1. THE AUSTRALIA AND NEW ZEALAND CARDIOTHORACIC ORGAN TRANSPLANT REGISTRY
TWENTIETH ANNUAL REPORT
1984 – 2015
ANZCOTR 2015

2. NUMBER OF ALL TRANSPLANT TYPES BY YEAR 1984 - 2015
ANZCOTR 2015

3. NUMBER OF ALL TRANSPLANTS* 1984 - 2015
*Includes domino, heterotopic and retransplants
ANZCOTR 2015

4. ALL HEART TRANSPLANTS BY HOSPITAL 1984 - 2015

5. HEART LUNG TRANSPLANTS BY HOSPITAL 1986 - 2015
Prince Charles 2005 figure includes one retransplant
ANZCOTR 2015

6. SINGLE LUNG TRANSPLANTS BY HOSPITAL 1990 - 2015
ANZCOTR 2015

7. BILATERAL LUNG TRANSPLANTS BY HOSPITAL 1992 - 2015
Includes retransplants
ANZCOTR 2015

8. COMBINED WAITING LIST ACTIVITY 2015
HEARTS TOTAL
LUNGS TOTAL
Active as at 1 January 2015 68
124
New Additions during 2015
117
230
From on hold to Active from 2014 17 23
Removals from Waiting List (Permanent)
W1 - Transplant Performed
106
218
W2 - Patients condition Improved 1 4
W3 - Too ill, new dev of contraindications etc 8 14
W4 - Patient declined 2
W5 - Transferred to another interstate list
W6 - Died waiting 5 9
W7-Removed - unspecified 3
TOTAL at Year end - (Active) 31 December 2015 59 90
Total at month end inactive - (On HOLD) 37
*Contains complete calendar year activity from all Registry Participant Centres. NB lungs column includes heart/lung procedures
ANZCOTR 2015

9. MEAN WAIT TIME IN DAYS TO TRANSPLANT BY TRANSPLANT TYPE BY RECIPIENT ABO TYPE 2015*
These figures relate to Transplants performed in the calendar year 2015 only
** Too few cases to calculate a standard deviation
ANZCOTR 2015

10. PRE TRANSPLANT DIAGNOSIS HEART 1984 - 2015
ANZCOTR 2015

11. PRE TRANSPLANT DIAGNOSIS 1984 - 2015 n = 2585
ANZCOTR 2015

12. PRE-TRANSPLANT STATUS HEARTS 1996 -2015
ANZCOTR 2015

13. PRE-TRANSPLANT STATUS HEARTS 1993 - 2015
ANZCOTR 2015

14. DONOR / RECIPIENT STATE OF ORIGIN HEARTS 1984 - 2015
Number
ANZCOTR 2015

15. DONOR / RECIPIENT STATE OF ORIGIN HEARTS 1984 - 2015
ANZCOTR 2015

16. Mean Waiting Time to Transplant HEARTS 1984 - 2015
DAYS
YEAR
ANZCOTR 2015

17. WAITING DAYS TO HEART TRANSPLANT 1984-2015
year n
mean
std dev + -
median
min-max
1984 14 44 77 10
4-295
1985 19 46 54
3-209
1986 32 67 76 37
3-295
1987 30 61 80 40
3-424
1988 56
102 33
1-400
1989 93 86 87
1-445
1990
103 99
154 35
1-842
1991
126 57
1-633
1992
115
119 51
1-790
1993
114
116
127 78
1-626
1994
104
192
219
128
1-999*
1995
108
203
236
107
3-999*
1996
171
200 92
2-999*
1997
105
228
265
1998 82
185
117
1999 75
260
133
2000 70
196
227
120
2001
177
212 88
2002
148 64
2003
143
162 91
1-782
2004
134
176
1-908
2005 89
159
169
113
2-792
2006 79
150
155
2-764
2007 63
163
180
125
1-974
2008
174
1-976
2009 68
147
132
5-565
2010 74
232 97
0-999*
2011
165
1-586
2012 84
202
213
139
2-1181
2013
225
298
0-1668
2014 95
197
279 96
0-1638
2015
194
123
0-1027
ANZCOTR 2015
Due to limitations in the software, values over 1000 , until 2012, are represented as 999

18. Mean Recipient Age at Transplant HEARTS 1984 -2015
Age(yrs)
Year
ANZCOTR 2015

19. RECIPIENT AGE AT HEART TRANSPLANT YEARS 1984 - 2015
mean
std dev + -
median
min-max
1984 14 33 15 39
11-51
1985 19 13 38
10-54
1986 32 40 43
11-57
1987 30 41 12 46
13-56
1988 56 45
4-63
1989 93 42
1-65
1990
103 47
6-65
1991 52
1-64
1992
115 51
4-66
1993
114
1994
104 50
1-66
1995
108 16
2-68
1996 48 53
10-64
1997
105
9-66
1998 82
1999 75
2-67
2000 70 49
12-66
2001 80
2-64
2002 18
7-70
2003 88
1-67
2004 76
2005 89
5-65
2006 79 17
3-67
2007 66
5-71
2008
6-67
2009 68
1-69
2010 74
5-70
2011
5-72
2012 84
2013
1-70
2014 95
2015
102 20
1-72
ANZCOTR 2015

20. Hearts Mean Donor Age
Age in years
Year
ANZCOTR 2015

21. DONOR AGE HEARTS - YEARS 1984-2015
ANZCOTR 2015

22. HEARTS – Mean Cold Ischemic Time 1984 - 2015
Minutes
Year
ANZCOTR 2015

23. MEAN COLD HEART ISCHEMIC TIME - MINUTES 1984-2015
year n
mean
std dev +-
median
min-max
1984 14 74 16 70
54-108
1985 19
114 41 95
53-183
1986 32
136 47
133
80-235
1987 30
151 45
155
60-260
1988 56
152 44
158
78-240
1989 93
150 57
147
39-311
1990
103
165
144
54-441
1991
178 80
163
55-390
1992
115
183 76
164
52-420
1993
207 82
198
41-446
1994
104
193 75
190
75-445
1995
108
208 98
186
42-465
1996
201 79
177
60-405
1997
105
211 90
194
60-454
1998
240
213
74-612
1999
236
101
244
43-447
2000
247 89
242
2001
265
102
253
2002
237
224
2003 88
258
268
2004 87
239
88-427
2005 91
59-491
2006
246 84
238
2007 66
248
73-510
2008 86
252
2009 68
231
227
90-254
2010
229
226
94-390
2011
2012 67
59-448
2013
225
209
70-470
2014
234
230
59-482
2015 99
64-412
ANZCOTR 2015

24. ACTUARIAL SURVIVAL - HEART TRANSPLANT 1984 - 2015
n* = Number alive at start of year
ANZCOTR 2015

25. ACTUARIAL SURVIVAL - HEART TRANSPLANT 1984 - 2015
Percent Survival
YEAR
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ANZCOTR 2015

26. ACTUARIAL SURVIVAL – ORTHOTOPIC v HETEROTOPIC v DOMINO v RETRANSPLANTS 1984 - 2015
ANZCOTR 2015

27. Actuarial Survival Orthotopic v Heterotopic v Domino Hearts v Retransplant 1984 - 2015
Percent Survival
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ANZCOTR 2015

28. ACTUARIAL SURVIVAL ALL HEARTS PERIOD COMPARISON 1984 – 2015
v p<0.05
v p<0.05
Percent Survival
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ANZCOTR 2015

29. ACTUARIAL SURVIVAL HEARTS PERIOD COMPARISON 1984 - 2015
*N = NUMBER ALIVE AT START OF YEAR
ANZCOTR 2015

30. ACTUARIAL SURVIVAL PRE TRANSPLANT DIAGNOSIS 1984 - 2015
IDCM v IHD p<0.005
IHD v Others p<0.005
Percent
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ANZCOTR 2015

31. ACTUARIAL SURVIVAL PRE TRANSPLANT DIAGNOSIS HEARTS 1984 – 2015
ANZCOTR 2015

32. ACTUARIAL SURVIVAL PRE-TRANSPLANT STATUS HEARTS 1984 - 2015
p=ns
Percent
Survival
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ANZCOTR 2015

33. ACTUARIAL SURVIVAL PRE-TRANSPLANT STATUS HEARTS 1984 - 2015
ANZCOTR 2015

34. ACTUARIAL SURVIVAL RECIPIENT AGE BY GENDER HEARTS 1984 - 2015
*N= NUMBER ALIVE AT START OF YEAR
ANZCOTR 2015

35. ACTUARIAL SURVIVAL BY RECIPIENT AGE AND GENDER HEARTS 1984 - 2015
Percent Survival
MALES 0-39 yrsv MALES>39yrs p<0.005
MALES>39yrs v FEMALES>39yrs p <0.05
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ANZCOTR 2015

36. ACTUARIAL SURVIVAL RECIPIENT AGE HEARTS 1984 - 2015
60+ v all groups p=<0.001
50 to 59 v 0 to p=<0.05
50 to 59 v 17 to 39 p=<0.001
50 to 59 v 40 to 49 p=<0.05
Percent Survival
YEAR
2 OF THE 11 CASES IN THE GREATER THAN 59 YEARS CATEGORY ARE HETEROTOPIC HEART TRANSPLANTS
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ANZCOTR 2015

37. ACTUARIAL SURVIVAL RECIPIENT AGE HEARTS 1984 - 2015*
ANZCOTR 2015
* 2 OF THE 16 CASES IN THE GREATER THAN 59 YEARS CATEGORY ARE HETEROTOPIC HEART TRANSPLANTS

38. ACTUARIAL SURVIVAL DONOR AGE HEARTS 1984 - 2015*
ANZCOTR 2015
* 2 OF THE 16 CASES IN THE GREATER THAN 59 YEARS CATEGORY ARE HETEROTOPIC HEART TRANSPLANTS

39. ACTUARIAL SURVIVAL DONOR AGE HEARTS 1984 - 2015
0-16yrs v 40-49yrs p<0.001
0-16yrs v 50-59yrs p<0.005
17-39yrs v 40-49yrs p<0.001
17-39yrs v 50-59yrs p<0.009
Percent Survival
YEAR
2 OF THE 11 CASES IN THE GREATER THAN 59 YEARS CATEGORY ARE HETEROTOPIC HEART TRANSPLANTS
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ANZCOTR 2015

40. ACTUARIAL SURVIVAL DONOR GENDER HEARTS 1984 - 2015
ANZCOTR 2015

41. ACTUARIAL SURVIVAL DONOR GENDER HEARTS 1984 - 2015
p=ns
Percent Survival
An excellent addition this year would be a graph of age and gender survival - to prove or disprove the point eg that females >55 are dreadful donors are are males >50 (my observation)
Year
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ANZCOTR 2015

42. ACTUARIAL SURVIVAL DONOR AGE AND DONOR GENDER HEARTS 1984 - 2015
Percent Survival
Year
Females 0-55 n=786, Females 56+ n=43, Males 0-50=1580, Males 51+ n=151
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ANZCOTR 2015

43. ACTUARIAL SURVIVAL RECIPIENT GENDER HEARTS 1984 - 2015
ANZCOTR 2015

44. ACTUARIAL SURVIVAL RECIPIENT GENDER HEARTS 1984 - 2015
Percent Survival
p=ns
Year
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ANZCOTR 2015

45. ACTUARIAL SURVIVAL ISCHEMIC TIME HEARTS 1984 - 2015
ANZCOTR 2015

46. ACTUARIAL SURVIVAL ISCHEMIC TIME HEARTS 1984 - 2015
p=ns
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ANZCOTR 2015

47. ACTUARIAL SURVIVAL CROSSMATCH HEARTS 1984 - 2015
ANZCOTR 2015

48. ACTUARIAL SURVIVAL CROSSMATCH HEARTS 1984 - 2015
p < 0.01
Percent Survival
Year
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ANZCOTR 2015

49. ACTUARIAL SURVIVAL PEAK PANEL REACTIVE ANTIBODIES ALL HEARTS 1984 - 2015
ANZCOTR 2015

50. ACTUARIAL SURVIVAL PEAK PRA ALL HEARTS 1984 - 2015
p=ns
Percent Survival
Year
ANZCOTR 2015
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel

51. ACTUARIAL SURVIVAL CMV IgG SEROLOGICAL STATUS HEARTS 1984 - 2015
ANZCOTR 2015

52. ACTUARIAL SURVIVAL CMV IgG SEROLOGICAL STATUS HEARTS 1984 - 2015
p=ns
Percent Survival
Year
R+ve = R+veD+ve or R+veD-ve
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ANZCOTR 2015

53. ACTUARIAL SURVIVAL HLA MISMATCH HEARTS 1984 - 2015
ANZCOTR 2015

54. ACTUARIAL SURVIVAL HLA MISMATCH HEARTS 1984 - 2015
p<0.05
Percent Survival
Year
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ANZCOTR 2015

55. ACTUARIAL SURVIVAL HLA DR LOCUS MISMATCH HEARTS 1984 - 2015
ANZCOTR 2015

56. ACTUARIAL SURVIVAL HLA DR LOCUS MISMATCH HEARTS 1984 - 2015
p= ns
Percent Survival
Year
ANZCOTR 2015
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel

57. ACTUARIAL SURVIVAL MALIGNANCIES HEART 1984 - 2015
*Survival of the group who were defined by having developed a malignancy
ANZCOTR 2015

58. ACTUARIAL SURVIVAL MALIGNANCIES HEARTS 1984 - 2015
Percent Survival
ptld v other mal p=<0.005
Year
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ANZCOTR 2015

59. RECIPIENT CAUSE OF DEATH - HEARTS 1984 - 2015 n = 1249
29%
No of Deaths
17%
14%
15% 9% 7% 4% 4% 1%
TxCAD
Misc
Infection
Acute Rejection
Other Malignancies
NSGF
PTLD
CVA
Hemorrhage
ANZCOTR 2015

60. CAUSE OF DEATH HEARTS
ANZCOTR 2015

61. CAUSE OF DEATH ALL HEARTS <5 YEARS AFTER TX 1984-2015No %
Infection
127 24
Misc (incl 6 no data ) 98 18
Rejection 91 17
Non Specific Graft Failure 70 13
Graft Atherosclerosis (TxCAD) 58 11
Non Lymphoid Malignancy 31 6
Lymphoproliferative Disease (PTLD) 2
CVA 20 4
Haemorrhage
Graft Atherosclerosis & Rejection 9
1.5
Pulmonary Failure 1
Pulmonary Hypertension .5
Totals
538
100.0
ANZCOTR 2015

62. CAUSE OF DEATH ALL HEARTS ≥5 YEARS AFTER TX 1984-2015
 No  %
Misc (incl 18 data pending)
232 33
Graft Atherosclerosis (TxCAD)
153 22
Non Lymphoid Malignancy
158
Infection 56 8
Lymphoproliferative Disease (PTLD) 32 4
Rejection 21 3
CVA 23
Non Specific Graft Failure 18 2
Pulmonary Failure 6 1
Haemorrhage
0.5
Graft Atherosclerosis & Rejection
Pulmonary Hypertension
Totals
711
100.0
ANZCOTR 2015

63. MALIGNANCIES* - HEART n = 676 1984 - 2015
PTLD 15 %
Other 85 %
*Only then the forst diagnosis is counted
ANZCOTR 2015

64. MALIGNANCIES - HEART N=676 1984 - 2015
ANZCOTR 2015

65. Reason for Transplant Heart Lung 1986 – 2015 n=189
ANZCOTR 2015

66. REASON FOR TRANSPLANT HEART LUNG n = 189 1986 - 2015
Primary Pulmonary Hypertension
Eisenmenger's Syndrome
Congenital Heart Disease
Cystic Fibrosis
Alpha-1-Antitrypsin Deficiency
Emphysema
Cryptogenic Fibrosing Alveolitis
Other Pulmonary Hypertension
Bronchiectasis
Miscellaneous
Total
ANZCOTR 2015

67. Reason for Transplant Single Lung 1990 – 2015 n=498
ANZCOTR 2015

68. REASON FOR TRANSPLANT SINGLE LUNG 1990 - 2015 n = 498
ANZCOTR 2015

69. Reason for Transplant Bilateral Lung 1992 – 2015 n=2125
ANZCOTR 2015

70. REASON FOR TRANSPLANT BILATERAL LUNG 1992 - 2015 n = 2125
ANZCOTR 2015

71. Donor / Recipient State of Origin All Lungs 1986 - 2015
Number
ANZCOTR 2015
*Retransplants and unknown state of origins are not included

72. DONOR / RECIPIENT STATE OF ORIGIN ALL LUNGS 1986 - 2015
*Retransplants and unknown state of origins are not included
ANZCOTR 2015

73. Mean Wait to Transplant All Lungs 1990 - 2015
Days
Year
ANZCOTR 2015

74. MEAN WAITING TIME TO LUNG TRANSPLANT – DAYS 1990 - 2015
A total of 50 patients waited longer than 1000 days and were included in the above analysis as 999 days (due to limitations in the software)
ANZCOTR 2015

75. Mean Recipient Age at Transplant LUNGS 1989 - 2015
Age in Years
ANZCOTR 2015

76. MEAN RECIPIENT AGE AT LUNG TRANSPLANT 1989 - 2015
ANZCOTR 2015

77. Mean Donor Age at Transplant ALL LUNGS 1989 - 2015
Years of Age
ANZCOTR 2015

78. MEAN DONOR AGE AT TRANSPLANT LUNGS 1989 - 2015
ANZCOTR 2015

79. LUNGS MEAN COLD ISCHEMIC TIME 1989 - 2015
Minutes
ANZCOTR 2015

80. LUNGS - MEAN COLD ISCHEMIC TIME 1989 - 2015 MINUTES
ANZCOTR 2015

81. Recipient Gender % Lung Transplants 1986 - 2015
ANZCOTR 2015

82. Recipient Gender Lung Transplants 1986 - 2015
ANZCOTR 2015

83. ACTUARIAL SURVIVAL ALL LUNGS 1986 - 2015
ANZCOTR 2015

84. ACTUARIAL SURVIVAL ALL LUNG TRANSPLANTS 1986 - 2015
SL v HL p<0.005
SL v BL p<0.005
Percent Survival
Year
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ANZCOTR 2015

85. ACTUARIAL SURVIVAL DCD DONORS V DBD DONORS 2006 - 2015
Percent Survival
p=ns
Year
ANZCOTR 2015
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel

86. ACTUARIAL SURVIVAL DCD DONORS v DBD DONORS 2006 - 2015
ANZCOTR 2015

87. ACTUARIAL SURVIVAL RECIPIENT AGE ALL LUNGS* 1986 - 2015
ANZCOTR 2015
* Single, Bilateral and Heart Lung procedures all combined

88. ACTUARIAL SURVIVAL RECIPIENT AGE ALL LUNGS 1984 - 2015
17-39 v p = <0.00
17-39 v > p = <0.005
17-39 v p = <0.05
40-49 v p = <0.05
60+ v p = <0.05
Percent Survival
YEAR
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ANZCOTR 2015

89. ACTUARIAL SURVIVAL DONOR AGE ALL LUNGS 1986 - 2015
Percent Survival
0-16 yrs vs 40-49yrs p<0.05
17-39yrs vs 40-49yrs p<0.05
YEAR
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ANZCOTR 2015

90. ACTUARIAL SURVIVAL DONOR AGE ALL LUNGS 1986 – 2015
ANZCOTR 2015

91. ACTUARIAL SURVIVAL ISCHEMIC TIME ALL LUNGS 1986 - 2015
ANZCOTR 2015

92. ACTUARIAL SURVIVAL ISCHEMIC TIME ALL LUNGS 1986 - 2015
p=ns
Percent Survival
Year
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ANZCOTR 2015

93. ACTUARIAL SURVIVAL CROSSMATCH ALL LUNGS 1986 - 2015
ANZCOTR 2015

94. ACTUARIAL SURVIVAL CROSSMATCH LUNGS 1986 - 2015
Percent Survival
p=ns
Year
ANZCOTR 2015
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel

95. ACTUARIAL SURVIVAL CMV STATUS ALL LUNGS 1986 - 2015
ANZCOTR 2015

96. ACTUARIAL SURVIVAL CMV STATUS ALL LUNGS 1986 - 2015
R-D+ vs R+ p<0.05
Percent Survival
Years
R+ve = R+ve/D+ve or R+ve/D-ve
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ANZCOTR 2015

97. ACTUARIAL SURVIVAL HLA MISMATCH ALL LUNGS 1986 - 2015
ANZCOTR 2015

98. ACTUARIAL SURVIVAL HLA MISMATCH ALL LUNGS 1986 – 2015
MM0-1 v MM p<0.05
MM0-1 v MM p<0.05
Percent Survival
Years
ANZCOTR 2015
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel

99. ACTUARIAL SURVIVAL HLA DR LOCUS MISMATCH ALL LUNGS 1986 -2015
p=ns
Percent Survival
Years
ANZCOTR 2015
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel

100. ACTUARIAL SURVIVAL HLA DR LOCUS MISMATCH ALL LUNGS 1986 – 2015
ANZCOTR 2015

101. CAUSE OF DEATH - ALL LUNGS 1986 - 2015
ANZCOTR 2015

102. CAUSE OF DEATH - LUNGS 1986 - 2015 n = 1428
ANZCOTR 2015

103. CAUSE OF DEATH ALL LUNGS < 5 YEARS POST TX
ANZCOTR 2015