TECHNICAL 7 (20.0%)0002 (3.0%) OTHER 7 (20.0%)11 (26.8%)4 (9.1%)1 (4.0%)10 (15.2%) ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):

56 PEDIATRIC HEART-LUNG TRANSPLANT RECIPIENTS: Relative Incidence of Leading Causes of Death (Deaths: April June 2010) ISHLT 2011 ISHLT J Heart Lung Transplant Oct; 30 (10):


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