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2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. HEART TRANSPLANTATION Overall.

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Presentation on theme: "2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. HEART TRANSPLANTATION Overall."— Presentation transcript:

1 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. HEART TRANSPLANTATION Overall

2 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. NUMBER OF HEART TRANSPLANTS REPORTED BY YEAR * Numbers may be low due to delayed reporting. Number of Transplants *

3 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. HEART TRANSPLANTS: Donor Age by Year of Transplant

4 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. AGE DISTRIBUTION OF HEART RECIPIENTS (1982-2001) % of Trnsplants % of Transplants

5 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. AGE DISTRIBUTION OF HEART TRANSPLANT RECIPIENTS BY ERA 1985-19961997-2001

6 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. HEART TRANSPLANTATION Actuarial Survival (1982-2001) N=60,936 Half-life = 9.3 years Conditional Half-life = 11.8 years

7 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. HEART TRANSPLANTATION Adult Recipients

8 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. DIAGNOSIS IN ADULT HEART TRANSPLANTS

9 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART TRANSPLANTATION Actuarial Survival by Era (1982-2001) All comparisons significant at p < 0.002 Survival (%)

10 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART TRANSPLANTATION Actuarial Survival by Age Group (1982-2001) Survival (%) Survival comparisons All pair-wise comparisons are statistically significant at p < 0.05 except: 18-34 vs. 35-49 and 65-69 vs. 70+

11 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART RE-TRANSPLANTS 1-Year Survival 124170 32 29316495 35 8822 271

12 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART TRANSPLANTS (1996-2001) Risk Factors for 1 Year Mortality In Descending Order of Magnitude N=13,049

13 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART TRANSPLANTS (1996-2001) Risk Factors for 1 Year Mortality In Descending Order of Magnitude N=13,049

14 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART TRANSPLANTS (1996-2001) Risk Factors for 1 Year Mortality Continuous Factors N=13,049

15 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART TRANSPLANTS (1996-2001) Risk Factors for 1 Year Mortality Continuous Factors N=13,049

16 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART TRANSPLANTS (1996-2001) Risk Factors for 1 Year Mortality Continuous Factors N=13,049

17 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART TRANSPLANTS (1996-2001) Risk Factors for 1 Year Mortality Continuous Factors N=13,049

18 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART TRANSPLANTS (1996-2001) Factors Not Significant for 1 Year Mortality Year of Transplant In ICU or hospital prior to transplant On inotropes for life support ICD CMV mismatch Recipient pregnancy status Weight (donor or recipient) Height (donor) Donor clinical infection Donor cause of death

19 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART TRANSPLANTS (April 1994-December 1996) Risk Factors for 5 Year Mortality In Descending Order of Magnitude N=9,519

20 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART TRANSPLANTS (April 1994-December 1996) Risk Factors for 5 Year Mortality Continuous Factors N=9,519

21 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART TRANSPLANTS (April 1994-December 1996) Risk Factors for 5 Year Mortality Continuous Factors N=9,519

22 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART TRANSPLANTS (April 1994-December 1996) Risk Factors for 5 Year Mortality Continuous Factors N=9,519

23 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART TRANSPLANTS (April 1994-December 1996) Factors Not Significant for 5 Year Mortality Year of Transplant VAD/ECMO/IABP In ICU or hospital prior to transplant On inotropes for life support CMV mismatch Recipient pregnancy status Weight (donor or recipient) Height (donor) Donor clinical infection Donor history of hypertension

24 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART TRANSPLANTS (April 1994-December 1996) Risk Factors for 5 Year Mortality Conditional on Survival to 1 Year In Descending Order of Magnitude N=7,738

25 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART TRANSPLANTS (April 1994-December 1996) Risk Factors for 5 Year Mortality Conditional on Survival to 1 Year Continuous Factors N=7,738

26 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART TRANSPLANTS (April 1994-December 1996) Risk Factors for 5 Year Mortality Conditional on Survival to 1 Year Continuous Factors N=7,738

27 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART TRANSPLANTS (April 1994-December 1996) Risk Factors for 5 Year Mortality Conditional on Survival to 1 Year: Combination of Donor Age and Center Volume

28 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART TRANSPLANTS (April 1994-December 1996) Factors Not Significant for Conditional 5 Year Mortality Year of Transplant Any form of life support CMV mismatch Ischemia time Bilirubin Donor cause of death In ICU or hospital prior to tx Weight (donor or recipient) Height (donor or recipient) Gender (donor or recipient) Donor clinical infection Recipient pregnancy status

29 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART RECIPIENTS Functional Status (April 1994-December 2001)

30 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART RECIPIENTS Employment Status (U.S. Data: April 1994-December 2001)

31 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART RECIPIENTS Rehospitalization Post-transplant (April 1994 - December 2001)

32 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART RECIPIENTS Induction Immunosuppression For follow-ups between October 1999 and December 2001

33 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART RECIPIENTS Maintenance Immunosuppression at Any Time During Follow-up Period For follow-ups between October 1999 and December 2001

34 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART RECIPIENTS Maintenance Immunosuppression at Time of Follow-up For follow-ups between October 1999 and December 2001

35 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART RECIPIENTS Maintenance Immunosuppression at Time of Follow-up For follow-ups between October 1999 and December 2001 1 Year Follow-up (N = 3,165)5 Year Follow-up (N = 2,588)

36 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART RECIPIENTS Maintenance Immunosuppression at Time of Follow-up For follow-ups between October 1999 and December 2001

37 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. POST-HEART TRANSPLANT MORBIDITY FOR ADULTS Cumulative Incidence for Survivors (April 1994-December 2000)

38 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. Freedom from CAV and Freedom from Renal Dysfunction* For Adult Heart Recipients (April 1994-December 2000) * Renal dysfunction = Creatinine > 2.5 mg/dl, dialysis or renal transplant

39 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. MALIGNANCY POST-HEART TRANSPLANTATION FOR ADULTS Cumulative Incidence for Survivors (April 1994-December 2001) Malignancy/Type1-Year Survivors5-Year Survivors No Malignancy12,671 (96.6%)3,203 (81.8%) Malignancy (all types combined)443 (3.4%)712 (18.2%) Malignancy Type Skin184404 Lymph10763 Other103155 Lymph + Skin8 Lymph + Other13 Skin + Other34 Lymph + Skin + Other2 Type Not Reported4933

40 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. Freedom from Malignancy For Adult Heart Recipients (April 1994-December 2000)

41 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART TRANSPLANTATION Risk Factors for CAV Within 3 Years (April 1994 - December 1998) N=6,851

42 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART TRANSPLANTATION Risk Factors for CAV Within 3 Years (April 1994 - December 1998) Continuous Factors N=6,851

43 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART TRANSPLANTATION Risk Factors for CAV Within 3 Years (April 1994 - December 1998) Continuous Factors N=6,851

44 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART TRANSPLANTATION Risk Factors for CAV Within 7 Years (April 1994 - December 1995) N=2,546

45 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART TRANSPLANTATION Risk Factors for CAV Within 7 Years (April 1994 - December 1995) Continuous Factors N=2,546

46 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART TRANSPLANT RECIPIENTS: Cause of Death (1982-2001) Timing of Death

47 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART TRANSPLANTS RECIPIENTS: Cause of Death by Era: Deaths in 0-30 Days Year of Transplant

48 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART TRANSPLANTS RECIPIENTS: Cause of Death by Era: Deaths in 31 Days-1 Year Year of Transplant

49 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART TRANSPLANTS RECIPIENTS: Cause of Death by Era: Deaths in >1 Year - 3 Years Year of Transplant

50 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART TRANSPLANTS RECIPIENTS: Cause of Death by Era: Deaths in >3 Years - 5 Years Year of Transplant

51 2002 ISHLT J Heart Lung Transplant 2002; 21: 950-970. ADULT HEART TRANSPLANTS RECIPIENTS: Cause of Death by Era: Deaths in >5 Years Year of Transplant


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