Presentation is loading. Please wait.

Presentation is loading. Please wait.

HEART TRANSPLANTATION Overall ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781.

Similar presentations


Presentation on theme: "HEART TRANSPLANTATION Overall ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781."— Presentation transcript:

1 HEART TRANSPLANTATION Overall ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

2 NUMBER OF HEART TRANSPLANTS REPORTED BY YEAR ISHLT 2007 NOTE: This figure includes only the heart transplants that are reported to the ISHLT Transplant Registry. As such, this should not be construed as evidence that the number of hearts transplanted worldwide has declined in recent years. J Heart Lung Transplant 2007;26: 769-781

3 AVERAGE CENTER VOLUME Heart Transplants: January 1, 1992 - June 30, 1996 and January 1, 2002 – June 30, 2006 ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

4 DISTRIBUTION OF TRANSPLANTS BY CENTER VOLUME Heart Transplants : January 1, 1992 - June 30, 1996 and January 1, 2002 – June 30, 2006 ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

5 HEART TRANSPLANTS: Donor Age by Year of Transplant ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

6 AGE DISTRIBUTION OF HEART RECIPIENTS (1/1982-6/2006) % of Trnsplants % of Transplants ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

7 AGE DISTRIBUTION OF HEART TRANSPLANT RECIPIENTS BY ERA P < 0.0001 ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

8 HEART TRANSPLANTATION Kaplan-Meier Survival (1/1982-6/2005) ISHLT 2007 N at risk at 22 years: 33 HEART TRANSPLANTATION Kaplan-Meier Survival (1/1982-6/2005) J Heart Lung Transplant 2007;26: 769-781

9 HEART TRANSPLANTATION Adult Recipients ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

10 DIAGNOSIS IN ADULT HEART TRANSPLANTS ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

11 ADULT HEART TRANSPLANTS: RECIPIENT AGE DISTRIBUTION BY LOCATION Transplants between January 2000 and June 2006 ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

12 ADULT HEART TRANSPLANTS: DONOR AGE DISTRIBUTION BY LOCATION Transplants between January 2000 and June 2006 ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

13 ADULT HEART TRANSPLANTATION Kaplan-Meier Survival by Era (Transplants: 1/1982 – 6/2005) Survival (%) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

14 ADULT HEART TRANSPLANTATION Kaplan-Meier Survival by Age Group (Transplants: 1/1982-6/2005) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

15 ADULT HEART TRANSPLANTATION Kaplan-Meier Survival by Age Group (Transplants: 1/1998-6/2005) ISHLT 2007 HALF-LIFE 18-34: NA; 35-49: NA; 50-59: NA; 60-64: 8.3 years; 65-69: 8.1 years; 70+: 7.3 years J Heart Lung Transplant 2007;26: 769-781

16 ADULT HEART TRANSPLANTATION Kaplan-Meier Survival by Diagnosis (Transplants: 1/1982-6/2005) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

17 ADULT HEART TRANSPLANTATION Kaplan-Meier Survival by Diagnosis Conditional on Survival to 1 Year (Transplants: 1/1982-6/2005) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

18 ADULT HEART TRANSPLANTATION Kaplan-Meier Survival by Diagnosis (Transplants: 1/2000-6/2005) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

19 ADULT HEART TRANSPLANTATION Kaplan-Meier Survival by Diagnosis Conditional on Survival to 1 Year (Transplants: 1/2000-6/2005) ISHLT 2007 Cardiomyopathy vs. Re-TX: p =.006; Cardiomyopathy vs. Other: p =.02 ; CAD vs. Re-TX: p =.03; Congenital vs. Re-TX: p =.01; Valvular vs. Other: =.01; Re-TX vs. Other: p =.0003 J Heart Lung Transplant 2007;26: 769-781

20 ADULT HEART TRANSPLANTATION Kaplan-Meier Survival by PVR (Transplants: 1/2002-6/2005) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

21 ADULT HEART TRANSPLANTATION Kaplan-Meier Survival by VAD usage (Transplants: 1/1999-6/2005) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

22 ADULT HEART TRANSPLANTATION Kaplan-Meier Survival by VAD usage and Era (Transplants: 1/1999-6/2005) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

23 ADULT HEART TRANSPLANTS 1-Year Predicted Survival Model (Transplants: 1/2002-6/2005) Impact of Pre-Transplant VAD ISHLT 2007 Recipient: 54 y.o., Dx=cardiomyopathy, weight=78 kg, PVR=2.2, volume=22/year, bilirubin=0.8, PA systolic=40, creatinine=1.3 mg/dl, ischemia=180 min Donor: 30 y.o., weight = 77 kg J Heart Lung Transplant 2007;26: 769-781

24 ADULT HEART RE-TRANSPLANTS 1-Year Survival ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

25 ADULT HEART RECIPIENTS Functional Status of Surviving Recipients (Follow-ups: 1995 - June 2006) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

26 ADULT HEART RECIPIENTS Employment Status of Surviving Recipients (Follow-ups: 1995 - June 2006) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

27 ADULT HEART RECIPIENTS Rehospitalization Post-transplant of Surviving Recipients (Follow-ups: 1995 - June 2006) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

28 ADULT HEART RECIPIENTS Induction Immunosuppression (Transplants: January 2001 – June 2006) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

29 ADULT HEART RECIPIENTS Induction Immunosuppression (Transplants: 1995, 2000 and 2005) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

30 ADULT HEART TRANSPLANTATION Kaplan-Meier Survival by Induction Type (Transplants: 1/2000-6/2005, conditional on survival to 14 days) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

31 ADULT HEART RECIPIENTS Maintenance Immunosuppression at Time of Follow-up (Follow-ups: January 2003 - June 2006) NOTE: Different patients are analyzed in Year 1 and Year 5 ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

32 ADULT HEART RECIPIENTS Maintenance Immunosuppression at Time of 1 Year Follow-up NOTE: Different patients are analyzed in each time frame. ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

33 ADULT HEART RECIPIENTS Maintenance Immunosuppression Drug Combinations at Time of Follow-up (Follow-ups: January 2004 - June 2006) NOTES: Different patients are analyzed in Year 1 and Year 5. In the Year 1 cohort 73.9% of patients were on prednisone; in the Year 5 cohort 56.8% of patients were on prednisone. ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

34 ADULT HEART RECIPIENTS Maintenance Immunosuppression Drug Combinations at Time of Follow-up (Follow-ups: January 2004 - June 2006) NOTES: Different patients are analyzed in Year 1 and Year 5. ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

35 ADULT HEART RECIPIENTS Maintenance Immunosuppression Drug Combinations at Time of Follow-up For the Same Patients (Follow-ups: January 1999 - June 2006) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

36 PERCENTAGE OF ADULT HEART TRANSPLANT RECIPIENTS TREATED FOR REJECTION IN 1ST YEAR Stratified by Type of Induction (Transplants: January 1, 2000 - June 30, 2005) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

37 NUMBER OF REJECTION EPISODES FOR ADULT HEART TRANSPLANT RECIPIENTS TREATED FOR REJECTION IN 1ST YEAR Stratified by Type of Induction (Transplants: January 1, 2000 - June 30, 2005) Overall: no induction vs. OKT3 (p = 0.0017); polyclonal vs. OKT3 (p=0.0065); IL2 vs. OKT3 (p=0.0003). 18-44: no induction vs. IL2 (p = 0.037). 45-62: no induction vs. OKT3 (p = 0.0025); IL2 vs. OKT3 (p = 0.0034). 63+: polyclonal vs. OKT3 (p = 0.0228). For females: no induction vs. OKT3 (p = 0.0078); IL2 vs. OKT3 (p = 0.0466). For males: no induction vs. OKT3 (p =0.040); polyclonal vs. OKT3 (p=0.045); IL2 vs. OKT3 (p = 0.0022). ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

38 PERCENTAGE OF ADULT HEART TRANSPLANT RECIPIENTS TREATED FOR REJECTION IN 1ST YEAR Stratified by Maintenance Immunosuppression (Transplants: January 1, 2000 - June 30, 2005) Overall: p<0.0001 18-44: p<0.0001 Male: p<0.0001 ISHLT 2007 NOTE: There were 1,119 patients with cyclosporine+AZA and 138 with tacrolimus+AZA. These groups were excluded due to small numbers. J Heart Lung Transplant 2007;26: 769-781

39 NUMBER OF REJECTION EPISODES FOR ADULT HEART TRANSPLANT RECIPIENTS TREATED FOR REJECTION IN 1ST YEAR Stratified by Maintenance Immunosuppression (Transplants: January 1, 2000 - June 30, 2005) ISHLT 2007 NOTE: Cyclosporine+AZA and tacrolimus+AZA were excluded due to small numbers. J Heart Lung Transplant 2007;26: 769-781

40 ADULT HEART TRANSPLANTATION Kaplan-Meier Survival Stratified by Rejection Within 1 st Year Conditional on survival to 1 year for transplants: 1/1999-6/2004 ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

41 POST-HEART TRANSPLANT MORBIDITY FOR ADULTS Cumulative Prevalence in Survivors at 1 Year Post-Transplant (Follow-ups: April 1994 – December 1997 and January 2002 - June 2006) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

42 POST-HEART TRANSPLANT MORBIDITY FOR ADULTS Cumulative Prevalence in Survivors at 5 and 10 Years Post-Transplant (Follow-ups: April 1994 - June 2006) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

43 FREEDOM FROM CARDIAC ALLOGRAFT VASCULOPATHY AND FREEDOM FROM SEVERE RENAL DYSFUNCTION* For Adult Heart Recipients (Follow-ups: April 1994-June 2006) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

44 PATIENT SURVIVAL AFTER REPORT OF CAV AND PATIENT SURVIVAL IN PATIENTS WITHOUT CAV* (Transplants: April 1994-June 2004) ISHLT 2007 * Patients without CAV conditioned on survival to median time of CAV development (514 days) J Heart Lung Transplant 2007;26: 769-781

45 MALIGNANCY POST-HEART TRANSPLANTATION FOR ADULTS Cumulative Prevalence in Survivors (Follow-ups: April 1994 - June 2006) Malignancy/Type1-Year Survivors 5-Year Survivors 10-Year Survivors No Malignancy20441 (97.1%)7780 (84.9%)1264 (68.1%) Malignancy (all types combined)612 (2.9%)1389 (15.1%)592 (31.9%) Malignancy Type Skin282937360 Lymph14212738 Other132359108 Type Not Reported5639126 Other includes: prostate (11, 34, 17), adenocarcinoma (7, 4, 2), lung (5, 4, 1), bladder (4, 5, 4), sarcoma (3, 3, 1), breast (2, 8, 3), cervical (2, 4, 0), colon (2, 3, 1), and renal (2, 7, 2). Numbers in parentheses are those reported within 1 year, 5 years and 10 years, respectively. ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

46 FREEDOM FROM MALIGNANCY For Adult Heart Recipients (Follow-ups: April 1994 - June 2006) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

47 ADULT HEART TRANSPLANT RECIPIENTS: Cause of Death (Deaths: January 1992 - June 2006) CAUSE OF DEATH 0-30 Days (N = 3,006) 31 Days – 1 Year (N = 2,722) >1 Year – 3 Years (N = 2,135) >3 Years – 5 Years (N = 1,857) >5 Years – 10 Years (N = 4,054) >10 Years (N = 2,107) CARDIAC ALLOGRAFT VASCULOPATHY 52 (1.7%)127 (4.7%)298 (14.0%)299 (16.1%)581 (14.3%)309 (14.7%) ACUTE REJECTION193 (6.4%)338 (12.4%)220 (10.3%)82 (4.4%)69 (1.7%)26 (1.2%) LYMPHOMA2 (0.1%)54 (2.0%)85 (4.0%)96 (5.2%)195 (4.8%)73 (3.5%) MALIGNANCY, OTHER1 (0.0%)57 (2.1%)218 (10.2%)340 (18.3%)749 (18.5%)392 (18.6%) CMV4 (0.1%)34 (1.2%)16 (0.7%)3 (0.2%)5 (0.1%)1 (0.0%) INFECTION, NON-CMV393 (13.1%)896 (32.9%)276 (12.9%)180 (9.7%)442 (10.9%)213 (10.1%) PRIMARY FAILURE804 (26.7%)196 (7.2%)134 (6.3%)81 (4.4%)186 (4.6%)43 (2.0%) GRAFT FAILURE453 (15.1%)304 (11.2%)365 (17.1%)298 (16.0%)579 (14.3%)310 (14.7%) TECHNICAL233 (7.8%)28 (1.0%)17 (0.8%)17 (0.9%)36 (0.9%)20 (0.9%) OTHER162 (5.4%)175 (6.4%)187 (8.8%)147 (7.9%)339 (8.4%)175 (8.3%) MULTIPLE ORGAN FAILURE 356 (11.8%)268 (9.8%)117 (5.5%)102 (5.5%)309 (7.6%)190 (9.0%) RENAL FAILURE20 (0.7%)25 (0.9%)36 (1.7%)65 (3.5%)225 (5.6%)173 (8.2%) PULMONARY133 (4.4%)108 (4.0%)96 (4.5%)85 (4.6%)172 (4.2%)99 (4.7%) CEREBROVASCULAR 200 (6.7%)112 (4.1%)70 (3.3%)62 (3.3%)167 (4.1%)83 (3.9%) J Heart Lung Transplant 2007;26: 769-781 ISHLT

48 ADULT HEART TRANSPLANT RECIPIENTS: Cause of Death from Leading Causes by Era (Deaths: January 1992 - June 2006) CAUSE OF DEATH DATE OF DEATH 0-30 Days (N = 3,005) 31 Days – 1 Year (N = 2,722) >1 Year – 3 Years (N = 2,135) >3 Years – 5 Years (N = 1,857) >5 Years – 10 Years (N = 4,054) >10 Years (N = 2,107) ACUTE REJECTION 1992-1997 122 (7.1%)231 (14.3%)113 (9.3%)41 (4.4%)16 (1.1%) 1998-6/200671 (5.5%)107 (9.7%)107 (11.7%)41 (4.4%)53 (2.0%) CARDIAC ALLOGRAFT VASCULOPATHY 1992-199732 (1.9%)83 (5.1%)184 (15.1%)189 (20.1%)262 (18.3%) 1998-6/200620 (1.6%)44 (4.0%)114 (12.4%)110 (12.0%)319 (12.2%) GRAFT FAILURE 1992-1997258 (15.0%)179 (11.0%)200 (16.4%)119 (12.7%)174 (12.1%) 1998-6/2006195 (15.2%)125 (11.4%)165 (18.0%)179 (18.8%)405 (15.5%) MALIGNANCY, OTHER 1992-19971 (0.1%)40 (2.5%)118 (9.7%)177 (18.8%)257 (17.9%) 1998-6/20060 (0.0%)17 (1.5%)100 (10.9%)163 (17.8%)492 (18.8%) PRIMARY FAILURE 1992-1997508 (29.5%)168 (10.4%)105 (8.6%)49 (5.2%)99 (6.9%) 1998-6/2006296 (23.1%)28 (2.5%)29 (3.2%)32 (3.5%)87 (3.3%) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

49 ADULT HEART TRANSPLANT RECIPIENTS: Cumulative Incidence of Leading Causes of Death (Transplants: January 1992 - June 2005) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

50 ADULT HEART TRANSPLANTS (1/2002-6/2005) Risk Factors for 1 Year Mortality 2007 ISHLT (N=7,024) * Temporary circulatory support includes ECMO and Abiomed. J Heart Lung Transplant 2007;26: 769-781

51 ADULT HEART TRANSPLANTS (1/2002-6/2005) Risk Factors for 1 Year Mortality 2007 ISHLT (N=7,024) J Heart Lung Transplant 2007;26: 769-781

52 ADULT HEART TRANSPLANTS (1/2002-6/2005) Risk Factors for 1 Year Mortality 2007 ISHLT J Heart Lung Transplant 2007;26: 769-781

53 ADULT HEART TRANSPLANTS (1/2002-6/2005) Relative Risk of 1 Year Mortality with 95% Confidence Limits Recipient Age 2007 ISHLT (N=7,024) J Heart Lung Transplant 2007;26: 769-781

54 ADULT HEART TRANSPLANTS (1/2002-6/2005) Relative Risk of 1 Year Mortality with 95% Confidence Limits Donor Age 2007 ISHLT (N=7,024) J Heart Lung Transplant 2007;26: 769-781

55 ADULT HEART TRANSPLANTS (1/2002-6/2005) Relative Risk of 1 Year Mortality with 95% Confidence Limits Recipient Weight 2007 ISHLT (N=7,024) J Heart Lung Transplant 2007;26: 769-781

56 ADULT HEART TRANSPLANTS (1/2002-6/2005) Relative Risk of 1 Year Mortality with 95% Confidence Limits Ischemia Time 2007 ISHLT (N=7,024) J Heart Lung Transplant 2007;26: 769-781

57 ADULT HEART TRANSPLANTS (1/2002-6/2005) Relative Risk of 1 Year Mortality with 95% Confidence Limits Center Volume 2007 ISHLT (N=7,024) J Heart Lung Transplant 2007;26: 769-781

58 ADULT HEART TRANSPLANTS (1/2002-6/2005) Relative Risk of 1 Year Mortality with 95% Confidence Limits Pre-Transplant Bilirubin 2007 ISHLT (N=7,024) J Heart Lung Transplant 2007;26: 769-781

59 ADULT HEART TRANSPLANTS (1/2002-6/2005) Relative Risk of 1 Year Mortality with 95% Confidence Limits Pre-Transplant Creatinine 2007 ISHLT (N=7,024) J Heart Lung Transplant 2007;26: 769-781

60 ADULT HEART TRANSPLANTS (1/2002-6/2005) Relative Risk of 1 Year Mortality with 95% Confidence Limits Recipient PA Systolic Pressure 2007 ISHLT (N=7,024) J Heart Lung Transplant 2007;26: 769-781

61 ADULT HEART TRANSPLANTS (1/2002-6/2005) Relative Risk of 1 Year Mortality with 95% Confidence Limits Recipient PVR 2007 ISHLT (N=7,024) J Heart Lung Transplant 2007;26: 769-781

62 ADULT HEART TRANSPLANTS (1/2002-6/2005) Factors Not Significant for 1 Year Mortality Recipient Factors: Prior malignancy, PCW, gender, hospitalized, prior transfusions Donor Factors: Clinical infection, history of diabetes, height, weight, gender, history of hypertension, cause of death, history of malignancy 2007 ISHLT J Heart Lung Transplant 2007;26: 769-781

63 ADULT HEART TRANSPLANTS (1/2002-6/2005) 1-Year Predicted Survival Model ISHLT 2007 Recipient: 55 y.o., Dx=CAD, weight=78 kg, PVR=2.2, volume=22/year, PA systolic=40, ischemia=180 min Donor: Weight = 77 kg J Heart Lung Transplant 2007;26: 769-781

64 ADULT HEART TRANSPLANTS (1/1999-6/2001) Risk Factors for 5 Year Mortality 2007 ISHLT (N=5,147) * Other = not cardiomyopathy, coronary artery disease, valvular heart disease, or congenital heart disease J Heart Lung Transplant 2007;26: 769-781

65 ADULT HEART TRANSPLANTS (1/1999-6/2001) Risk Factors for 5 Year Mortality 2007 ISHLT (N=5,147) J Heart Lung Transplant 2007;26: 769-781

66 ADULT HEART TRANSPLANTS (1/1999-6/2001) Relative Risk of 5 Year Mortality with 95% Confidence Limits Recipient Age 2007 ISHLT (N=5,147) J Heart Lung Transplant 2007;26: 769-781

67 ADULT HEART TRANSPLANTS (1/1999-6/2001) Relative Risk of 5 Year Mortality with 95% Confidence Limits Donor Age 2007 ISHLT (N=5,147) J Heart Lung Transplant 2007;26: 769-781

68 ADULT HEART TRANSPLANTS (1/1999-6/2001) Relative Risk of 5 Year Mortality with 95% Confidence Limits Ischemia Time 2007 ISHLT (N=5,147) J Heart Lung Transplant 2007;26: 769-781

69 ADULT HEART TRANSPLANTS (1/1999-6/2001) Relative Risk of 5 Year Mortality with 95% Confidence Limits Center Volume 2007 ISHLT (N=5,147) J Heart Lung Transplant 2007;26: 769-781

70 ADULT HEART TRANSPLANTS (1/1999-6/2001) Relative Risk of 5 Year Mortality with 95% Confidence Limits BMI Ratio 2007 ISHLT (N=5,147) J Heart Lung Transplant 2007;26: 769-781

71 ADULT HEART TRANSPLANTS (1/1999-6/2001) Relative Risk of 5 Year Mortality with 95% Confidence Limits Pre-Transplant Bilirubin 2007 ISHLT (N=5,147) J Heart Lung Transplant 2007;26: 769-781

72 ADULT HEART TRANSPLANTS (1/1999-6/2001) Relative Risk of 5 Year Mortality with 95% Confidence Limits Pre-Transplant Creatinine 2007 ISHLT (N=5,147) J Heart Lung Transplant 2007;26: 769-781

73 ADULT HEART TRANSPLANTS (1/1999-6/2001) Factors Not Significant for 5 Year Mortality Recipient Factors: VAD, thoracotomy, sternotomy, pulmonary embolism, IV inotropes, prior malignancy, PRA Donor Factors: History of cancer, clinical infection, cause of death, history of hypertension Transplant Factors: CMV mismatch, ABO match 2007 ISHLT J Heart Lung Transplant 2007;26: 769-781

74 ADULT HEART TRANSPLANTS (1/1999-6/2001) 5-Year Predicted Survival Model ISHLT 2007 Recipient: 55 y.o., Dx=CAD, weight=78 kg, PVR=2.2, volume=24/year, PA systolic=42, ischemia=180 min; BMI ratio = 1; HLA mismatch = 5 Donor: Weight = 75 kg J Heart Lung Transplant 2007;26: 769-781

75 ADULT HEART TRANSPLANTS (1/1999-6/2001) Risk Factors for 5 Year Mortality Conditional on Survival to 1 Year 2007 ISHLT (N=4,079) J Heart Lung Transplant 2007;26: 769-781

76 ADULT HEART TRANSPLANTS (1/1999-6/2001) Borderline Significant Risk Factors for 5 Year Mortality Conditional on Survival to 1 Year 2007 ISHLT (N=4,079) J Heart Lung Transplant 2007;26: 769-781

77 ADULT HEART TRANSPLANTS (1/1999-6/2001) Risk Factors for 5 Year Mortality Conditional on Survival to 1 Year 2007 ISHLT (N=4,079) J Heart Lung Transplant 2007;26: 769-781

78 ADULT HEART TRANSPLANTS (1/1999-6/2001) Relative Risk of 5 Year Mortality with 95% Confidence Limits Conditional on Survival to 1 Year Recipient Age 2007 ISHLT (N=4,079) J Heart Lung Transplant 2007;26: 769-781

79 ADULT HEART TRANSPLANTS (1/1999-6/2001) Relative Risk of 5 Year Mortality with 95% Confidence Limits Conditional on Survival to 1 Year Donor Age 2007 ISHLT (N=4,079) J Heart Lung Transplant 2007;26: 769-781

80 ADULT HEART TRANSPLANTS (1/1999-6/2001) Relative Risk of 5 Year Mortality with 95% Confidence Limits Conditional on Survival to 1 Year BMI Ratio 2007 ISHLT (N=4,079) J Heart Lung Transplant 2007;26: 769-781

81 ADULT HEART TRANSPLANTS (1991-6/1995) Risk Factors for 10 Year Mortality 2007 ISHLT (N=11,870) * Other = not cardiomyopathy, coronary artery disease, valvular heart disease, or congenital heart disease J Heart Lung Transplant 2007;26: 769-781

82 ADULT HEART TRANSPLANTS (1991-6/1995) Risk Factors for 10 Year Mortality 2007 ISHLT (N=11,870) J Heart Lung Transplant 2007;26: 769-781

83 ADULT HEART TRANSPLANTS (1991-6/1995) Relative Risk of 10 Year Mortality with 95% Confidence Limits Recipient Age 2007 ISHLT (N=11,870) J Heart Lung Transplant 2007;26: 769-781

84 ADULT HEART TRANSPLANTS (1991-6/1995) Relative Risk of 10 Year Mortality with 95% Confidence Limits Donor Age 2007 ISHLT (N=11,870) J Heart Lung Transplant 2007;26: 769-781

85 ADULT HEART TRANSPLANTS (1991-6/1995) Relative Risk of 10 Year Mortality with 95% Confidence Limits Pre-Transplant Recipient Height 2007 ISHLT (N=11,870) J Heart Lung Transplant 2007;26: 769-781

86 ADULT HEART TRANSPLANTS (1991-6/1995) Relative Risk of 10 Year Mortality with 95% Confidence Limits Center Volume 2007 ISHLT (N=11,870) J Heart Lung Transplant 2007;26: 769-781

87 ADULT HEART TRANSPLANTS (1991-6/1995) Relative Risk of 10 Year Mortality with 95% Confidence Limits Ischemia Time 2007 ISHLT (N=11,870) J Heart Lung Transplant 2007;26: 769-781

88 ADULT HEART TRANSPLANTS (1991-6/1995) Relative Risk of 10 Year Mortality with 95% Confidence Limits Pre-transplant PRA 2007 ISHLT (N=11,870) J Heart Lung Transplant 2007;26: 769-781

89 ADULT HEART TRANSPLANTS (1991-6/1995) Risk Factors for 10 Year Mortality Conditional on Survival to 3 Years 2007 ISHLT (N=8,426) J Heart Lung Transplant 2007;26: 769-781

90 ADULT HEART TRANSPLANTS Risk Factors for 10 Year Mortality Conditional on Survival to 3 Years 2007 ISHLT (N=8,426) J Heart Lung Transplant 2007;26: 769-781

91 ADULT HEART TRANSPLANTS (1991-6/1995) Relative Risk of 10 Year Mortality with 95% Confidence Limits Conditional on Survival to 3 Years Recipient Age 2007 ISHLT (N=8,426) J Heart Lung Transplant 2007;26: 769-781

92 ADULT HEART TRANSPLANTS (1991-6/1995) Relative Risk of 10 Year Mortality with 95% Confidence Limits Conditional on Survival to 3 Years Donor Age 2007 ISHLT (N=8,426) J Heart Lung Transplant 2007;26: 769-781

93 ADULT HEART TRANSPLANTS (1991-6/1995) Relative Risk of 10 Year Mortality with 95% Confidence Limits Conditional on Survival to 3 Years Pre-Transplant Recipient Weight 2007 ISHLT (N=8,426) J Heart Lung Transplant 2007;26: 769-781

94 ADULT HEART TRANSPLANTS (1991-6/1995) Relative Risk of 10 Year Mortality with 95% Confidence Limits Conditional on Survival to 3 Years Donor Weight 2007 ISHLT (N=8,426) J Heart Lung Transplant 2007;26: 769-781

95 ADULT HEART TRANSPLANTS (1988-6/1991) Risk Factors for 15 Year Mortality 2007 ISHLT (N=3,500) J Heart Lung Transplant 2007;26: 769-781

96 ADULT HEART TRANSPLANTS Risk Factors for 15 Year Mortality 2007 ISHLT (N=3,500) J Heart Lung Transplant 2007;26: 769-781

97 ADULT HEART TRANSPLANTS (1988-6/1991) Relative Risk of 15 Year Mortality with 95% Confidence Limits Recipient Age 2007 ISHLT (N=3,500) J Heart Lung Transplant 2007;26: 769-781

98 ADULT HEART TRANSPLANTS (1988-6/1991) Relative Risk of 15 Year Mortality with 95% Confidence Limits Donor Age 2007 ISHLT (N=3,500) J Heart Lung Transplant 2007;26: 769-781

99 ADULT HEART TRANSPLANTS (1988-6/1991) Risk Factors for 15 Year Mortality Conditional on Survival to 5 Years 2007 ISHLT (N=2,322) * Other = not cardiomyopathy, coronary artery disease, valvular heart disease, or congenital heart disease J Heart Lung Transplant 2007;26: 769-781

100 ADULT HEART TRANSPLANTS Risk Factors for 15 Year Mortality Conditional on Survival to 5 Years 2007 ISHLT (N=2,322) J Heart Lung Transplant 2007;26: 769-781

101 ADULT HEART TRANSPLANTS (1988-6/1991) Relative Risk of 15 Year Mortality with 95% Confidence Limits Conditional on Survival to 5 Years Recipient Age 2007 ISHLT (N=2,322) J Heart Lung Transplant 2007;26: 769-781

102 ADULT HEART TRANSPLANTS (1988-6/1991) Relative Risk of 15 Year Mortality with 95% Confidence Limits Conditional on Survival to 5 Years Donor Age 2007 ISHLT (N=2,322) J Heart Lung Transplant 2007;26: 769-781

103 ADULT HEART TRANSPLANTS (1995-6/2001) Risk Factors for Developing Cardiac Allograft Vasculopathy within 5 Years (N=7,711) ISHLT * Due to the statistically significant interaction of donor gender and donor age, the relative risk for donor gender must be considered in the context of donor age rather than independently. 2007 J Heart Lung Transplant 2007;26: 769-781

104 ADULT HEART TRANSPLANTS (1995-6/2001) Risk Factors for Developing Cardiac Allograft Vasculopathy within 5 Years ISHLT 2007 (N=7,711) J Heart Lung Transplant 2007;26: 769-781

105 ADULT HEART TRANSPLANTS (1995-6/2001) Relative Risk of Developing Cardiac Allograft Vasculopathy within 5 Years with 95% Confidence Limits Donor Age, Donor Gender and Recipient Gender ISHLT 2007 (N=7,711) Relative risk includes impact of donor gender, recipient gender and donor age. J Heart Lung Transplant 2007;26: 769-781

106 ADULT HEART TRANSPLANTS (1995-6/2001) Relative Risk of Developing Cardiac Allograft Vasculopathy within 5 Years with 95% Confidence Limits Recipient Age ISHLT 2007 (N=7,711) J Heart Lung Transplant 2007;26: 769-781

107 ADULT HEART TRANSPLANTS (1995-6/2001) Relative Risk of Developing Cardiac Allograft Vasculopathy within 5 Years with 95% Confidence Limits Center Volume ISHLT 2007 (N=7,711) J Heart Lung Transplant 2007;26: 769-781

108 ADULT HEART TRANSPLANTS (4/1994-6/2001) Risk Factors for Developing Renal Dysfunction within 5 Years Limited to Recipients without Severe Renal Dysfunction* Pre-Transplant (N=11,145) ISHLT 2007 *Severe renal dysfunction = creatinine > 2.5 mg/dl or dialysis J Heart Lung Transplant 2007;26: 769-781

109 ADULT HEART TRANSPLANTS (4/1994-6/2001) Risk Factors for Developing Renal Dysfunction within 5 Years Limited to Recipients without Severe Renal Dysfunction Pre-Transplant ISHLT 2007 (N=11,145) *Severe renal dysfunction = creatinine > 2.5 mg/dl or dialysis J Heart Lung Transplant 2007;26: 769-781

110 ADULT HEART TRANSPLANTS (4/1994-6/2001) Risk Factors for Developing Renal Dysfunction within 5 Years Limited to Recipients without Severe Renal Dysfunction* Pre-Transplant Recipient Pre-Transplant Creatinine ISHLT 2007 (N=11,145) *Severe renal dysfunction = creatinine > 2.5 mg/dl or dialysis J Heart Lung Transplant 2007;26: 769-781

111 ADULT HEART TRANSPLANTS (4/1994-6/2001) Risk Factors for Developing Renal Dysfunction within 5 Years Limited to Recipients without Severe Renal Dysfunction* Pre-Transplant Recipient Age ISHLT 2007 (N=11,145) *Severe renal dysfunction = creatinine > 2.5 mg/dl or dialysis J Heart Lung Transplant 2007;26: 769-781

112 ADULT HEART TRANSPLANTS (4/1994-6/2001) Risk Factors for Developing Renal Dysfunction within 5 Years Limited to Recipients without Severe Renal Dysfunction* Pre-Transplant Recipient Weight ISHLT 2007 (N=11,145) *Severe renal dysfunction = creatinine > 2.5 mg/dl or dialysis J Heart Lung Transplant 2007;26: 769-781

113 ADULT HEART TRANSPLANTS (4/1994-6/2001) Risk Factors for Developing Renal Dysfunction within 5 Years Limited to Recipients without Severe Renal Dysfunction* Pre-Transplant Donor Weight ISHLT 2007 (N=11,145) *Severe renal dysfunction = creatinine > 2.5 mg/dl or dialysis J Heart Lung Transplant 2007;26: 769-781

114 ADULT HEART TRANSPLANTS (4/1994-6/2001) Risk Factors for Developing Renal Dysfunction within 5 Years Limited to Recipients without Severe Renal Dysfunction* Pre-Transplant Recipient PRA ISHLT 2007 (N=11,145) *Severe renal dysfunction = creatinine > 2.5 mg/dl or dialysis J Heart Lung Transplant 2007;26: 769-781


Download ppt "HEART TRANSPLANTATION Overall ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781."

Similar presentations


Ads by Google