The Registry of the International Society for Heart and Lung Transplantation: Thirty-first Official Adult Heart Transplant Report—2014; Focus Theme: Retransplantation

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The Registry of the International Society for Heart and Lung Transplantation: Thirty-first Official Adult Heart Transplant Report—2014; Focus Theme: Retransplantation Lars H. Lund, MD, Leah B. Edwards, PhD, Anna Y. Kucheryavaya, MS, PhD, Christian Benden, MD, Jason D. Christie, MD, MS, Anne I. Dipchand, MD, FRCPC, Fabienne Dobbels, PhD, Samuel B. Goldfarb, MD, Bronwyn J. Levvey, RN, Bruno Meiser, MD, Roger D. Yusen, MD, MPH, Josef Stehlik, MD, MPH The Journal of Heart and Lung Transplantation Volume 33, Issue 10, Pages 996-1008 (October 2014) DOI: 10.1016/j.healun.2014.08.003 Copyright © 2014 Terms and Conditions

Figure 1 Number of heart transplants (all recipient ages) by year (1982–2012) and geographic region. Includes heart transplants reported to the International Society for Heart and Lung Transplantation Transplant Registry (an estimated 66% of all heart transplants worldwide) and may not fully mirror numbers or changes worldwide. The Journal of Heart and Lung Transplantation 2014 33, 996-1008DOI: (10.1016/j.healun.2014.08.003) Copyright © 2014 Terms and Conditions

Figure 2 Average annual heart transplant volume by center for all recipient ages (transplants: 2006–June 2013). Columns show the number of centers performing the number of transplants on the x-axis (e.g., 114 centers perform 10–19 heart transplants per year). The curve shows the percentage of all transplants performed at centers performing the number of transplants listed on the x-axis (e.g., 38% of all heart transplants are performed by the 114 centers that each performed 10–19 heart transplants per year). The Journal of Heart and Lung Transplantation 2014 33, 996-1008DOI: (10.1016/j.healun.2014.08.003) Copyright © 2014 Terms and Conditions

Figure 3 Recipient (adults) and donor age matching for primary transplants and retransplants (transplants: 2006–June 2013). The Journal of Heart and Lung Transplantation 2014 33, 996-1008DOI: (10.1016/j.healun.2014.08.003) Copyright © 2014 Terms and Conditions

Figure 4 Recipient age distribution (adult and pediatric) by era. The Journal of Heart and Lung Transplantation 2014 33, 996-1008DOI: (10.1016/j.healun.2014.08.003) Copyright © 2014 Terms and Conditions

Figure 5 Diagnosis by recipient age group in adult heart transplants (2006–June 2013). For some retransplants (Retx) diagnosis other than retransplant is reported, so the total percentage of retransplants performed may be greater. CAD, coronary artery disease. The Journal of Heart and Lung Transplantation 2014 33, 996-1008DOI: (10.1016/j.healun.2014.08.003) Copyright © 2014 Terms and Conditions

Figure 6 Time between previous and current transplant for adult heart transplants (2006–June 2013). The Journal of Heart and Lung Transplantation 2014 33, 996-1008DOI: (10.1016/j.healun.2014.08.003) Copyright © 2014 Terms and Conditions

Figure 7 Diagnosis (indication for retransplantation) by location for adult heart retransplants (2006–June 2013). CAV, coronary allograft vasculopathy. The Journal of Heart and Lung Transplantation 2014 33, 996-1008DOI: (10.1016/j.healun.2014.08.003) Copyright © 2014 Terms and Conditions

Figure 8 Panel reactive antibody (PRA) by type of transplant in adult heart primary transplants and retransplants (2006–June 2013). The Journal of Heart and Lung Transplantation 2014 33, 996-1008DOI: (10.1016/j.healun.2014.08.003) Copyright © 2014 Terms and Conditions

Figure 9 Durable and temporary mechanical circulatory support use by type of transplant in adult heart primary transplants and retransplants (2006–June 2013). ECMO, extracorporeal membrane oxygenation; LVAD, left ventricular assist device; RVAD, right ventricular assist device; TAH, total artificial heart. The Journal of Heart and Lung Transplantation 2014 33, 996-1008DOI: (10.1016/j.healun.2014.08.003) Copyright © 2014 Terms and Conditions

Figure 10 Kaplan-Meier long-term survival by era in adult heart transplants. The Journal of Heart and Lung Transplantation 2014 33, 996-1008DOI: (10.1016/j.healun.2014.08.003) Copyright © 2014 Terms and Conditions

Figure 11 Kaplan-Meier (A) 1-year survival, (B) long-term survival, and (C) long-term survival conditional on survival to 1 year by diagnosis for adult heart transplants (1982–June 2012). CAD, coronary artery disease. The Journal of Heart and Lung Transplantation 2014 33, 996-1008DOI: (10.1016/j.healun.2014.08.003) Copyright © 2014 Terms and Conditions

Figure 12 Kaplan-Meier (A) 1-year survival, (B) long-term survival, and (C) long-term survival conditional on survival to 1 year by diagnosis (indication for retransplantation) for adult heart retransplants (1982–June 2012). CAV, cardiac allograft vasculopathy. The Journal of Heart and Lung Transplantation 2014 33, 996-1008DOI: (10.1016/j.healun.2014.08.003) Copyright © 2014 Terms and Conditions

Figure 13 Survival according to transplant type and pre-transplant ventricular assist device (VAD) and inotrope use in adult heart primary transplants and retransplants (1999–June 2012). LVAD, left ventricular assist device. The Journal of Heart and Lung Transplantation 2014 33, 996-1008DOI: (10.1016/j.healun.2014.08.003) Copyright © 2014 Terms and Conditions

Figure 14 Causes of death (1994–June 2013) by primary vs different indications for retransplantation in adult heart primary transplants and retransplants. CAV, cardiac allograft vasculopathy; CMV, cytomegalovirus; PTLD, post-transplant lymphoproliferative disorder. The Journal of Heart and Lung Transplantation 2014 33, 996-1008DOI: (10.1016/j.healun.2014.08.003) Copyright © 2014 Terms and Conditions

Figure 15 Induction immunosuppression by location and type of transplant in adult heart primary transplants and retransplants (2005–June 2013). ALG, anti-lymphocyte globulin; ATG, anti-thymocyte globulin; IL-2R, interleukin-2 receptor. The Journal of Heart and Lung Transplantation 2014 33, 996-1008DOI: (10.1016/j.healun.2014.08.003) Copyright © 2014 Terms and Conditions

Figure 16 Maintenance immunosuppression at 1-year and 5-year follow-up by location and type of transplant for adult heart primary transplants and retransplants (2008–June 2013). MMF, mycophenolate mofetil, MPA, mycophenolic acid. The Journal of Heart and Lung Transplantation 2014 33, 996-1008DOI: (10.1016/j.healun.2014.08.003) Copyright © 2014 Terms and Conditions

Figure 17 Freedom from hospitalization for rejection by era for adult heart transplants (1994–June 2012). The sample size does not allow separation into primary transplants and retransplants. The Journal of Heart and Lung Transplantation 2014 33, 996-1008DOI: (10.1016/j.healun.2014.08.003) Copyright © 2014 Terms and Conditions

Figure 18 Categorical risk factors for 1-year post-transplant mortality in multivariate analysis for adult heart transplants (2007–June 2012). BiVAD, biventricular assist device; CAD, coronary artery disease; CI, confidence interval; CM, cardiomyopathy; ECMO, extracorporal membrane oxygenation; F, female; HR, hazard ratio; IV, intravenous; LCL, lower confidence limit; LVAD, left ventricular assist device; M, male; RVAD, right ventricular assist device; rx, medication; UCL, upper confidence limit. The Journal of Heart and Lung Transplantation 2014 33, 996-1008DOI: (10.1016/j.healun.2014.08.003) Copyright © 2014 Terms and Conditions