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LUNG TRANSPLANTATION Pediatric Recipients ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982.

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Presentation on theme: "LUNG TRANSPLANTATION Pediatric Recipients ISHLT 2005 J Heart Lung Transplant 2005;24: 945-982."— Presentation transcript:

1 LUNG TRANSPLANTATION Pediatric Recipients ISHLT 2005 J Heart Lung Transplant 2005;24:

2 AGE DISTRIBUTION OF PEDIATRIC LUNG RECIPIENTS (Transplants: January June 2004) ISHLT 2005 J Heart Lung Transplant 2005;24:

3 AGE DISTRIBUTION OF PEDIATRIC LUNG RECIPIENTS (Transplants: January June 2004) ISHLT 2005 J Heart Lung Transplant 2005;24:

4 AGE DISTRIBUTION BY DONOR TYPE FOR PEDIATRIC LUNG RECIPIENTS (Transplants: January June 2004) ISHLT 2005 J Heart Lung Transplant 2005;24:

5 AGE DISTRIBUTION BY DONOR TYPE FOR PEDIATRIC LUNG RECIPIENTS (Transplants: January June 2004) ISHLT 2005 J Heart Lung Transplant 2005;24:

6 AGE DISTRIBUTION FOR DONORS OF PEDIATRIC LUNG RECIPIENTS (Transplants: January June 2004) ISHLT 2005 J Heart Lung Transplant 2005;24:

7 AGE DISTRIBUTION FOR DONORS OF PEDIATRIC LUNG RECIPIENTS (Transplants: January June 2004) ISHLT 2005 J Heart Lung Transplant 2005;24:

8 AGE DISTRIBUTION OF PEDIATRIC LUNG RECIPIENTS By Year of Transplant Number of Transplants ISHLT 2005 J Heart Lung Transplant 2005;24:

9 NUMBER OF CENTERS REPORTING PEDIATRIC LUNG TRANSPLANTS ISHLT 2005 J Heart Lung Transplant 2005;24:

10 PEDIATRIC LUNG TRANSPLANTATION: Indications (Transplants: January June 2004) DIAGNOSISAGE: < 1 YearAGE: 1-10 Years Cystic Fibrosis7236.5% Primary Pulmonary Hypertension713.7%2613.2% Congenital Heart Disease2447.1%2110.7% Idiopathic Pulmonary Fibrosis126.1% Pulmonary Vascular Disease713.7%63.0% Re-Transplant: Non-Obliterative bronchiolitis 35.9%84.1% Re-Transplant: Obliterative bronchiolitis115.6% Interstitial Pneumonitis35.9%73.6% Obliterative Bronchiolitis (Not Re-Transplant) 94.6% Bronchiectasis21.0% COPD/Emphysema21.0% Other713.7%2110.7% ISHLT 2005 J Heart Lung Transplant 2005;24:

11 DIAGNOSIS IN PEDIATRIC LUNG RECIPIENTS Age: Years ISHLT 2005 J Heart Lung Transplant 2005;24:

12 PEDIATRIC LUNG TRANSPLANTATION Kaplan-Meier Survival by Procedure Type (Transplants: January June 2003) P = ISHLT 2005 J Heart Lung Transplant 2005;24:

13 PEDIATRIC LUNG TRANSPLANTATION Kaplan-Meier Survival for Congenital Diagnosis (Transplants: January 1990 – June 2003) ISHLT 2005 J Heart Lung Transplant 2005;24:

14 PEDIATRIC LUNG TRANSPLANTATION Kaplan-Meier Survival by Procedure Type Diagnosis: Primary Pulmonary Hypertension (Transplants: January June 2003) P = ISHLT 2005 J Heart Lung Transplant 2005;24:

15 PEDIATRIC LUNG TRANSPLANTATION Kaplan-Meier Survival by Age Group (Transplants: January June 2003) ISHLT 2005 J Heart Lung Transplant 2005;24:

16 PEDIATRIC LUNG TRANSPLANTATION Conditional Kaplan-Meier Survival by Age Group (Transplants: January June 2003) HALF-LIFE <1 Year: 7.1 Years 1-10 Years: 10.5 Years Years: 6.1 Years ISHLT 2005 J Heart Lung Transplant 2005;24:

17 PEDIATRIC LUNG TRANSPLANTATION Kaplan-Meier Survival by Era (Transplants: January June 2003) ISHLT 2005 J Heart Lung Transplant 2005;24:

18 PEDIATRIC LUNG TRANSPLANTATION Kaplan-Meier Survival by Donor Type for Age years (Transplants: January June 2003) HALF-LIFE Deceased: 3.7 Years Living: 3.8 Years ISHLT 2005 J Heart Lung Transplant 2005;24:

19 PEDIATRIC LUNG RECIPIENTS Functional Status of Surviving Recipients (Follow-ups: April 1994-June 2004) ISHLT 2005 J Heart Lung Transplant 2005;24:

20 PEDIATRIC LUNG RECIPIENTS Rehospitalization Post-transplant of Surviving Recipients (Follow-ups: April June 2004) ISHLT 2005 J Heart Lung Transplant 2005;24:

21 PEDIATRIC LUNG RECIPIENTS Induction Immunosuppression For follow-ups between January 2001 and June 2004 ISHLT 2005 J Heart Lung Transplant 2005;24:

22 PEDIATRIC LUNG RECIPIENTS Induction Immunosuppression (Follow-ups: January June 2004) ISHLT 2005 J Heart Lung Transplant 2005;24:

23 PEDIATRIC LUNG RECIPIENTS Maintenance Immunosuppression at Time of Follow-up (F ollow-ups: January 2001 and June 2004) NOTE: Different patients are analyzed in Year 1 and Year 5 ISHLT 2005 J Heart Lung Transplant 2005;24:

24 PEDIATRIC LUNG TRANSPLANTATION Kaplan-Meier Survival Stratified by Induction Use (Transplants: January June 2004) ISHLT 2005 J Heart Lung Transplant 2005;24:

25 PEDIATRIC LUNG RECIPIENTS Maintenance Immunosuppression at Time of Follow-up (Follow-ups: January 2001 and June 2004) 1 Year Follow-up (N = 118)5 Year Follow-up (N = 66) NOTE: Different patients are analyzed in Year 1 and Year 5 ISHLT 2005 J Heart Lung Transplant 2005;24:

26 PEDIATRIC LUNG RECIPIENTS Maintenance Immunosuppression Drug Combinations at Time of Follow-up Report (Follow-ups: January 2001 and June 2004) NOTE: Different patients are analyzed in Year 1 and Year 5 ISHLT 2005 J Heart Lung Transplant 2005;24:

27 POST-LUNG TRANSPLANT MORBIDITY FOR PEDIATRICS Cumulative Prevalence in Survivors within 1 Year Post-Transplant (Follow-ups: April June 2004) ISHLT 2005 J Heart Lung Transplant 2005;24:

28 POST-LUNG TRANSPLANT MORBIDITY FOR PEDIATRICS Cumulative Prevalence in Survivors within 5 Years Post-Transplant (Follow-ups: April June 2004) ISHLT 2005 J Heart Lung Transplant 2005;24:

29 Freedom from Bronchiolitis Obliterans For Pediatric Lung Recipients (Follow-ups: April June 2004) ISHLT 2005 J Heart Lung Transplant 2005;24:

30 Freedom from Severe Renal Dysfunction* For Pediatric Lung Recipients (Follow-ups: April June 2004) * Severe renal dysfunction = Creatinine > 2.5 mg/dl, dialysis or renal transplant ISHLT 2005 J Heart Lung Transplant 2005;24:

31 FREEDOM FROM BRONCHIOLITIS OBLITERANS For Pediatric Lung Recipients by Induction Use (Transplants: April June 2004) ISHLT 2005 J Heart Lung Transplant 2005;24:

32 MALIGNANCY POST-LUNG TRANSPLANTATION FOR PEDIATRICS Cumulative Incidence for Survivors (Follow-ups: April June 2004) Malignancy/Type1-Year Survivors5-Year Survivors No Malignancy354 (94.4%)80 (90.9%) Malignancy (all types combined)23 (5.6%)8 (9.1%) Malignancy Type Lymph207 Other21 Other includes Liver and primitive neuroectodermal tumor. ISHLT 2005 J Heart Lung Transplant 2005;24:

33 Freedom from Malignancy For Pediatric Lung Recipients (Follow-ups: April June 2004) ISHLT 2005 J Heart Lung Transplant 2005;24:

34 PEDIATRIC LUNG TRANSPLANT RECIPIENTS: Cause Of Death (Deaths: January June 2004) CAUSE OF DEATH 0-30 Days (N = 60) 31 Days - 1 Year (N = 89) >1 Year - 3 Years (N = 99) >3 Years - 5 Years (N = 46) >5 Years (N = 26) BRONCHIOLITIS 6 (6.7%)34 (34.3%)20 (43.5%)12 (46.2%) ACUTE REJECTION 1 (1.7%)3 (3.4%)1 (2.2%) LYMPHOMA 3 (3.4%)4 (4.0%)1 (2.2%)3 (11.5%) CMV 7 (7.9%) INFECTION, NON-CMV 7 (11.7%)34 (38.2%)20 (20.2%)12 (26.1%)2 (7.7%) GRAFT FAILURE 22 (36.7%)16 (18.0%)17 (17.2%)4 (8.7%)4 (15.4%) CARDIOVASCULAR 8 (13.3%)2 (2.2%)2 (2.0%) TECHNICAL 9 (15.0%)1 (1.1%) MULTIPLE ORGAN FAILURE 2 (3.3%)9 (10.1%)9 (9.1%)3 (6.5%)2 (7.7%) OTHER 11 (18.3%)8 (9.0%)13 (13.1%)4 (8.7%)3 (11.5%) ISHLT 2005 J Heart Lung Transplant 2005;24:


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