HEART TRANSPLANTATION Adult Recipients JHLT Oct; 32(10):

Table of Contents  Donor and recipient characteristics: slides 3-24  Survival slides: slides  Immunosuppression: slides  Morbidity: slides  Multivariable analyses: slides  2013 focus theme: age: slides JHLT Oct; 32(10):

 Diagnosis: slides 4-6  Recipient and donor characteristics: slides 7-24 Donor and Recipient Characteristics: JHLT Oct; 32(10):

Adult Heart Transplants Diagnosis JHLT Oct; 32(10):

Adult Heart Transplants Diagnosis: Cardiomyopathy vs. CAD by Location JHLT Oct; 32(10):

Adult Heart Transplants Diagnosis by Location (Transplants: January 2006 – June 2012) JHLT Oct; 32(10):

Adult Heart Transplants Donor and Recipient Characteristics (N = 37,146) (N = 17,183) /2012 (N = 22,318) p-value Recipient age (years) 54.0 ( )54.0 ( )54.0 ( )< Donor age (years) 31.0 ( )33.0 ( )34.0 ( )< Donor and recipient age difference (years) ( )-17.0 ( )-16.0 ( )< Recipient weight (kg) 75.0 ( )77.6 ( )79.4 ( )< Recipient height (cm) ( )174.0 ( )175.0 ( ) Recipient BMI 22.7 ( )24.2 ( )24.4 ( )< Donor weight (kg) 75.0 ( ) ( )79.4 ( )< Donor height (cm) ( ) ( )175.0 ( )< Donor BMI 24.2 ( ) ( )25.5 ( )< Continuous factors are expressed as median (5 th -95 th percentiles) 1 Based on 4/ transplants. JHLT Oct; 32(10):

Adult Heart Transplants Donor and Recipient Characteristics (N = 37,146) (N = 17,183) /2012 (N = 22,318) p-value Recipient/donor gender (% male) 80.7%/ 68.4%77.9%/ 69.1%75.9%/ 69.2%<0.0001/ Male recipient/ female donor 21.3%18.5%16.7%< Female recipient/ male donor 9.2%9.7%9.9% Recipient/donor diabetes mellitus 13.1%*/ 1.6% %/ 2.0%25.3%/ 3.0%<0.0001/ < Recipient prior history of dialysis 3.0% 1 4.3%4.2%< Recipient amiodarone use (US only) 21.7% %30.5%< Recipient/donor cigarette history -/ 38.0% % 2 / 29.1%46.4%/ 18.6%0.8536/ < Recipient/donor hypertension 34.5% 1 / 10.8% %/ 11.4%45.3%/ 13.8%<0.0001/ < Recipient prior cardiac surgery -39.1% %< Recipient Peripheral Vascular Disease 3.8% 1 3.2%2.9% Recipient previous malignancy 3.3% 1 4.5%6.6%< Recipient COPD 3.2% 1 3.2%4.3%< Ischemic time (hours) 2.9 ( )3.1 ( )3.3 ( )< Continuous factors are expressed as median (5 th -95 th percentiles) 1 Based on 4/ transplants. 2 Based on 7/ transplants. (Cont’d) JHLT Oct; 32(10):

Adult Heart Transplants Donor and Recipient Characteristics (N = 37,146) (N = 17,183) /2012 (N = 22,318) p-value Most recent PRA > 10% 1 Overall 7.7%8.9% % 3 < Class I % 4 - Class II --9.6% 4 - Creatinine at time of transplant (mg/dL) 1.2 ( )1.2 ( )1.2 ( )< Pulmonary vascular resistance (Wood units) 2.2 ( ) ( )2.1 ( )< HLA Mismatches 4.3%4.4%3.8% %40.1%38.4% % 57.8% %8.9%13.8% Continuous factors are expressed as median (5 th -95 th percentiles) 2 Based on US /2004 transplants and non US transplants. 3 Based on non US transplants. 4 Based on US transplants. 5 Based on 4/ transplants. 1 PRA was collected as a single percentage outside of US. Until mid-2004 PRA was collected in US as a single percentage. After this date, PRA was collected separately for Class I and Class II. (Cont’d) JHLT Oct; 32(10):

Adult Heart Transplants Donor and Recipient Characteristics (N = 37,146) (N = 17,183) /2012 (N = 22,318) p-value Diagnosis Cardiomyopathy 46.2%48.2%54.0% < Coronary artery disease 45.8%42.7%36.8% Valvular 3.9%3.5%2.8% Retransplant 1.9%2.2%2.5% Congenital 1.8%2.7%2.9% Other causes 0.4%0.6%0.9% Donor cause of death Head trauma 45.9%54.6%45.8% < Stroke 29.0%32.9%24.4% Other 25.0%12.5%29.8% (Cont’d) JHLT Oct; 32(10):

Adult Heart Transplants Donor and Recipient Characteristics (N = 37,146) (N = 17,183) /2012 (N = 22,318) p-value Pre-operative support (multiple items may be reported) Hospitalized at time of transplant 60.8%47.9%44.3%< On IV inotropes 55.7% %42.4%< LVAD 12.1% %28.5%< IABP 6.4%6.7%6.1% RVAD -5.0% 3 3.7% Ventilator 3.3%3.2%2.7% TAH 0.1% 2 0.1%1.0%< ECMO 0.3% 4 0.5%1.1%< Based on 4/ transplants. 2 Based on 11/ transplants. 3 Based on 2005 transplants. 4 Based on 5/ transplants. (Cont’d) JHLT Oct; 32(10):

Adult Heart Transplants Recipient Gender By Location (Transplants: January 2006 – June 2012) JHLT Oct; 32(10):

Adult Heart Transplants Donor Gender By Location (Transplants: January 2006 – June 2012) JHLT Oct; 32(10):

Adult Heart Transplants PRA Distribution (Transplants: January 2006 – June 2012) If Class I and Class II values were reported separately, the higher of the two values was used. JHLT Oct; 32(10):

Adult Heart Transplants % of Patients Bridged with Mechanical Circulatory Support* (Transplants: January 2000 – December 2011) * LVAD, RVAD, TAH. ECMO is excluded. JHLT Oct; 32(10):

Adult Heart Transplants % of Patients Bridged with Mechanical Circulatory Support* by Year and Device Type * LVAD, RVAD, TAH. ECMO is excluded. JHLT Oct; 32(10):

Adult Heart Transplants Number and % of Combined Organ Transplants Reported By Year and Type of Transplant JHLT Oct; 32(10):

Adult Heart Transplants Recipient BMI Distribution By Location (Transplants: January 2006 – June 2012) JHLT Oct; 32(10):

Adult Heart Transplants Recipient BMI Distribution By Diagnosis (Transplants: January 2006 – June 2012) JHLT Oct; 32(10):

Adult Heart Transplants Recipient Diabetes Mellitus Distribution By Location (Transplants: January 2006 – June 2012) JHLT Oct; 32(10):

Adult Heart Transplants Recipient Diabetes Mellitus Distribution By Diagnosis (Transplants: January 2006 – June 2012) JHLT Oct; 32(10):

Adult Heart Transplants Recipient Cigarette History By Location (Transplants: January 2006 – June 2012) JHLT Oct; 32(10):

Adult Heart Transplants Recipient Cigarette and COPD History By Diagnosis (Transplants: January 2006 – June 2012) JHLT Oct; 32(10):

Adult Heart Transplants Ischemic time Distribution By Location (Transplants: January 2006 – June 2012) JHLT Oct; 32(10):

Survival Analyses:  by era: slides and  by gender: slides  by diagnosis: slides  by PVR: slides  by BMI: slide 46  by comorbidities: slides  by VAD usage: slides  by re-transplant: slide 54  by employment status at 1 year post transplant: slide 55  by age: see slides in the age theme section  by immunosuppression: see slides 66, 72 and 79 in the immunosuppression section  Cause of death: slides JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by Era (Transplants: January 1982 – June 2011) All pair-wise comparisons were significant at p < except vs /2011 (p = ) JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by Era Conditional on Survival to 1 Year (Transplants: January 1982 – June 2011) All pair-wise comparisons were significant at p < except vs /2011 (p=0.9440) and vs /2011 (p=0.0569) JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by Recipient Gender (Transplants: January 1982 – June 2011) p < JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by Recipient Gender Conditional on Survival to 1 Year (Transplants: January 1982 – June 2011) p < JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by Donor/Recipient Gender (Transplants: January 1982 – June 2011) All pair-wise comparisons with male/female were significant at p < No other pair-wise comparisons were significant at p < 0.05 JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by Donor/Recipient Gender Conditional on Survival to 1 Year (Transplants: January 1982 – June 2011) All pair-wise comparisons were significant at p < 0.05 except male/male vs. female/male and female/male vs. female/female JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by Diagnosis (Transplants: January 1982 – June 2011) All pair-wise comparisons were significant at p < 0.01 except cardiomyopathy vs. congenital (p=0.9113). Median survival (years): Cardiomyopathy= 11.6; CAD=9.4; Congenital=14.4; Retransplant=6.3; Valvular=10.9 JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by Diagnosis Conditional on Survival to 1 Year (Transplants: January 1982 – June 2011) All pair-wise comparisons were significant at p < except cardiomyopathy vs. valvular (p = ) and CAD vs. retransplant (p = ) Median survival (years): Cardiomyopathy=14.2; CAD=11.9; Congenital=21.2; Retransplant=10.8; Valvular=14.6 JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival Within 1 Year by Diagnosis (Transplants: January 2006 – June 2011) All pair-wise comparisons were significant at p < 0.05 except cardiomyopathy vs. CAD, congenital vs. retransplant, congenital vs. valvular, retransplant vs. valvular JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by Diagnosis (Transplants: January 2003 – June 2011) All pair-wise comparisons with cardiomyopathy are significant at p < No other pair-wise comparisons were significant at p < JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by Diagnosis Conditional on Survival to 1 Year (Transplants: January 2003 – June 2011) No pair-wise comparisons are significant at p < 0.05 except cardiomyopathy vs. CAD, CAD vs. congenital and congenital vs. retransplant JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by Era (Transplants: January 1982 – June 2011) Diagnosis: Cardiomyopath y All comparisons were significant at p < except vs /2011 (p=0.9689) JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by Era (Transplants: January 1982 – June 2011) Diagnosis: Coronary Artery Disease JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by Era (Transplants: January 1982 – June 2011) Diagnosis: Congenital No pair-wise comparisons were significant at p < 0.05 JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by Era (Transplants: January 1982 – June 2011) Diagnosis: Retransplant JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by Era (Transplants: January 1982 – June 2011) Diagnosis: Valvular No pair-wise comparisons were significant at p < 0.05 except vs (p = ) JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by PVR (Transplants: January 2003 – June 2011) 1-<3 vs. 3-<5: p = No other pair-wise comparisons were significant at p < 0.05 JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by Donor/Recipient Weight Ratio (Transplants: January 2003 – June 2011) For recipients with PVR: 1–<3 wood units No pair-wise comparisons were significant at p < 0.05 JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by Donor/Recipient Weight Ratio (Transplants: January 2003 – June 2011) For recipients with PVR: 3–<5 wood units No pair-wise comparisons were significant at p < 0.05 JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by Donor/Recipient Weight Ratio (Transplants: January 2003 – June 2011) For recipients with PVR: 5+ wood units No pair-wise comparisons were significant at p < 0.05 JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by BMI Group (Transplants: January 2006 – June 2011) No pair-wise comparisons were significant at p < 0.05 except 18.5<25 vs. 25-<30 (p < ) JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by Recipient Diabetes Mellitus (Transplants: January 2003 – June 2011) p < JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by Recipient Cigarette History (Transplants: July 2004 – June 2011) p = JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by Recipient COPD History (Transplants: January 2003 – June 2011) p = JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by VAD usage (Transplants: April 1994 – June 2011) Pulsatile vs. Continuous: p= Pulsatile vs. No LVAD/No Inotropes: p = No other pair-wise comparisons were significant at p < 0.05 JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by VAD usage (Transplants: January 2003 – June 2011) Pulsatile vs. No LVAD/No Inotropes: p = Pulsatile vs. No LVAD/Inotropes: p = Continuous vs. No LVAD/Inotropes: p = No other pair-wise comparisons were significant at p < 0.05 JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by VAD usage Conditional on Survival to 6 Months (Transplants: January 1999 – June 2011) Continuous vs. No LVAD/No Inotropes: p = No other pair-wise comparisons were significant at p < 0.05 JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by VAD usage (Transplants: January 2005 – June 2011) All pair-wise comparisons with LVAD+RVAD Pulsatile were significant at p < 0.05 except LVAD Pulsatile vs. LVAD+RVAD Pulsatile No other pair-wise comparisons were significant at p < JHLT Oct; 32(10):

Adult Heart Re-Transplants 1 Year Survival Time between previous and current transplant Comparison of survival for interval ≤ 12 months vs. > 12 months: p < Comparison of survival for interval ≤ 12 months vs. > 12 months for 1/2003-6/2011: p < JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by Employment Status at 1 Year Conditional on Survival to 1 Year (1 Year Follow-ups: January 2000 – June 2011) p < JHLT Oct; 32(10):

Adult Heart Transplants Cause of Death (Deaths: January 1994 – June 2012) CAUSE OF DEATH 0-30 Days (N = 5,297) 31 Days – 1 Year (N = 4,547) >1 Year – 3 Years (N = 3,307) >3 Years – 5 Years (N = 2,890) >5 Years – 10 Years (N = 7,315) >10 Years – 15 Years (N = 4,774) >15 Years (N = 3,436) Cardiac Allograft Vasculopathy 77 (1.5%)172 (3.8%)413 (12.5%)406 (14.0%)1,020 (13.9%)675 (14.1%)299 (12.3%) Acute Rejection251 (4.7%)442 (9.7%)334 (10.1%)140 (4.8%)139 (1.9%)47 (1.0%)17 (0.7%) Lymphoma3 (0.1%)56 (1.2%)78 (2.4%)98 (3.4%)275 (3.8%)149 (3.1%)69 (2.8%) Malignancy, Other4 (0.1%)111 (2.4%)408 (12.3%)563 (19.5%)1,542 (21.1%)1,002 (21.0%)459 (18.8%) CMV3 (0.1%)51 (1.1%)15 (0.5%)6 (0.2%)6 (0.1%)3 (0.1%)0 Infection, Non-CMV690 (13.0%)1,402 (30.8%)412 (12.5%)283 (9.8%)781 (10.7%)497 (10.4%)277 (11.4%) Graft Failure2,063 (38.9%)780 (17.2%)845 (25.6%)641 (22.2%)1,323 (18.1%)796 (16.7%)405 (16.6%) Technical382 (7.2%)72 (1.6%)23 (0.7%)25 (0.9%)90 (1.2%)61 (1.3%)31 (1.3%) Other304 (5.7%)319 (7.0%)268 (8.1%)227 (7.9%)577 (7.9%)326 (6.8%)197 (8.1%) Multiple Organ Failure938 (17.7%)688 (15.1%)198 (6.0%)179 (6.2%)505 (6.9%)385 (8.1%)230 (9.4%) Renal Failure29 (0.5%)45 (1.0%)48 (1.5%)91 (3.1%)414 (5.7%)396 (8.3%)221 (9.1%) Pulmonary160 (3.0%)176 (3.9%)134 (4.1%)130 (4.5%)313 (4.3%)195 (4.1%)108 (4.4%) Cerebrovascular393 (7.4%)233 (5.1%)131 (4.0%)101 (3.5%)330 (4.5%)242 (5.1%)123 (5.0%) Total N of Deaths5,9855,1473,9553,5289,0256,1393,186 Percentages represent % of deaths in the respective time period. Total number of deaths includes deaths with unknown causes. JHLT Oct; 32(10):

Adult Heart Transplants Cause of Death from Leading Causes by Time since Transplant and Era (Deaths: January 1994 – June 2012) Deaths 1994 – 2001Deaths 2002 – 6/2012 Since only leading causes of death are shown, sum of percentages for each time period is less than 100% JHLT Oct; 32(10):

Adult Heart Transplants Relative Incidence of Leading Causes of Death (Deaths: January 1994 – June 2012) Since only leading causes of death are shown, sum of percentages for each time period is less than 100% JHLT Oct; 32(10):

Adult Heart Transplants Cumulative Incidence of Leading Causes of Death (Transplants: January 1994 – June 2011) JHLT Oct; 32(10):

Adult Heart Transplants Relative Incidence of Leading Causes of Death (Deaths: January 2006 – June 2012) Since only leading causes of death are shown, sum of percentages for each time period is less than 100% JHLT Oct; 32(10):

Adult Heart Transplants Cumulative Incidence of Leading Causes of Death (Transplants: January 2005 – June 2011) JHLT Oct; 32(10):

 Induction: slides and  Maintenance: slides and  Rejection: slides Immunosuppression: JHLT Oct; 32(10):

Adult Heart Transplants Induction Immunosuppression (Transplants: January 2005 – June 2012) Analysis is limited to patients who were alive at the time of the discharge JHLT Oct; 32(10):

Adult Heart Transplants Induction Immunosuppression by Location (Transplants: January 2005 – June 2012) Analysis is limited to patients who were alive at the time of the discharge JHLT Oct; 32(10):

Adult Heart Transplants Induction Immunosuppression (Transplants: 2002, 2007 and 1/2012–6/2012) Analysis is limited to patients who were alive at the time of the discharge JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by Induction Type Conditional on Survival to 14 Days (Transplants: January 2001 – June 2011) No induction vs. IL-2R: p = Polyclonal vs. IL-2R: p = No other pair-wise comparisons were significant at p < 0.05 JHLT Oct; 32(10):

Adult Heart Transplants Maintenance Immunosuppression at Time of Follow-up (Follow-ups: January 2008 – June 2012) Analysis is limited to patients who were alive at the time of the follow-up JHLT Oct; 32(10):

Adult Heart Transplants Maintenance Immunosuppression at Time of 1 Year Follow-up by Year Analysis is limited to patients who were alive at the time of the follow-up NOTE: Different patients are analyzed in each time frame JHLT Oct; 32(10):

Adult Heart Transplants Maintenance Immunosuppression Drug Combinations at Time of Follow-up (Follow-ups: January 2006 – June 2012) Analysis is limited to patients who were alive at the time of the follow-up NOTE: Different patients are analyzed in Year 1 and Year 5 JHLT Oct; 32(10):

Adult Heart Transplants Maintenance Immunosuppression Drug Combinations at Time of Follow-up (Follow-ups: January 2001 – June 2012) For the Same Patients at Year 1 and 5 Analysis is limited to patients who were alive at the time of the follow-up JHLT Oct; 32(10):

Adult Heart Transplants Maintenance Immunosuppression Drug Combinations at Time of Follow-up by Location (Follow-ups: January 2006 – June 2012) Analysis is limited to patients who were alive at the time of the follow-up NOTE: Different patients are analyzed in Year 1 and Year 5 Year 1Year 5 JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by Maintenance Immunosuppression at 1 year (Transplants: January 2001 – June 2011) Conditional on Survival to 1 Year p = JHLT Oct; 32(10):

Adult Heart Transplants % of Recipients Experiencing Treated Rejection Between Transplant Discharge and 1-Year Follow-Up by Year Treated rejection = Recipient was reported to (1) have at least one acute rejection episode that was treated with an anti-rejection agent; or (2) have been hospitalized for rejection. JHLT Oct; 32(10):

Adult Heart Transplants % of Recipients Experiencing Any Rejection Between Transplant Discharge and 1-Year Follow-Up by Year Any rejection = Recipient was reported to (1) have at least one acute rejection episode; or (2) have been hospitalized for rejection. JHLT Oct; 32(10):

Adult Heart Transplants % of Recipients Experiencing Treated Rejection between Transplant Discharge and 1-Year Follow-Up by Type of Induction (Follow-ups: January 2005 – June 2012) Analysis is limited to patients who were alive at the time of the follow-up Treated rejection = Recipient was reported to (1) have at least one acute rejection episode that was treated with an anti-rejection agent; or (2) have been hospitalized for rejection. JHLT Oct; 32(10):

Adult Heart Transplants % of Recipients Experiencing Any Rejection between Transplant Discharge and 1-Year Follow-Up by Type of Induction (Follow-ups: January 2005 – June 2012) Analysis is limited to patients who were alive at the time of the follow-up Any rejection = Recipient was reported to (1) have at least one acute rejection episode; or (2) have been hospitalized for rejection. JHLT Oct; 32(10):

Adult Heart Transplants % of Recipients Experiencing Treated Rejection between Transplant Discharge and 1-Year Follow-Up by Maintenance Immunosuppression (Follow-ups: January 2005 – June 2012) Analysis is limited to patients who were alive at the time of the follow-up Treated rejection = Recipient was reported to (1) have at least one acute rejection episode that was treated with an anti-rejection agent; or (2) have been hospitalized for rejection. JHLT Oct; 32(10):

Adult Heart Transplants % of Recipients Experiencing Any Rejection between Transplant Discharge and 1-Year Follow-Up by Maintenance Immunosuppression (Follow-ups: January 2005 – June 2012) Analysis is limited to patients who were alive at the time of the follow-up Any rejection = Recipient was reported to (1) have at least one acute rejection episode; or (2) have been hospitalized for rejection. JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by Treatment for Rejection Within 1 st Year (1 Year Follow-ups: January 2005 – June 2011) Conditional on survival to 1 year All pair-wise comparisons were significant at p < except No rejection vs. Untreated rejection (p = ) Treated rejection = Recipient was reported to (1) have at least one acute rejection episode that was treated with an anti-rejection agent; or (2) have been hospitalized for rejection. No rejection = Recipient had (i) no acute rejection episodes and (ii) was reported either as not hospitalized for rejection or did not receive anti-rejection agents. JHLT Oct; 32(10):

Adult Heart Transplants Freedom from Hospitalization for Rejection by Era (Transplants: April 1994 – June 2011) All pair-wise comparisons were statistically significant at p < JHLT Oct; 32(10):

 Functional status: slide 82  Employment: slides  Hospitalization: slide 85  CAV: slides  Renal dysfunction: slides and  Malignancy: slides Morbidity: JHLT Oct; 32(10):

Adult Heart Transplants Functional Status of Surviving Recipients by Karnofsky Score ( Follow-ups: January 2006 – June 2012) JHLT Oct; 32(10):

Adult Heart Transplants Employment Status of Surviving Recipients (Follow-ups: January 2000 – June 2012) JHLT Oct; 32(10):

Adult Heart Transplants Employment Status of Surviving Recipients Age at Follow-up: Years (Follow-ups: January 2000 – June 2012) JHLT Oct; 32(10):

Adult Heart Transplants Rehospitalization Post-transplant of Surviving Recipients (Follow-ups: January 2000 – June 2012) JHLT Oct; 32(10):

Adult Heart Transplants Cumulative Morbidity Rates in Survivors within 1, 5 and 10 Years Post-Transplant (Follow-ups: January 1995 – June 2012) Outcome Within 1 Year Total N with known response Within 5 Years Total N with known response Within 10 Years Total N with known response Hypertension*72.3%(N = 26,852)92.2%(N = 12,534)- Renal Dysfunction26.3%(N = 29,301)52.5%(N = 14,680)68.4%(N = 4,879) Abnormal Creatinine ≤ 2.5 mg/dl18.1% 33.3% 38.3% Creatinine > 2.5 mg/dl6.4% 15.1% 20.5% Chronic Dialysis1.5% 2.9% 6.0% Renal Transplant0.3% 1.2% 3.6% Hyperlipidemia*60.0%(N = 28,102)87.8%(N = 13,876)- Diabetes*25.7%(N = 29,289)38.1%(N = 14,470)- Cardiac Allograft Vasculopathy7.8%(N = 26,480)30.2%(N = 10,651)50.1%(N = 2,815) * Data are not available 10 years post transplant JHLT Oct; 32(10):

Adult Heart Transplants Cumulative Morbidity Rates in Survivors within 1, 5 and 10 Years Post-Transplant (Follow-ups: January 1995 – June 2002) For the Same Patients Outcome Within 1 Year Total N with known response Within 5 Years Total N with known response Within 10 Years Total N with known response Renal Dysfunction22.8%(N = 2,233)49.4%(N = 2,233)65.9%(N = 2,233) Abnormal Creatinine ≤ 2.5 mg/dl16.5% 34.6% 40.3% Creatinine > 2.5 mg/dl6.0% 13.0% 17.9% Chronic Dialysis0.1% 0.9% 4.3% Renal Transplant0.2% 0.9% 3.4% Cardiac Allograft Vasculopathy6.8%(N = 2,233)29.6%(N = 2,233)49.0%(N = 2,233) Only patients with known responses reported on every annual follow-up through the 10-year follow- up were included. JHLT Oct; 32(10):

Adult Heart Transplants Cumulative Morbidity Rates in Survivors within 1 and 5 Years Post-Transplant (Follow-ups: January 2001 – June 2007) For the Same Patients OutcomeWithin 1 Year Total N with known response Within 5 Years Total N with known response Hypertension73.2%(N = 3,439)88.5%(N = 3,439) Renal Dysfunction26.4%(N = 3,439)50.1%(N = 3,439) Abnormal Creatinine ≤ 2.5 mg/dl22.2% 37.7% Creatinine > 2.5 mg/dl3.5% 9.5% Chronic Dialysis0.5% 1.9% Renal Transplant0.3% 1.0% Hyperlipidemia72.6%(N = 3,439)89.5%(N = 3,439) Diabetes29.7%(N = 3,439)40.6%(N = 3,439) Cardiac Allograft Vasculopathy5.7%(N = 3,439)27.0%(N = 3,439) Only patients with known responses reported on every annual follow-up through the 5-year follow- up were included. JHLT Oct; 32(10):

Adult Heart Transplants Freedom from Cardiac Allograft Vasculopathy by Era (Transplants: April 1994 – June 2011) p < JHLT Oct; 32(10):

Adult Heart Transplants Freedom from Cardiac Allograft Vasculopathy by Ischemia Time (Transplants: April 1994 – June 2011) p = JHLT Oct; 32(10):

Adult Heart Transplants Freedom from Cardiac Allograft Vasculopathy by Gender (Transplants: April 1994 – June 2011) p < JHLT Oct; 32(10):

Adult Heart Transplants Survival After Report of CAV Within 3 Years of Transplant and Survival In Patients Without CAV* (Transplants: April 1994 – June 2011) p < * Patient survival for those without CAV within 3 years after transplant was conditioned on survival to median time of CAV development (512 days). Median time to CAV development is based on patients who developed CAV within 3 years of transplant. JHLT Oct; 32(10):

Adult Heart Transplants Survival After Report of CAV Within 3 Years of Transplant and Survival In Patients Without CAV* by Era (Transplants: April 1994 – June 2011) 4/ : No CAV vs. CAV p < /2011: No CAV vs. CAV p < No CAV: 4/ vs /2011 p = CAV: 4/ vs /2011 p = * Patient survival for those without CAV within 3 years after transplant was conditioned on survival to median time of CAV development (512 days). Median time to CAV development is based on patients who developed CAV within 3 years of transplant. JHLT Oct; 32(10):

Adult Heart Transplants Freedom from Severe Renal Dysfunction by Era* (Transplants: April 1994 – June 2011) p < * Severe renal dysfunction = Creatinine > 2.5 mg/dl (221 μmol/L), dialysis or renal transplant JHLT Oct; 32(10):

Adult Heart Transplants Freedom from Severe Renal Dysfunction* Stratified by Ischemia Time (Transplants: April 1994 – June 2011) p = * Severe renal dysfunction = Creatinine > 2.5 mg/dl (221 μmol/L), dialysis or renal transplant JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by Renal Dysfunction Within 1 st Year Conditional on Survival to 1 Year (1 year follow-ups: April 1994 – June 2011) p < JHLT Oct; 32(10):

Adult Heart Transplants Post Transplant Malignancy (Follow-ups: April 1994 – June 2012) Cumulative Morbidity Rates in Survivors Malignancy/Type 1-Year Survivors 5-Year Survivors 10-Year Survivors No Malignancy 30,892 (97.4%)13,813 (85.9%)4,073 (72.1%) Malignancy (all types combined) 827 (2.6%)2,264 (14.1%)1,578 (27.9%) Malignancy Type* Skin 409 (1.3%)1,493 (9.3%)1,119 (19.8%) Lymphoma 170 (0.5%)174 (1.1%)102 (1.8%) Other 190 (0.6%)667 (4.1%)496 (8.8%) Type Not Reported 58 (0.2%)46 (0.3%)18 (0.3%) * Recipients may have experienced more than one type of malignancy so sum of individual malignancy types may be greater than total number with malignancy. “Other” includes: prostate (11, 35, 21), adenocarcinoma (7, 7, 4), lung (6, 4, 1), bladder (4, 5, 4), Kaposi's sarcoma (0, 3, 1), breast (2, 7, 2), cervical (2, 5, 2), colon (2, 4, 2), and renal (2, 7, 2). Numbers in parentheses are those reported within 1 year, 5 years and 10 years, respectively. JHLT Oct; 32(10):

Adult Heart Transplants Freedom from Malignancy by Type (Follow-ups: April 1994 – June 2012) JHLT Oct; 32(10):

Adult Heart Transplants Freedom from Malignancy by Maintenance Immunosuppression Combinations at Discharge Conditional on Survival to 14 days (Transplants: January 2001 – June 2011) p = JHLT Oct; 32(10):

Adult Heart Transplants Freedom from Malignancy by Era (Transplants: April 1994 – June 2011) p < JHLT Oct; 32(10):

Adult Heart Transplants Freedom from Malignancy by Era and Gender (Transplants: April 1994 – June 2011) All pair-wise comparisons were significant at p < 0.05 except Female 4/ vs. Female /2011 JHLT Oct; 32(10):

Adult Heart Transplants Freedom from Skin Malignancy by Era (Transplants: April 1994 – June 2011) p < JHLT Oct; 32(10):

Adult Heart Transplants Freedom from Lymphoma by Era (Transplants: April 1994 – June 2011) p < JHLT Oct; 32(10):

Adult Heart Transplants Freedom from Other* Malignancy by Era (Transplants: April 1994 – June 2011) p < * Other malignancy includes all types of malignancy except skin and lymphoma JHLT Oct; 32(10):

Adult Heart Transplants Survival After Report of Malignancy Within 3 Years of Transplant and Survival In Patients Without Malignancy* (Transplants: April 1994 – June 2011) p < * Patient survival for those without malignancy within 3 years after transplant was conditioned on survival to median time of malignancy development (545 days). Median time to malignancy development is based on patients who developed malignancy within 3 years of transplant. JHLT Oct; 32(10):

Adult Heart Transplants Survival After Report of Skin Malignancy or Lymphoma Within 3 Years of Transplant and Survival In Patients Without Malignancy * (Transplants: April 1994 – June 2011) All pair-wise comparisons were significant at p < * Patient survival for those without malignancy within 3 years after transplant was conditioned on survival to median time of malignancy development (545 days). Median time to malignancy development is based on patients who developed malignancy within 3 years of transplant. JHLT Oct; 32(10):

 1 year mortality: slides  5 year mortality: slides  5 year mortality conditional on survival to 1 year: slides  10 year mortality: slides  15 year mortality: slides  20 year mortality: slides  Developing severe renal dysfunction within 1 year: slides  Developing severe renal dysfunction within 5 years: slides  Developing non-skin malignancy within 8 years: slides  Developing CAV within 5 years: slides Multivariable Analyses: JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2006-6/2011) Risk Factors For 1 Year Mortality VARIABLE NHazard Ratio P-value95% Confidence Interval Temporary circulatory support* < Total artificial heart Diagnosis: Congenital vs. cardiomyopathy < Recipient history of dialysis < Recipient on ventilator at time of transplant Chronic pulsatile flow device < Chronic continuous flow device < Previous transplant N = 10,473 * Temporary circulatory support includes ECMO and temporary pulsatile flow devices. JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2006-6/2011) Risk Factors For 1 Year Mortality (continued) VARIABLE NHazard Ratio P-value95% Confidence Interval Male recipient/female donor vs. male recipient/male donor Recipient with infection requiring IV drug therapy within 2 weeks prior to transplant Previous transfusion Not hospitalized just prior to transplant Ventricular remodeling Transplant year: 2006 vs. 2010/ Transplant year: 2007 vs. 2010/ Transplant year: 2008 vs. 2010/ N = 10,473 * Temporary circulatory support includes ECMO and temporary pulsatile flow devices. JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2006-6/2011) Risk Factors For 1 Year Mortality Continuous Factors (see figures) Recipient ageIschemia time Recipient heightRecipient pre-transplant bilirubin BMI ratioRecipient pre-transplant creatinine Donor agePRA Class II Transplant center volumeRecipient pulmonary artery systolic pressure JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2006-6/2011) Risk Factors For 1 Year Mortality with 95% Confidence Limits Recipient Age p < (N = 10,473) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS Risk Factors For 1, 5, 10 and 20 Year Mortality Recipient Age JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2006-6/2011) Risk Factors For 1 Year Mortality with 95% Confidence Limits Donor Age p < (N = 10,473) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS Risk Factors For 1, 5, 10 and 20 Year Mortality Donor Age JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2006-6/2011) Risk Factors For 1 Year Mortality with 95% Confidence Limits Recipient Height p = (N = 10,473) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2006-6/2011) Risk Factors For 1 Year Mortality with 95% Confidence Limits Donor BMI/Recipient BMI ratio p = (N = 10,473) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2006-6/2011) Risk Factors For 1 Year Mortality with 95% Confidence Limits Ischemia Time p < (N = 10,473) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2006-6/2011) Risk Factors For 1 Year Mortality with 95% Confidence Limits Center Volume p = (N = 10,473) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2006-6/2011) Risk Factors For 1 Year Mortality with 95% Confidence Limits Recipient Pre-Transplant Bilirubin p < (N = 10,473) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2006-6/2011) Risk Factors For 1 Year Mortality with 95% Confidence Limits Recipient Pre-Transplant Creatinine p < (N = 10,473) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2006-6/2011) Risk Factors For 1 Year Mortality with 95% Confidence Limits PRA Class II (%) p = (N = 10,473) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2006-6/2011) Risk Factors For 1 Year Mortality with 95% Confidence Limits Pulmonary Artery Systolic Pressure p = (N = 10,473) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors For 5 Year Mortality VARIABLE NHazard Ratio P-value95% Confidence Interval Temporary circulatory support* < Total artificial heart Continuous flow device or VAD with type unknown Recipient history of dialysis < Diagnosis: Congenital vs. cardiomyopathy Recipient on ventilator at time of transplant Female recipient with prior pregnancy/ male donor vs. male recipient/male donor PRA > 10% N = 10,332 * Temporary circulatory support includes ECMO and temporary pulsatile flow devices. JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors For 5 Year Mortality (continued) VARIABLE NHazard Ratio P-value95% Confidence Interval Recipient Hep B core (+) Recipient with infection requiring IV drug therapy within 2 weeks prior to transplant Number of HLA mismatches at A locus (per locus) 0 A MM (N=677) 1 A MM (N=4910) 2 A MM (N=4745) Donor cause of death: anoxia vs. head trauma Recipient history of diabetes Chronic pulsatile flow device Diagnosis: coronary artery disease vs. cardiomyopathy Ventricular remodeling N = 10,332 JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors For 5 Year Mortality Continuous Factors (see figures) Recipient ageIschemia time Recipient heightRecipient pre-transplant bilirubin Recipient BMIRecipient pre-transplant creatinine Donor ageRecipient PVR Donor BMIRecipient diastolic PA pressure Transplant center volume JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors For 5 Year Mortality with 95% Confidence Limits Recipient Age p < (N = 10,332) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors For 5 Year Mortality with 95% Confidence Limits Donor Age p < (N = 10,332) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors For 5 Year Mortality with 95% Confidence Limits Recipient Height p = (N = 10,332) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors For 5 Year Mortality with 95% Confidence Limits Recipient and Donor BMI Recipient BMI: p < Donor BMI: p = (N = 10,332) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors For 5 Year Mortality with 95% Confidence Limits Ischemia Time p < (N = 10,332) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors For 5 Year Mortality with 95% Confidence Limits Center Volume p = (N = 10,332) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors For 5 Year Mortality with 95% Confidence Limits Recipient Pre-Transplant Bilirubin p = (N = 10,332) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors For 5 Year Mortality with 95% Confidence Limits Recipient Pre-Transplant Creatinine p < (N = 10,332) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors For 5 Year Mortality with 95% Confidence Limits Pulmonary Vascular Resistance p = (N = 10,332) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors For 5 Year Mortality with 95% Confidence Limits Recipient Pulmonary Artery Diastolic Pressure p = (N = 10,332) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors For 5 Year Mortality Conditional on Survival to 1 Year VARIABLE NHazard Ratio P-value95% Confidence Interval No Cyclo, TAC or Sirolimus at 1 year < No AZA, MMF/MPA or Sirolimus at 1 year < Rejection between discharge and 1 st year < Polyclonal agent and IL-2R antagonist used for induction Recipient history of dialysis prior to transplant Recipient Hep B core (+) and Hep B surface antigen not positive Dialysis prior to discharge Female recipient with prior pregnancy/ male donor vs. male recipient/male donor N = 8,873 JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors For 5 Year Mortality Conditional on Survival to 1 Year (continued) VARIABLE NHazard Ratio P-value95% Confidence Interval Donor cause of death: anoxia vs. head trauma Treated for infection prior to discharge IL-2R antagonist used for induction (no polyclonal agent) Recipient history of diabetes mismatches at the A locus Defibrillator prior to transplant Ventricular remodeling prior to transplant AZA vs. MMF/MPA N = 8,873 JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors For 5 Year Mortality Conditional on Survival to 1 Year Continuous Factors (see figures) Recipient ageRecipient pre-transplant creatinine Recipient heightDonor/recipient height ratio Recipient BMIRecipient TPG Donor age JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors For 5 Year Mortality with 95% Confidence Limits Conditional on Survival to 1 Year Recipient Age p < (N = 8,873) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors For 5 Year Mortality with 95% Confidence Limits Conditional on Survival to 1 Year Recipient Height p = (N = 8,873) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors For 5 Year Mortality with 95% Confidence Limits Conditional on Survival to 1 Year Recipient BMI p = (N = 8,873) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors For 5 Year Mortality with 95% Confidence Limits Conditional on Survival to 1 Year Donor Age p = (N = 8,873) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors For 5 Year Mortality with 95% Confidence Limits Conditional on Survival to 1 Year Donor Height/Recipient Height Ratio P = (N = 8,873) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors For 5 Year Mortality with 95% Confidence Limits Conditional on Survival to 1 Year Recipient Pre-Transplant Creatinine P = (N = 8,873) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors For 5 Year Mortality with 95% Confidence Limits Conditional on Survival to 1 Year Transpulmonary Pressure Gradient p = (N = 8,873) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (1997-6/2002) Risk Factors For 10 Year Mortality VARIABLE NHazard Ratio P-value95% Confidence Interval ECMO Ventilator at time of transplant < Recipient on dialysis < Repeat transplant < Recipient history of diabetes < PRA > 20% < Female recipient with prior pregnancy < Diagnosis: congenital vs. CM Transplant year: 1997 vs. 2001/ < N = 11,531 JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (1997-6/2002) Risk Factors For 10 Year Mortality (continued) VARIABLE NHazard Ratio P-value95% Confidence Interval Year of transplant: 1998 vs. 2001/ Prior cerebrovascular event Diagnosis: coronary artery disease vs. CM < Year of transplant: 1999 vs. 2001/ Year of transplant: 2000 vs. 2001/ Donor history of hypertension On VAD at time of transplant Not hospitalized at transplant HLA mismatches (A + B + DR) vs < N = 11,531 JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (1997-6/2002) Risk Factors For 10 Year Mortality Continuous Factors (see figures) Recipient ageIschemia time Recipient weightRecipient pre-transplant bilirubin Donor ageRecipient pre-transplant creatinine Transplant center volume JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (1997-6/2002) Risk Factors For 10 Year Mortality with 95% Confidence Limits Recipient Age p < (N = 11,531) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (1997-6/2002) Risk Factors For 10 Year Mortality with 95% Confidence Limits Donor Age p < (N = 11,531) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (1997-6/2002) Risk Factors For 10 Year Mortality with 95% Confidence Limits Recipient Weight p = (N = 11,531) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (1997-6/2002) Risk Factors For 10 Year Mortality with 95% Confidence Limits Ischemia Time p < (N = 11,531) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (1997-6/2002) Risk Factors For 10 Year Mortality with 95% Confidence Limits Center Volume p < (N = 11,531) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (1997-6/2002) Risk Factors For 10 Year Mortality with 95% Confidence Limits Recipient Pre-Transplant Bilirubin p = (N = 11,531) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (1997-6/2002) Risk Factors For 10 Year Mortality with 95% Confidence Limits Recipient Pre-Transplant Creatinine p < (N = 11,531) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (1992-6/1997) Risk Factors For 15 Year Mortality VARIABLE NHazard Ratio P-value95% Confidence Interval Retransplant < Diagnosis: not cardiomyopathy, coronary artery disease, congenital heart disease, valvular heart disease or retransplant vs. CM On ventilator < Recipient Hep B Core (+) PR A> 20% Transplant year: 1992 vs. 1996/ < Female recipient/male donor vs. male recipient/male donor N = 11,055 JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (1992-6/1997) Risk Factors For 15 Year Mortality (continued) VARIABLE NHazard Ratio P-value95% Confidence Interval On VAD at transplant Diagnosis: Coronary artery disease vs. cardiomyopathy < Transplant year: 1993 vs. 1996/ Male recipient/female donor vs. male recipient/male donor mismatches at DR locus < Transplant year: 1994 vs. 1996/ N = 11,055 JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (1992-6/1997) Risk Factors For 15 Year Mortality Continuous Factors (see figures) Recipient ageTransplant center volume Difference in recipient and donor ageIschemia time Recipient BMIRecipient pre-transplant creatinine Donor height JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (1992-6/1997) Risk Factors For 15 Year Mortality with 95% Confidence Limits Recipient Age p < (N = 11,055) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (1992-6/1997) Risk Factors For 15 Year Mortality with 95% Confidence Limits Donor Age – Recipient Age p < (N = 11,055) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (1992-6/1997) Risk Factors For 15 Year Mortality with 95% Confidence Limits Recipient BMI p = (N = 11,055) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (1992-6/1997) Risk Factors For 15 Year Mortality with 95% Confidence Limits Donor Height p = (N = 11,055) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (1992-6/1997) Risk Factors For 15 Year Mortality with 95% Confidence Limits Ischemia Time p < (N = 11,055) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (1992-6/1997) Risk Factors For 15 Year Mortality with 95% Confidence Limits Center Volume p = (N = 11,055) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (1992-6/1997) Risk Factors For 15 Year Mortality with 95% Confidence Limits Recipient Pre-Transplant Creatinine p < (N = 11,055) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (1987-6/1992) Risk Factors For 20 Year Mortality VARIABLE NHazard Ratio P-value95% Confidence Interval Retransplant < Diagnosis: not cardiomyopathy, coronary artery disease, congenital heart disease, valvular heart disease or retransplant vs. cardiomopathy < Transplant year: 1987 vs. 1991/ < Transplant year: 1988 vs. 1991/ < Diagnosis: Coronary artery disease vs. cardiomyopathy < Transplant year: 1989 vs. 1991/ Female recipient vs. male recipient N = 18,951 JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (1987-6/1992) Risk Factors For 20 Year Mortality Continuous Factors (see figures) Recipient ageTransplant center volume Donor age JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (1987-6/1992) Risk Factors For 20 Year Mortality with 95% Confidence Limits Recipient Age p < (N = 18,951) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (1987-6/1992) Risk Factors For 20 Year Mortality with 95% Confidence Limits Donor Age p < (N = 18,951) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (1987-6/1992) Risk Factors For 20 Year Mortality with 95% Confidence Limits Center Volume p < (N = 18,951) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2006-6/2011) Risk Factors for Developing Severe Renal Dysfunction within 1 Year Limited to Recipients without Severe Renal Dysfunction* Pre-Transplant Conditional on Survival to Transplant Discharge VARIABLE NHazard Ratio P-value95% Confidence Interval Dialysis prior to discharge < Female recipient/female donor vs. male recipient/male donor < Infection requiring IV antibiotics within 2 weeks prior to transplant Rejection prior to discharge Cyclosporine vs. Tacrolimus at discharge Post-transplant cardiac re-operation prior to discharge Ventilatory support at transplant Continuous chronic device Male recipient/female donor vs. male recipient/male donor Hospitalized (inc. ICU) at transplant Diagnosis: Valvular disease vs. cardiomyopathy N = 8,861 *Severe renal dysfunction = creatinine > 2.5 mg/dl or dialysis JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2006-6/2011) Risk Factors for Developing Severe Renal Dysfunction within 1 Year Limited to Recipients without Severe Renal Dysfunction* Pre-Transplant Conditional on Survival to Transplant Discharge Continuous Factors (see figures) Recipient ageRecipient pre-transplant creatinine Recipient BSA *Severe renal dysfunction = creatinine > 2.5 mg/dl or dialysis JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2006-6/2011) Risk Factors for Developing Severe Renal Dysfunction within 1 Year Limited to Recipients without Severe Renal Dysfunction* Pre-Transplant Conditional on Survival to Transplant Discharge Recipient Age p = (N = 8,861) *Severe renal dysfunction = creatinine > 2.5 mg/dl or dialysis JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2006-6/2011) Risk Factors for Developing Severe Renal Dysfunction within 1 Year Limited to Recipients without Severe Renal Dysfunction* Pre-Transplant Conditional on Survival to Transplant Discharge Recipient BSA p = (N = 8,861) *Severe renal dysfunction = creatinine > 2.5 mg/dl or dialysis JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2006-6/2011) Risk Factors for Developing Severe Renal Dysfunction within 1 Year Limited to Recipients without Severe Renal Dysfunction* Pre-Transplant Conditional on Survival to Transplant Discharge Recipient Pre-Transplant Creatinine p < (N = 8,861) *Severe renal dysfunction = creatinine > 2.5 mg/dl or dialysis JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors for Developing Severe Renal Dysfunction within 5 Years Limited to Recipients without Severe Renal Dysfunction* Pre-Transplant Conditional on Survival to Transplant Discharge VARIABLE NHazard Ratio P-value95% Confidence Interval Dialysis prior to discharge < Multiple induction agents reported vs. none Transplant year: 2002 vs. 2005/ < Continuous chronic device Female recipient Transplant year: 2003 vs. 2006/ N = 8,182 *Severe renal dysfunction = creatinine > 2.5 mg/dl or dialysis JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors for Developing Severe Renal Dysfunction within 5 Years Limited to Recipients without Severe Renal Dysfunction* Pre-Transplant Conditional on Survival to Transplant Discharge (continued) VARIABLE NHazard Ratio P-value95% Confidence Interval Pulsatile chronic device < Recipient history of diabetes < IL-2R antagonist used for induction Cyclosporine vs. Tacrolimus at discharge Rejection prior to discharge HLA mismatch (per mismatch) N = 8,182 *Severe renal dysfunction = creatinine > 2.5 mg/dl or dialysis JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors for Developing Severe Renal Dysfunction within 5 Years Limited to Recipients without Severe Renal Dysfunction* Pre-Transplant Conditional on Survival to Transplant Discharge Continuous Factors (see figures) Recipient ageRecipient pulmonary artery systolic pressure Recipient weightRecipient pre-transplant creatinine *Severe renal dysfunction = creatinine > 2.5 mg/dl or dialysis JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors for Developing Severe Renal Dysfunction within 5 Years Limited to Recipients without Severe Renal Dysfunction* Pre-Transplant Conditional on Survival to Transplant Discharge Recipient Age p = (N = 8,182) *Severe renal dysfunction = creatinine > 2.5 mg/dl or dialysis JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors for Developing Severe Renal Dysfunction within 5 Years Limited to Recipients without Severe Renal Dysfunction* Pre-Transplant Conditional on Survival to Transplant Discharge Recipient Weight p = (N = 8,182) *Severe renal dysfunction = creatinine > 2.5 mg/dl or dialysis JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors for Developing Severe Renal Dysfunction within 5 Years Limited to Recipients without Severe Renal Dysfunction* Pre-Transplant Conditional on Survival to Transplant Discharge Recipient Pre-Transplant Creatinine p < (N = 8,182) *Severe renal dysfunction = creatinine > 2.5 mg/dl or dialysis JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors for Developing Severe Renal Dysfunction within 5 Years Limited to Recipients without Severe Renal Dysfunction* Pre-Transplant Conditional on Survival to Transplant Discharge Recipient Pulmonary Artery Systolic Pressure p < (N = 8,182) *Severe renal dysfunction = creatinine > 2.5 mg/dl or dialysis JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2000-6/2004) Risk Factors for Developing Non-Skin Malignancy within 8 Years Limited to Recipients without Malignancy Pre-Transplant Conditional on Survival to Transplant Discharge VARIABLE NHazard Ratio P-value95% Confidence Interval Multiple induction agents reported Donor history of cancer Female recipient/female donor vs. male recipient/male donor Pacemaker prior to discharge Transplant year: 2000 vs. 2003/ < Transplant year: 2001 vs. 2003/ Implantable defibrillator prior to transplant N = 5,179 JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2000-6/2004) Risk Factors for Developing Non-Skin Malignancy within 8 Years Limited to Recipients without Malignancy Pre-Transplant Conditional on Survival to Transplant Discharge Continuous Factors (see figures) Recipient ageRecipient PVR Ischemia timeRecipient PA systolic Transplant center volume JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2000-6/2004) Risk Factors for Developing Non-Skin Malignancy within 8 Years Limited to Recipients without Malignancy Pre-Transplant Conditional on Survival to Transplant Discharge Recipient Age p < (N = 5,179) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2000-6/2004) Risk Factors for Developing Non-Skin Malignancy within 8 Years Limited to Recipients without Malignancy Pre-Transplant Conditional on Survival to Transplant Discharge Ischemia Time p = (N = 5,179) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2000-6/2004) Risk Factors for Developing Non-Skin Malignancy within 8 Years Limited to Recipients without Malignancy Pre-Transplant Conditional on Survival to Transplant Discharge Center Volume p = (N = 5,179) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2000-6/2004) Risk Factors for Developing Non-Skin Malignancy within 8 Years Limited to Recipients without Malignancy Pre-Transplant Conditional on Survival to Transplant Discharge Pulmonary Vascular Resistance p = (N = 5,179) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2000-6/2004) Risk Factors for Developing Non-Skin Malignancy within 8 Years Limited to Recipients without Malignancy Pre-Transplant Conditional on Survival to Transplant Discharge Pre-Transplant PA Mean Pressure p = (N = 5,179) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors for Developing CAV within 5 Years Conditional on Survival to Transplant Discharge VARIABLE NHazard Ratio P-value95% Confidence Interval OTK3 used for induction < AZA vs. MMF/MPA at discharge Pacemaker prior to discharge Rejection prior to discharge Cyclosporine vs. Tacrolimus at discharge < Donor history of hypertension N = 7,778 JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors for Developing CAV within 5 Years Conditional on Survival to Transplant Discharge (continued) VARIABLE NHazard Ratio P-value95% Confidence Interval Female recipient/female donor with prior pregnancy vs. male recipient/male donor Male recipient/female donor vs. male recipient/male donor Recipient history of malignancy Female recipient without prior pregnancy/ female donor vs. male recipient/male donor Diagnosis: Congenital vs. cardiomyopathy N = 7,778 JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors for Developing CAV within 5 Years Conditional on Survival to Transplant Discharge Continuous Factors (see figures) Recipient BMIDonor age Donor/recipient BSA ratio JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors for Developing CAV within 5 Years Conditional on Survival to Transplant Discharge Recipient BMI p = (N = 7,778) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors for Developing CAV within 5 Years Conditional on Survival to Transplant Discharge Donor BSA/Recipient BSA p = (N = 7,778) JHLT Oct; 32(10):

ADULT HEART TRANSPLANTS (2002-6/2007) Risk Factors for Developing CAV within 5 Years Conditional on Survival to Transplant Discharge Donor Age p < (N = 7,778) JHLT Oct; 32(10):

2013 Focus Theme: Age  Age distribution: slides and 208  Recipient characteristics by age: slides  Age mismatch: slides  Survival by age: slides  Age and immunosuppression: slides  Age and complications: slides  Age and cause of death: slides JHLT Oct; 32(10):

Adult Heart Transplants Donor and Recipient Age (Transplants: January 2006 – June 2012) JHLT Oct; 32(10):

Adult Heart Transplants Donor and Recipient Age (Transplants: January 2006 – June 2012) JHLT Oct; 32(10):

Adult Heart Transplants Diagnosis by Age Group (Transplants: January 2006 – June 2012) JHLT Oct; 32(10):

Adult Heart Transplants Recipient Age Distribution by Location (Transplants: January 2006 – June 2012) Mean/median recipient age: Europe = 50.2/53.0 North America = 52.2/55.0 Other = 47.2/50.0 JHLT Oct; 32(10):

Adult Heart Transplants Donor Age Distribution by Location (Transplants: January 2006 – June 2012) Mean/median donor age: Europe = 40.4/43.0 North America = 31.7/29.0 Other = 31.7/29.0 JHLT Oct; 32(10):

Adult Heart Transplants Donor and Recipient Characteristics by Recipient Age Group (Transplants: January 2006 – June 2012) (N = 4,053) (N = 11,632) (N = 6,287) 70+ (N = 346) p- value Donor age (years) 30.0 ( )35.0 ( )36.0 ( )36.0 ( )< Donor and recipient age difference (years) 2.0 ( )-17.0 ( )-28.0 ( )-35.0 ( )< Recipient BMI 22.6 ( )24.6 ( )25.0 ( )24.9 ( )< Donor BMI 24.8 ( )25.7 ( )25.7 ( )26.3 ( )< Recipient/donor gender (% male) 65.5%/ 67.1%76.5%/ 69.7%81.0%/ 69.5%89.9%/ 68.1% <0.0001/ Male recipient/ female donor 13.7%16.4%18.5%25.5%< Female recipient/ male donor 15.4%9.7%7.1%3.8%< Recipient prior cardiac surgery 38.7%44.6%52.9%53.8%< Continuous factors are expressed as median (5 th -95 th percentiles) JHLT Oct; 32(10):

Adult Heart Transplants Donor and Recipient Characteristics by Recipient Age Group (Transplants: January 2006 – June 2012) (N = 4,053) (N = 11,632) (N = 6,287) 70+ (N = 346) p- value Recipient previous malignancy 4.3%5.3%9.6%11.0%< Creatinine at time of transplant 1.0 ( )1.2 ( )1.3 ( )1.3 ( )< Pulmonary vascular resistance (Wood units) 2.0 ( )2.1 ( ) 2.1 ( ) Diagnosis Cardiomyopathy 74.3%54.8%40.5%36.7% < Coronary artery disease 7.3%37.4%53.4%57.1% Valvular 1.7%3.0%3.3%2.6% Retransplant 5.3%2.0%1.6%3.2% Congenital 9.9%1.9%0.5%0.0% Other causes 1.4%0.8%0.6%0.3% Continuous factors are expressed as median (5 th -95 th percentiles) (Cont’d) JHLT Oct; 32(10):

Adult Heart Transplants Donor and Recipient Characteristics by Recipient Age Group (Transplants: January 2006 – June 2012) (N = 4,053) (N = 11,632) (N = 6,287) 70+ (N = 346) p- value Pre-operative support (multiple items may be reported) Hospitalized at time of transplant 51.3%44.2%41.1%39.7%< On IV inotropes 45.6%41.6%42.1%39.9% LVAD 29.7%29.6%26.6%18.0%< IABP 6.5% 5.1%7.5% RVAD 5.7%4.0%2.3%1.3%< Ventilator 3.5%2.7%2.3%3.7% TAH 1.1% 0.6%0.0% ECMO 2.1%1.1%0.7%0.0%< (Cont’d) JHLT Oct; 32(10):

Adult Heart Transplants Recipient Age Distribution by Gender (Transplants: January 2006 – June 2012) JHLT Oct; 32(10):

Adult Heart Transplants % of Patients Bridged with Mechanical Circulatory Support* by Year, Age Group and Device Type * LVAD, RVAD, TAH. ECMO is excluded. JHLT Oct; 32(10):

Adult Heart Transplants Number of Combined Organ Transplants Reported by Year, Age and Type of Transplant JHLT Oct; 32(10):

Adult Heart Transplants Donor and Recipient Age (Transplants: January 2006 – June 2012) R 2 = 0.01, p < JHLT Oct; 32(10):

Adult Heart Transplants Donor and Recipient Age Difference (Transplants: January 2006 – June 2012) JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by Age Group (Transplants: January 1982 – June 2011) All pair-wise comparisons were significant at p < 0.01 JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by Age Group (Transplants: January 2006 – June 2011) No pair-wise comparisons were significant at p < 0.05 except vs : p = vs : p= JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by Age Group (Transplants: January 1982 – June 2011) No pair-wise comparisons with 75+ were significant at p < All other pair-wise comparisons were significant at p < 0.05 except vs and vs JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by Donor Age Group (Transplants: January 1982 – June 2011) All pair-wise comparisons were significant at p < 0.05 except 0-10 vs and 0-10 vs JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by Donor and Recipient Age Difference Recipient Age = years (Transplants: January 1982 – June 2011) All pair-wise comparisons with 0+ were significant at p < No other pair-wise comparisons were significant at p < JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by Donor and Recipient Age Difference Recipient Age = years (Transplants: January 1982 – June 2011) All pair-wise comparisons were significant at p < 0.05 except <-30 vs <-20 and <0 vs. 0+ JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by Donor and Recipient Age Difference Recipient Age = years (Transplants: January 1982 – June 2011) All pair-wise comparisons were significant at p < 0.05 except <-20 vs <-10, <-10 vs. 0+ and <0 vs. 0+ JHLT Oct; 32(10):

Adult Heart Transplants Kaplan-Meier Survival by Donor and Recipient Age Difference Recipient Age = 70+ years (Transplants: January 1982 – June 2011) No pair-wise comparisons were significant at p < 0.05 except <-10 vs <-20 JHLT Oct; 32(10):

Adult Heart Transplants Induction Immunosuppression by Age Group (Transplants: January 2005 – June 2012) Analysis is limited to patients who were alive at the time of the discharge JHLT Oct; 32(10):

Adult Heart Transplants Maintenance Immunosuppression at Time of 1 Year Follow-up by Age Group (Follow-ups: January 2006 – June 2012) Analysis is limited to patients who were alive at the time of the follow-up JHLT Oct; 32(10):

Adult Heart Transplants % of Recipients Experiencing Treated Rejection between Transplant Discharge and 1-Year Follow-Up by Type of Induction (Follow-ups: January 2005 – June 2012) Analysis is limited to patients who were alive at the time of the follow-up Treated rejection = Recipient was reported to (1) have at least one acute rejection episode that was treated with an anti-rejection agent; or (2) have been hospitalized for rejection. JHLT Oct; 32(10):

Adult Heart Transplants % of Recipients Experiencing Any Rejection between Transplant Discharge and 1-Year Follow-Up by Type of Induction (Follow-ups: January 2005 – June 2012) Analysis is limited to patients who were alive at the time of the follow-up Any rejection = Recipient was reported to (1) have at least one acute rejection episode; or (2) have been hospitalized for rejection. JHLT Oct; 32(10):

Adult Heart Transplants % of Recipients Experiencing Treated Rejection between Transplant Discharge and 1-Year Follow-Up by Maintenance Immunosuppression (Follow-ups: January 2005 – June 2012) Analysis is limited to patients who were alive at the time of the follow-up Treated rejection = Recipient was reported to (1) have at least one acute rejection episode that was treated with an anti-rejection agent; or (2) have been hospitalized for rejection. JHLT Oct; 32(10):

Adult Heart Transplants % of Recipients Experiencing Any Rejection between Transplant Discharge and 1-Year Follow-Up by Maintenance Immunosuppression (Follow-ups: January 2005 – June 2012) Analysis is limited to patients who were alive at the time of the follow-up Any rejection = Recipient was reported to (1) have at least one acute rejection episode; or (2) have been hospitalized for rejection. JHLT Oct; 32(10):

Adult Heart Transplants Freedom from Cardiac Allograft Vasculopathy by Age Group (Transplants: April 1994 – June 2011) No pair-wise comparisons were significant at p < 0.05 JHLT Oct; 32(10):

Adult Heart Transplants Freedom From Severe Renal Dysfunction* by Age Group (Transplants: April 1994 – June 2011) All pair-wise comparisons were significant at p < 0.05 except vs. 70+ and vs. 70+ * Severe renal dysfunction = Creatinine > 2.5 mg/dl (221 μmol/L), dialysis or renal transplant JHLT Oct; 32(10):

Adult Heart Transplants Freedom from Malignancy by Age Group (Follow-ups: April 1994 – June 2012) All pair-wise comparisons were significant at p < except vs. 70+ (p=0.9554) JHLT Oct; 32(10):

Adult Heart Transplants Freedom from Skin Malignancy by Age Group (Follow-ups: April 1994 – June 2012) All pair-wise comparisons were significant at p < except vs. 70+ (p=0.9999) JHLT Oct; 32(10):

Adult Heart Transplants Freedom from Lymphoma by Age Group (Follow-ups: April 1994 – June 2012) No pair-wise comparisons were significant at p < 0.05 except vs : p = vs : p = JHLT Oct; 32(10):

Adult Heart Transplants Freedom From Non Skin Malignancy by Age Group (Follow-ups: April 1994 – June 2012) All pair-wise comparisons were significant at p < 0.05 except vs. 70+ and vs. 70+ JHLT Oct; 32(10):

Adult Heart Transplants Cause of Death for Age = (Deaths: January 1994 – June 2012) CAUSE OF DEATH 0-30 Days (N = 749) 31 Days – 1 Year (N = 639) >1 Year – 3 Years (N = 614) >3 Years – 5 Years (N = 448) >5 Years – 10 Years (N = 867) >10 Years – 15 Years (N = 555) >15 Years (N = 372) Cardiac Allograft Vasculopathy 9 (1.2%)36 (5.6%)86 (14.0%)83 (18.5%)195 (22.5%)141 (25.4%)73 (19.6%) Acute Rejection52 (6.9%)129 (20.2%)130 (21.2%)55 (12.3%)37 (4.3%)13 (2.3%)8 (2.2%) Lymphoma08 (1.3%)6 (1.0%)12 (2.7%)35 (4.0%)23 (4.1%)12 (3.2%) Malignancy, Other09 (1.4%)8 (1.3%)18 (4.0%)65 (7.5%)53 (9.5%)42 (11.3%) CMV07 (1.1%)1 (0.2%) 000 Infection, Non-CMV69 (9.2%)120 (18.8%)45 (7.3%)31 (6.9%)52 (6.0%)43 (7.7%)30 (8.1%) Graft Failure302 (40.3%)153 (23.9%)199 (32.4%)163 (36.4%)271 (31.3%)151 (27.2%)95 (25.5%) Technical63 (8.4%)14 (2.2%)3 (0.5%)2 (0.4%)16 (1.8%)7 (1.3%)1 (0.3%) Other49 (6.5%)62 (9.7%)68 (11.1%)35 (7.8%)77 (8.9%)38 (6.8%)31 (8.3%) Multiple Organ Failure111 (14.8%)58 (9.1%)31 (5.0%)23 (5.1%)48 (5.5%)39 (7.0%)30 (8.1%) Renal Failure2 (0.3%)4 (0.6%)2 (0.3%)8 (1.8%)24 (2.8%)19 (3.4%)26 (7.0%) Pulmonary26 (3.5%)18 (2.8%)24 (3.9%)10 (2.2%)21 (2.4%)10 (1.8%)12 (3.2%) Cerebrovascular66 (8.8%)21 (3.3%)11 (1.8%)7 (1.6%)26 (3.0%)18 (3.2%)12 (3.2%) Total N of Deaths , Percentages represent % of deaths in the respective time period. Total number of deaths includes deaths with unknown causes. JHLT Oct; 32(10):

Adult Heart Transplants Cause of Death for Age = (Deaths: January 1994 – June 2012) CAUSE OF DEATH 0-30 Days (N = 2,995) 31 Days – 1 Year (N = 2,458) >1 Year – 3 Years (N = 1,816) >3 Years – 5 Years (N =1,682) >5 Years – 10 Years (N = 4,587) >10 Years – 15 Years (N = 3,182) >15 Years (N = 1,700) Cardiac Allograft Vasculopathy 48 (1.6%)106 (4.3%)248 (13.7%)259 (15.4%)671 (14.6%)453 (14.2%)202 (11.9%) Acute Rejection147 (4.9%)233 (9.5%)163 (9.0%)65 (3.9%)76 (1.7%)29 (0.9%)9 (0.5%) Lymphoma2 (0.1%)32 (1.3%)47 (2.6%)56 (3.3%)176 (3.8%)108 (3.4%)50 (2.9%) Malignancy, Other4 (0.1%)59 (2.4%)224 (12.3%)331 (19.7%)998 (21.8%)689 (21.7%)346 (20.4%) CMV1 (0.0%)31 (1.3%)9 (0.5%)4 (0.2%)3 (0.1%)2 (0.1%)0 Infection, Non-CMV382 (12.8%)757 (30.8%)221 (12.2%)165 (9.8%)489 (10.7%)332 (10.4%)211 (12.4%) Graft Failure1,160 (38.7%)412 (16.8%)492 (27.1%)357 (21.2%)794 (17.3%)524 (16.5%)255 (15.0%) Technical221 (7.4%)33 (1.3%)15 (0.8%)17 (1.0%)57 (1.2%)47 (1.5%)26 (1.5%) Other183 (6.1%)182 (7.4%)140 (7.7%)128 (7.6%)370 (8.1%)213 (6.7%)143 (8.4%) Multiple Organ Failure538 (18.0%)376 (15.3%)102 (5.6%)105 (6.2%)292 (6.4%)247 (7.8%)155 (9.1%) Renal Failure17 (0.6%)23 (0.9%)28 (1.5%)57 (3.4%)268 (5.8%)256 (8.0%)137 (8.1%) Pulmonary83 (2.8%)83 (3.4%)56 (3.1%)81 (4.8%)194 (4.2%)135 (4.2%)80 (4.7%) Cerebrovascular209 (7.0%)131 (5.3%)71 (3.9%)57 (3.4%)199 (4.3%)147 (4.6%)86 (5.1%) Total N of Deaths3,4052,7852,1882,0465,6474,0932,200 Percentages represent % of deaths in the respective time period. Total number of deaths includes deaths with unknown causes. JHLT Oct; 32(10):

Adult Heart Transplants Cause of Death for Age = (Deaths: January 1994 – June 2012) CAUSE OF DEATH 0-30 Days (N = 1,501) 31 Days – 1 Year (N = 1,385) >1 Year – 3 Years (N = 838) >3 Years – 5 Years (N = 734) >5 Years – 10 Years (N = 1,803) >10 Years – 15 Years (N = 1,014) >15 Years (N = 362) Cardiac Allograft Vasculopathy 19 (1.3%)28 (2.0%)74 (8.8%)62 (8.4%)153 (8.5%)80 (7.9%)24 (6.6%) Acute Rejection51 (3.4%)77 (5.6%)37 (4.4%)20 (2.7%)26 (1.4%)5 (0.5%)0 Lymphoma1 (0.1%)16 (1.2%)25 (3.0%)30 (4.1%)64 (3.5%)18 (1.8%)7 (1.9%) Malignancy, Other041 (3.0%)170 (20.3%)205 (27.9%)463 (25.7%)254 (25.0%)71 (19.6%) CMV2 (0.1%)13 (0.9%)5 (0.6%)1 (0.1%)3 (0.2%)1 (0.1%)0 Infection, Non-CMV230 (15.3%)503 (36.3%)139 (16.6%)83 (11.3%)235 (13.0%)120 (11.8%)36 (9.9%) Graft Failure583 (38.8%)203 (14.7%)151 (18.0%)116 (15.8%)249 (13.8%)117 (11.5%)54 (14.9%) Technical93 (6.2%)25 (1.8%)5 (0.6%)6 (0.8%)13 (0.7%)5 (0.5%)4 (1.1%) Other70 (4.7%)73 (5.3%)56 (6.7%)63 (8.6%)124 (6.9%)74 (7.3%)23 (6.4%) Multiple Organ Failure278 (18.5%)239 (17.3%)59 (7.0%)49 (6.7%)161 (8.9%)99 (9.8%)44 (12.2%) Renal Failure10 (0.7%)16 (1.2%)18 (2.1%)26 (3.5%)115 (6.4%)116 (11.4%)58 (16.0%) Pulmonary49 (3.3%)72 (5.2%)52 (6.2%)38 (5.2%)96 (5.3%)49 (4.8%)16 (4.4%) Cerebrovascular115 (7.7%)79 (5.7%)47 (5.6%)35 (4.8%)101 (5.6%)76 (7.5%)25 (6.9%) Total N of Deaths1,6721, ,2171, Percentages represent % of deaths in the respective time period. Total number of deaths includes deaths with unknown causes. JHLT Oct; 32(10):

Adult Heart Transplants Cause of Death for Age = 70+ (Deaths: January 1994 – June 2012) CAUSE OF DEATH 0-30 Days (N = 52) 31 Days – 1 Year (N = 65) >1 Year – 3 Years (N = 39) >3 Years – 5 Years (N = 26) >5 Years – 10 Years (N = 58) >10 Years (N = 25) Cardiac Allograft Vasculopathy 1 (1.9%)2 (3.1%)5 (12.8%)2 (7.7%)1 (1.7%)1 (4.0%) Acute Rejection1 (1.9%)3 (4.6%)4 (10.3%)000 Malignancy, non Lymphoma 02 (3.1%)6 (15.4%)9 (34.6%)16 (27.6%)6 (24.0%) Infection, Non-CMV9 (17.3%)22 (33.8%)7 (17.9%)4 (15.4%)5 (8.6%)2 (8.0%) Graft Failure18 (34.6%)12 (18.5%)3 (7.7%)5 (19.2%)9 (15.5%)5 (20.0%) Technical5 (9.6%)0004 (6.9%)2 (8.0%) Other2 (3.8%)2 (3.1%)4 (10.3%)1 (3.8%)6 (10.3%)1 (4.0%) Multiple Organ Failure11 (21.2%)15 (23.1%)6 (15.4%)2 (7.7%)4 (6.9%)1 (4.0%) Renal Failure02 (3.1%)007 (12.1%)5 (20.0%) Pulmonary2 (3.8%)3 (4.6%)2 (5.1%)1 (3.8%)2 (3.4%)1 (4.0%) Cerebrovascular3 (5.8%)2 (3.1%)2 (5.1%)2 (7.7%)4 (6.9%)1 (4.0%) Total N of Deaths Percentages represent % of deaths in the respective time period. Total number of deaths includes deaths with unknown causes. JHLT Oct; 32(10):

Adult Heart Transplants Cumulative Incidence of Leading Causes of Death Age Group = Years (Transplants: January 2005 – June 2011) JHLT Oct; 32(10):

Adult Heart Transplants Cumulative Incidence of Leading Causes of Death Age Group = Years (Transplants: January 2005 – June 2011) JHLT Oct; 32(10):

Adult Heart Transplants Cumulative Incidence of Leading Causes of Death Age Group = Years (Transplants: January 2005 – June 2011) JHLT Oct; 32(10):

Adult Heart Transplants Cumulative Incidence of Leading Causes of Death Age Group = 70+ Years (Transplants: January 2005 – June 2011) JHLT Oct; 32(10):