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2003 ISHLT J Heart Lung Transplant 2003; 22: 610-72. LUNG TRANSPLANTATION Pediatric Recipients.

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Presentation on theme: "2003 ISHLT J Heart Lung Transplant 2003; 22: 610-72. LUNG TRANSPLANTATION Pediatric Recipients."— Presentation transcript:

1 2003 ISHLT J Heart Lung Transplant 2003; 22: LUNG TRANSPLANTATION Pediatric Recipients

2 2003 ISHLT J Heart Lung Transplant 2003; 22: AGE DISTRIBUTION OF PEDIATRIC LUNG RECIPIENTS (Transplants: January June 2002)

3 2003 ISHLT J Heart Lung Transplant 2003; 22: AGE DISTRIBUTION FOR DONORS OF PEDIATRIC LUNG RECIPIENTS (Transplants: January June 2002)

4 2003 ISHLT J Heart Lung Transplant 2003; 22: AGE DISTRIBUTION OF PEDIATRIC LUNG RECIPIENTS By Year of Transplant Number of Transplants

5 2003 ISHLT J Heart Lung Transplant 2003; 22: NUMBER OF CENTERS REPORTING PEDIATRIC LUNG TRANSPLANTS

6 2003 ISHLT J Heart Lung Transplant 2003; 22: PEDIATRIC LUNG TRANSPLANTATION: Indications (Transplants: January June 2002) DIAGNOSISAGE: < 1 YearAGE: 1-10 Years Cystic Fibrosis5634.1% PPH717.1%2414.6% Congenital Heart Disease2048.8%1911.6% IPF127.3% Pulmonary Vascular Disease512.2%63.7% Re-TX: Non-OB37.3%84.9% Re-TX: OB106.1% OB (Non-ReTX)63.7% Bronchiectasis21.2% COPD/Emphysema21.2% Other614.6%1911.6%

7 2003 ISHLT J Heart Lung Transplant 2003; 22: DIAGNOSIS IN PEDIATRIC LUNG RECIPIENTS Age: Years

8 2003 ISHLT J Heart Lung Transplant 2003; 22: PEDIATRIC LUNG TRANSPLANTATION Actuarial Survival for Congenital Diagnosis (Transplants: January 1990 – June 2001)

9 2003 ISHLT J Heart Lung Transplant 2003; 22: PEDIATRIC LUNG TRANSPLANTATION Actuarial Survival by Procedure Type (Transplants: January June 2001) P = 0.003

10 2003 ISHLT J Heart Lung Transplant 2003; 22: PEDIATRIC LUNG TRANSPLANTATION Actuarial Survival by Age Group (Transplants: January June 2001)

11 2003 ISHLT J Heart Lung Transplant 2003; 22: PEDIATRIC LUNG TRANSPLANTATION Conditional Actuarial Survival by Age Group (Transplants: January June 2001) HALF-LIFE <1 Year: ½-life = 7.1 Years 1-10 Years: ½-life = 5.9 Years Years: ½-life = 5.6 Years

12 2003 ISHLT J Heart Lung Transplant 2003; 22: PEDIATRIC LUNG TRANSPLANTATION Actuarial Survival by Era (Transplants: January June 2001)

13 2003 ISHLT J Heart Lung Transplant 2003; 22: PEDIATRIC LUNG TRANSPLANTATION Actuarial Survival by Procedure Type Diagnosis: PPH (Transplants: January June 2001) P = 0.002

14 2003 ISHLT J Heart Lung Transplant 2003; 22: PEDIATRIC LUNG RECIPIENTS Functional Status (Follow-ups: April 1994-June 2002)

15 2003 ISHLT J Heart Lung Transplant 2003; 22: PEDIATRIC LUNG RECIPIENTS Rehospitalization Post-transplant (Follow-ups: April June 2002)

16 2003 ISHLT J Heart Lung Transplant 2003; 22: PEDIATRIC LUNG RECIPIENTS Induction Immunosuppression For follow-ups between January 2000 and June 2002

17 2003 ISHLT J Heart Lung Transplant 2003; 22: PEDIATRIC LUNG RECIPIENTS Induction Immunosuppression (Follow-ups: January June 2002)

18 2003 ISHLT J Heart Lung Transplant 2003; 22: PEDIATRIC LUNG RECIPIENTS Maintenance Immunosuppression at Any Time During Follow-up Period For follow-ups between January 2000 and June 2002 NOTE: Different patients are analyzed in Year 1 and Year 5

19 2003 ISHLT J Heart Lung Transplant 2003; 22: PEDIATRIC LUNG RECIPIENTS Maintenance Immunosuppression at Time of Follow-up For follow-ups between January 2000 and June 2002 NOTE: Different patients are analyzed in Year 1 and Year 5

20 2003 ISHLT J Heart Lung Transplant 2003; 22: PEDIATRIC LUNG RECIPIENTS Maintenance Immunosuppression at Time of Follow-up For follow-ups between January 2000 and June Year Follow-up (N = 86)5 Year Follow-up (N = 55) NOTE: Different patients are analyzed in Year 1 and Year 5

21 2003 ISHLT J Heart Lung Transplant 2003; 22: PEDIATRIC LUNG RECIPIENTS Maintenance Immunosuppression Drug Combinations at Time of Follow-up Report For follow-ups between January 2000 and June 2002 NOTE: Different patients are analyzed in Year 1 and Year 5

22 2003 ISHLT J Heart Lung Transplant 2003; 22: POST-LUNG TRANSPLANT MORBIDITY FOR PEDIATRICS Cumulative Prevalence in Survivors within 1 Year Post-Transplant (Follow-ups: April 1994-June 2002)

23 2003 ISHLT J Heart Lung Transplant 2003; 22: POST-LUNG TRANSPLANT MORBIDITY FOR PEDIATRICS Cumulative Prevalence in Survivors within 5 Years Post-Transplant (Follow-ups: April 1994-June 2002)

24 2003 ISHLT J Heart Lung Transplant 2003; 22: Freedom from Bronchiolitis Obliterans For Pediatric Lung Recipients (Follow-ups: April June 2002)

25 2003 ISHLT J Heart Lung Transplant 2003; 22: Freedom from Severe Renal Dysfunction* For Pediatric Lung Recipients (Follow-ups: April June 2002) * Severe renal dysfunction = Creatinine > 2.5 mg/dl, dialysis or renal transplant

26 2003 ISHLT J Heart Lung Transplant 2003; 22: MALIGNANCY POST-LUNG TRANSPLANTATION FOR PEDIATRICS Cumulative Incidence for Survivors (Follow-ups: April June 2002) Malignancy/Type1-Year Survivors5-Year Survivors No Malignancy 304 (93.8%)53 (89.8%) Malignancy (all types combined) 20 (6.2%) 6 (10.2%) Malignancy Type Lymph186 Other2

27 2003 ISHLT J Heart Lung Transplant 2003; 22: Freedom from Malignancy For Pediatric Lung Recipients (Follow-ups: April June 2002)

28 2003 ISHLT J Heart Lung Transplant 2003; 22: PEDIATRIC LUNG RECIPIENTS Relationship of Diabetes and Cystic Fibrosis Transplants: April 1994 – June 2001 Diagnosis Report of Diabetes Developing Between Transplant and 1st Year* Report of Diabetes Developing Between Transplant and 3rd Year** NoYesNoYes Cystic Fibrosis % % % % Other Diagnosis % 4 2.7% % 6 9.2% *p < **p <

29 2003 ISHLT J Heart Lung Transplant 2003; 22: PEDIATRIC LUNG TRANSPLANT RECIPIENTS: Cause Of Death (Deaths: January June 2002) 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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