LUNG TRANSPLANTATION Overall 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132.

LUNG TRANSPLANTATION Overall 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

NUMBER OF LUNG TRANSPLANTS REPORTED BY YEAR AND PROCEDURE TYPE NOTE: This figure includes only the lung transplants that are reported to the ISHLT Transplant Registry. As such, this should not be construed as representing changes in the number of lung transplants performed worldwide. ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

AVERAGE CENTER VOLUME Lung Transplants: January 1, 2000 - June 30, 2010 ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

DISTRIBUTION OF TRANSPLANTS BY CENTER VOLUME Lung Transplants: January 1, 2000 - June 30, 2010 ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

LUNG TRANSPLANTS: Transplant Recipient Age by Year of Transplant Transplants: January 1, 1987 – June 30, 2010 ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

AGE DISTRIBUTION OF LUNG TRANSPLANT RECIPIENTS (1/1985-6/2010) ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

AGE DISTRIBUTION OF LUNG TRANSPLANT RECIPIENTS BY ERA Transplants with unknown recipient age were excluded from this tabulation. ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

LUNG TRANSPLANTS: Donor Age by Year of Transplant Transplants: January 1, 1987 – June 30, 2010 ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

DONOR AGE DISTRIBUTION FOR LUNG TRANSPLANTS (1/1985-6/2010) ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

DONOR AGE DISTRIBUTION FOR LUNG TRANSPLANTS BY ERA Transplants with unknown donor age were excluded from this tabulation. ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

LUNG TRANSPLANTATION Adult Recipients ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

AGE DISTRIBUTION OF ADULT LUNG TRANSPLANT RECIPIENTS (1/1985-6/2010) ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

AGE DISTRIBUTION OF ADULT LUNG TRANSPLANT RECIPIENTS BY ERA ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival (Transplants: January 1994 - June 2009) ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTATION: Indications (1/1995-6/2010) DIAGNOSISSLT (N = 12,339)BLT (N = 18,334)TOTAL (N = 30,673) COPD/Emphysema5,769 ( 46.8% )4,839 ( 26.4% )10,608 ( 34.6% ) Idiopathic Pulmonary Fibrosis3,995 ( 32.4% )2,938 ( 16.0% )6,933 ( 22.6% ) Cystic Fibrosis214 ( 1.7% )4,941 ( 26.9% )5,155 ( 16.8% ) Alpha-1728 ( 5.9% )1,225 ( 6.7% )1,953 ( 6.4% ) Idiopathic Pulmonary Arterial Hypertension78 ( 0.6% )894 ( 4.9% )972 ( 3.2% ) Pulmonary Fibrosis, Other424 ( 3.4% )537 ( 2.9% )961 ( 3.1% ) Bronchiectasis50 ( 0.4% )815 ( 4.4% )865 ( 2.8% ) Sarcoidosis236 ( 1.9% )547 ( 3.0% )783 ( 2.6% ) Re-Transplant: Obliterative Bronchiolitis253 ( 2.1% )219 ( 1.2% )472 ( 1.5% ) Connective Tissue Disease127 ( 1.0% )232 ( 1.3% )359 ( 1.2% ) Obliterative Bronchiolitis (Not Re- Transplant) 80 ( 0.6% )237 ( 1.3% )317 ( 1.0% ) LAM101 ( 0.8% )207 ( 1.1% )308 ( 1.0% ) Re-Transplant: Not Obliterative Bronchiolitis127 ( 1.0% )162 ( 0.9% )289 ( 0.9% ) Congenital Heart Disease43 ( 0.3% )224 ( 1.2% )267 ( 0.9% ) Cancer6 ( 0.0% )26 ( 0.1% )32 ( 0.1% ) Other108 ( 0.9% )291 ( 1.6% )399 ( 1.3% ) ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTATION: Distribution of Procedure Type for Major Indications (1994-2009) Year of TX Alpha-1COPDCystic FibrosisIPFIPAH DoubleSingleDoubleSingleDoubleSingleDoubleSingleDoubleSingle 199444.855.218.881.286.913.113.686.464.036.0 199545.554.522.078.090.29.828.271.889.310.7 199647.352.727.772.186.813.228.171.981.718.3 199746.453.627.572.592.67.421.578.590.39.7 199848.251.830.269.893.26.819.180.987.013.0 199946.653.427.971.991.38.723.376.486.413.6 200057.942.129.370.794.25.830.769.393.07.0 200159.940.130.269.893.96.131.468.690.010.0 200256.443.639.061.096.23.835.065.089.610.4 200365.234.843.256.895.64.441.358.795.74.3 200473.625.745.854.296.33.744.155.994.55.5 200578.022.049.350.697.32.745.954.192.67.4 200672.627.458.141.898.51.546.653.4100.00.0 200783.616.463.836.297.32.749.150.994.85.2 200880.419.665.234.898.41.651.348.793.86.2 200986.513.566.533.599.80.251.248.898.61.4 ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTATION Procedure Type within Indication, by Year ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTATION: Indications for Single Lung Transplants (Transplants: January 1995 - June 2010) *Other includes: Pulmonary Fibrosis, Other:3.4% Sarcoidosis: 1.9% Bronchiectasis: 0.4% Congenital Heart Disease: 0.3% LAM: 0.8% Connective Tissue Disease:1.0% OB (non-ReTx): 0.6% Miscellaneous:0.9% ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTATION: Indications for Bilateral/Double Lung Transplants (Transplants: January 1995 - June 2010) *Other includes: Pulmonary Fibrosis, Other:2.9% Sarcoidosis: 3.0% Bronchiectasis: 4.4% Congenital Heart Disease: 1.2% LAM: 1.1% Connective Tissue Disease:1.3% OB (non-ReTx): 1.3% Miscellaneous:1.7% ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTATION Major Indications By Year (%) ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTATION Major Indications By Year (Number) ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS: AGE DISTRIBUTION BY LOCATION Transplants between January 2000 and June 2010 ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS: DIAGNOSIS DISTRIBUTION BY LOCATION Transplants between January 2000 and June 2010 ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS: DONOR AGE DISTRIBUTION BY LOCATION Transplants between January 2000 and June 2010 ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Era (Transplants: January 1988 – June 2009) ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Age Group (Transplants: January 1990 – June 2009) ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Gender (Transplants: January 1990 – June 2009) ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival By Diagnosis (Transplants: January 1990 – June 2009) ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival By Diagnosis Conditional on Survival to 3 Months (Transplants: January 1990 – June 2009) ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival By Diagnosis Conditional on Survival to 1 Year (Transplants: January 1990 – June 2009) ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival for Eisenmengers Syndrome (Transplants: January 1990 – June 2009) ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival By Procedure Type (Transplants: January 1990 – June 2009) Diagnosis: Alpha-1 Antitrypsin Deficiency ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival By Procedure Type and Age (Transplants: January 1990 – June 2009) Diagnosis: Alpha-1 Antitrypsin Deficiency ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Procedure Type (Transplants: January 1990 – June 2009) Diagnosis: Emphysema/COPD ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Procedure Type and Age (Transplants: January 1990 – June 2009) Diagnosis: Emphysema/COPD ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Procedure Type (Transplants: January 1990 – June 2009) Diagnosis: Idiopathic Pulmonary Fibrosis ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Procedure Type (Transplants: January 1990 – June 2009) Diagnosis: Idiopathic Arterial Pulmonary Hypertension ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Procedure Type and Era (Transplants: January 1990 – June 2009) Diagnosis: Emphysema/COPD, Single Lung ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Procedure Type and Era (Transplants: January 1990 – June 2009) Diagnosis: Emphysema/COPD, Double Lung ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Procedure Type and Era (Transplants: January 1990 – June 2009) Diagnosis: Cystic Fibrosis, Double Lung ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Procedure Type and Era (Transplants: January 1990 – June 2009) Diagnosis: Idiopathic Pulmonary Fibrosis, Single Lung ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Procedure Type and Era (Transplants: January 1990 – June 2009) Diagnosis: Idiopathic Pulmonary Fibrosis, Double Lung ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Donor CMV status/Recipient CMV status (Transplants: October 1999 – June 2009) ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

PERCENTAGE OF ADULT LUNG TRANSPLANT RECIPIENTS Experiencing Rejection between Transplant Discharge and 1-Year Follow-Up Stratified by Donor/Recipient CMV status (Follow-ups: July 2004 - June 2010) D(-)/R(-): N = 1,110 D(-)/R(+): N = 1,378 D(+)/R(-): N = 1,533 D(+)/R(+): N = 2,463 No comparisons were statistically significant at 0.05 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. 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. ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

PERCENTAGE OF ADULT LUNG TRANSPLANT RECIPIENTS Experiencing Rejection between Transplant Discharge and 1-Year Follow-Up Stratified by Donor/Recipient CMV status (Follow-ups: July 2004 - June 2010) 18-3435-4950-5960-65>65FemaleMale No comparisons were statistically significant at 0.05 except D(+)/R(-) vs. D(+)/R(+): 35-49 (p=0.0147) and 50- 59: (p=0.0330) 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. 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. ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1997-6/2009) Risk Factors for 1 Year Mortality (N=13,937) *Other = All diagnoses other than COPD, IPAH, IPF, cystic fibrosis, pulmonary fibrosis, bronchiectasis, alpha-1 antitrypsin deficiency, retransplant and LAM. Reference group = COPD/Emphysema, Single lung ISHLT 2011 DIAGNOSISProcedure type NRelative Risk P-value95% Conf. Interval IPAHAll3792.06<.00011.53 -2.77 RetransplantAll4811.90<.00011.53 -2.35 Other*All8701.66<.00011.36 -2.02 Alpha-1 antitrypsin deficiencySingle3231.570.00041.22 -2.01 SarcoidosisDouble2931.560.00241.17 -2.09 Alpha-1 antitrypsin deficiencyDouble4501.360.01721.06 -1.75 Pulmonary Fibrosis (not IPF)All4041.360.00911.08 -1.72 IPFSingle2,0131.290.00591.08 -1.54 IPFDouble1,4281.260.02421.03 -1.54 Cystic FibrosisAll1,8671.160.19410.93 -1.46 LAMAll1160.410.03110.18 -0.92 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1997-6/2009) Risk Factors for 1 Year Mortality (N=13,937) ISHLT 2011 TRANSPLANT CHARACTERISTICSNRelative Risk P-value95% Conf. Interval Transplant year = 1997/1998 vs. 2008/20091,6251.89<.00011.61 -2.22 Transplant year = 1999/2000 vs. 2008/20091,6561.87<.00011.60 -2.19 Transplant year = 2001/2002 vs. 2008/20092,0231.51<.00011.29 -1.76 Donor CMV +/ Recipient CMV -2,8871.21<.00011.10 -1.32 Transplant year = 2005/2006 vs. 2008/20092,7641.180.01771.03 -1.36 Transplant year = 2007 vs. 2008/20091,4181.180.04251.01 -1.38 Transplant year = 2003/2004 vs. 2008/20092,1871.170.04241.01 -1.37 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1997-6/2009) Risk Factors for 1 Year Mortality (N=13,937) ISHLT 2011 DONOR CHARACTERISTICSNRelative Risk P-value95% Conf. Interval Donor history of diabetes5601.44<.00011.21 -1.72 RECIPIENT CHARACTERISTICS Recipient on dialysis612.66<.00011.84 -3.84 IV inotropes491.740.00761.16 -2.60 Hospitalized (including ICU)1,5131.70<.00011.50 -1.93 Ventilator4911.57<.00011.31 -1.88 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

(N=13,937) *Other = All diagnoses other than COPD, IPAH, IPF, cystic fibrosis, pulmonary fibrosis, bronchiectasis, alpha-1 antitrypsin deficiency, retransplant and LAM. Reference group = COPD/Emphysema, Single lung ISHLT 2011 RECIPIENT CHARACTERISTICSNRelative Risk P-value95% Conf. Interval Diagnosis = Bronchiectasis2731.340.05820.99 -1.80 Prior Sternotomy3191.220.08100.98 -1.52 Diagnosis = COPD/Emphysema, double lung1,9401.160.05171.00 -1.34 Recipient history of diabetes1,7481.110.09270.98 -1.25 Chronic steroid use6,6061.090.05061.00 -1.18 ADULT LUNG TRANSPLANTS (1997-6/2009) Borderline Significant Risk Factors for 1 Year Mortality ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Risk Factors for 1 Year Mortality ISHLT 2011 Continuous Factors (see figures) Recipient ageBilirubin Transplant center volumeRecipient oxygen required at rest Cardiac outputHeight difference Recipient FVC % predicted ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Risk Factors for 1 Year Mortality Recipient Age ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Risk Factors for 1 Year Mortality Center Volume ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Risk Factors for 1 Year Mortality Recipient Pre-Transplant Bilirubin ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Risk Factors for 1 Year Mortality Recipient Oxygen Required at Rest ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Risk Factors for 1 Year Mortality Recipient Pre-Transplant Cardiac Output ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Risk Factors for 1 Year Mortality Height Difference ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Risk Factors for 1 Year Mortality Recipient FVC (% predicted) ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Diagnosis = COPD/Emphysema Risk Factors for 1 Year Mortality (N=5,057) ISHLT 2011 RECIPIENT CHARACTERISTICSNRelative Risk P-value95% Confidence Interval Hospitalized (including ICU)2581.89<.00011.44 -2.47 Ventilator771.740.01261.13 -2.68 Chronic steroid use2,2831.320.00021.14 -1.52 TRANSPLANT CHARACTERISTICS Transplant Year: 1997/1998 vs. 2008/2009 6541.450.01321.08 -1.94 Transplant Year: 1999/2000 vs. 2008/2009 7541.380.02371.04 -1.83 Donor CMV +/ Recipient CMV -8441.260.01201.05 -1.50 DONOR CHARACTERISTICS Donor history of diabetes1961.510.01061.10 -2.07 Donor history of cancer740.380.03130.16 -0.92 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Diagnosis = COPD/Emphysema Risk Factors for 1 Year Mortality ISHLT 2011 Continuous Factors (see figures) Recipient ageTransplant center volume Recipient oxygen required at rest Cardiac output ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Diagnosis = COPD/Emphysema Risk Factors for 1 Year Mortality Recipient Age ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Diagnosis = COPD/Emphysema Risk Factors for 1 Year Mortality Center Volume ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Diagnosis = COPD/Emphysema Risk Factors for 1 Year Mortality Recipient Oxygen Required at Rest ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Diagnosis = COPD/Emphysema Risk Factors for 1 Year Mortality Recipient Pre-Transplant Cardiac Output ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Diagnosis = IPF Risk Factors for 1 Year Mortality (N=3,455) ISHLT 2011 RECIPIENT CHARACTERISTICSNRelative Risk P-value95% Confidence Interval Hospitalized (including ICU)3911.93<.00011.53 -2.44 Ventilator1281.680.00261.20 -2.35 Previous pregnancy7121.240.04381.01 -1.53 TRANSPLANT CHARACTERISTICS Transplant Year: 1999/2000 vs. 2008/20092782.56<.00011.90 -3.45 Transplant Year: 1997/1998 vs. 2008/20092542.49<.00011.82 -3.40 Transplant Year: 2001/2002 vs. 2008/20093631.660.00091.23 -2.24 Transplant Year: 2003/2004 vs. 2008/20095081.510.00291.15 -1.99 Donor CMV+ / Recipient CMV-6981.47<.00011.24 -1.74 Transplant Year: 2005/2006 vs. 2008/20098081.320.02311.04 -1.68 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Diagnosis = IPF Risk Factors for 1 Year Mortality ISHLT 2011 Continuous Factors (see figures) Recipient ageCenter volume Donor heightBilirubin Cardiac outputCreatinine PCO2Donor weight (borderline) FVC (% predicted) (borderline) Oxygen required at rest (borderline) ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Diagnosis = IPF Risk Factors for 1 Year Mortality Recipient Age ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Diagnosis = IPF Risk Factors for 1 Year Mortality Center volume ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Diagnosis = IPF Risk Factors for 1 Year Mortality Donor Height ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Diagnosis = IPF Risk Factors for 1 Year Mortality Recipient Bilirubin ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Diagnosis = IPF Risk Factors for 1 Year Mortality Recipient Pre-Transplant Cardiac Output ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Diagnosis = IPF Risk Factors for 1 Year Mortality Recipient Creatinine at Transplant ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Diagnosis = IPF Risk Factors for 1 Year Mortality Recipient PCO2 ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Diagnosis = IPF Risk Factors for 1 Year Mortality Donor Weight ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Diagnosis = IPF Risk Factors for 1 Year Mortality Recipient Oxygen Required at Rest ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Diagnosis = IPF Risk Factors for 1 Year Mortality Recipient FVC (% predicted) ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

(N=8,163) Reference group = COPD/Emphysema, Single lung ISHLT 2011 DIAGNOSIS Procedure type N Relative Risk P-value 95% Confidence Interval RetransplantAll2041.250.03801.01 -1.55 COPD/EmphysemaDouble9790.870.02380.78 -0.98 Cystic FibrosisAll1,1630.770.00750.64 -0.93 LAMAll710.510.00520.32 -0.82 ADULT LUNG TRANSPLANTS (1997-6/2005) Risk Factors for 5 Year Mortality ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1997-6/2005) Risk Factors for 5 Year Mortality (N=8,163) ISHLT 2011 TRANSPLANT CHARACTERISTICSN Relative Risk P-value 95% Confidenc e Interval Transplant year = 1997/1998 vs. 2003-20051,6251.34<.00011.22 -1.47 Transplant year = 1999/2000 vs. 2003-20051,6561.28<.00011.17 -1.40 Donor CMV +/ Recipient CMV -1,5441.140.00111.06 -1.24 DONOR CHARACTERISTICS Donor history of diabetes2381.350.00111.13 -1.61 Donor cause of death = anoxia4680.790.00200.68 -0.92 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1997-6/2005) Risk Factors for 5 Year Mortality (N=8,163) ISHLT 2011 RECIPIENT CHARACTERISTICSN Relative Risk P-value 95% Confidence Interval Recipient on dialysis212.180.00201.33 -3.59 IV inotropes472.09<.00011.46 -3.00 Hospitalized (including ICU)6121.300.00021.13 -1.49 Prior sternotomy3191.250.00351.08 -1.46 Recipient history of diabetes7171.200.00251.06 -1.34 Chronic steroid use3,8641.110.00181.04 -1.19 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1997-6/2005) Borderline Significant Risk Factors for 5 Year Mortality (N=8,163) Reference diagnosis group = COPD/Emphysema, Single lung ISHLT 2011 TRANSPLANT AND RECIPIENT CHARACTERISTICS N Relative Risk P-value 95% Confidence Interval Diagnosis = Alpha-1 antitrypsin deficiency, single lung 2831.190.06020.99 -1.42 Transplant year = 2001/2002 vs. 2003-20052,0231.090.05391.00 -1.19 0-3 HLA mismatches vs. 4-6 mismatches1,0930.920.08400.83 -1.01 Female recipient/female donor vs. male recipient/male donor 2,3210.870.05210.75 -1.00 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2005) Risk Factors for 5 Year Mortality ISHLT 2011 Continuous Factors (see figures) Recipient ageRecipient oxygen required at rest Transplant center volumeBilirubin Cardiac outputDonor age (borderline) Recipient FEV1 % predicted (borderline) ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2005) Risk Factors for 5 Year Mortality Recipient Pre-Transplant Bilirubin ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2005) Risk Factors for 5 Year Mortality Recipient Pre-Transplant Cardiac Output ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2005) Risk Factors for 5 Year Mortality Donor Age ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2005) Risk Factors for 5 Year Mortality Recipient FEV1 (% predicted) ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1997-6/2005) Risk Factors for 5 Year Mortality Conditional on Survival to 1 Year (N=6,305) Reference group = COPD/Emphysema, Single lung ISHLT 2011 DIAGNOSIS Procedure type N Relative Risk P-value 95% Conf. Interval COPD/EmphysemaDouble7960.820.01580.71 -0.96 IPFDouble3620.670.00230.52 -0.87 Alpha-1 antitrypsin deficiency Double2540.650.00210.50 -0.86 Cystic FibrosisAll9590.59<.00010.45 -0.76 IPAHAll2020.510.00110.34 -0.77 LAMAll630.480.01030.27 -0.84 Other*Single900.460.00110.29 -0.74 *Other = All diagnoses other than COPD, IPAH, IPF, cystic fibrosis, pulmonary fibrosis, bronchiectasis, alpha-1 antitrypsin deficiency, retransplant and LAM. ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1997-6/2005) Risk Factors for 5 Year Mortality Conditional on Survival to 1 Year (N=6,305) ISHLT 2011 DONOR CHARACTERISTICSN Relative Risk P-value 95% Confidence Interval Donor cause of death = anoxia3730.730.00300.59 -0.90 RECIPIENT CHARACTERISTICS Prior sternotomy2271.330.00761.08 -1.64 Hospitalized (including ICU)3971.290.00821.07 -1.55 Recipient history of diabetes5401.270.00251.09 -1.48 Chronic steroid use2,9441.100.04201.00 -1.20 Ventilator950.570.01060.37 -0.88 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1997-6/2005) Risk Factors for 5 Year Mortality Conditional on Survival to 1 Year (N=6,305) ISHLT 2011 TRANSPLANT CHARACTERISTICSN Relative Risk P-value 95% Confidence Interval Mismatches at HLA A locus, per mismatch 0 A MM (N=393) 1 A MM (N=3,216) 2 A MM (N=2,696) 1.160.03891.01 -1.34 Donor CMV +/ Recipient CMV -1,1751.150.00901.04 -1.28 Male donor/female recipient vs. male donor/male recipient 1,2831.150.03111.01 -1.30 POST- TRANSPLANT CHARACTERISTICS OB within 1 year post-transplant4152.18<.00011.90 -2.51 Post-transplant dialysis prior to discharge 1591.310.03891.01 -1.70 Rejection between discharge and 1 year2,8591.180.00031.08 -1.29 Treated for infection by discharge2,5111.120.01321.02 -1.22 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1997-6/2005) Borderline Significant Risk Factors for 5 Year Mortality Conditional on Survival to 1 Year (N=6,305) *Other = All diagnoses other than COPD, IPAH, IPF, cystic fibrosis, pulmonary fibrosis, bronchiectasis, alpha-1 antitrypsin deficiency, retransplant and LAM. Reference group = COPD/Emphysema, Single lung ISHLT 2011 CHARACTERISTICSN Relative Risk P-value 95% Confidence Interval Transplant year = 1997/1998 vs. 2003-20051,2241.120.07670.99 -1.27 Induction with IL2R-antagonist1,5460.900.05820.80 -1.00 Diagnosis = Other*, double lung1730.750.07050.55 -1.02 Diagnosis = Sarcoidosis1620.740.06040.54 -1.01 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2005) Risk Factors for 5 Year Mortality Conditional on Survival to 1 Year ISHLT 2011 Continuous Factors (see figures) Recipient ageTransplant center volume Cardiac output (borderline)Height difference (borderline) Recipient FEV1 % predicted (borderline) ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2005) Risk Factors for 5 Year Mortality Conditional on 1 Year Survival Recipient Age ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2005) Risk Factors for 5 Year Mortality Conditional on 1 Year Survival Center Volume ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2005) Risk Factors for 5 Year Mortality Conditional on 1 Year Survival Recipient Pre-Transplant Cardiac Output ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2005) Risk Factors for 5 Year Mortality Conditional on 1 Year Survival Height Difference ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (1/1997-6/2005) Risk Factors for 5 Year Mortality Conditional on 1 Year Survival Recipient FEV1 (% predicted) ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (7/1994-6/2000) Risk Factors for 10 Year Mortality (N=4,663) Reference group = COPD/Emphysema, Single lung ISHLT 2011 DIAGNOSIS Procedure type N Relative Risk P-value 95% Conf. Interval RetransplantAll1101.360.01031.07 -1.71 Alpha-1 antitrypsin deficiency Single2621.350.00021.15 -1.57 Cystic FibrosisAll6600.820.03570.68 -0.99 LAMAll410.600.02860.38 -0.95 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (7/1994-6/2000) Risk Factors for 10 Year Mortality (N=4,663) ISHLT 2011 DONOR CHARACTERISTICSN Relative Risk P-value 95% Confidence Interval Donor history of diabetes1001.360.00771.08 -1.70 RECIPIENT CHARACTERISTICS IV inotropes531.410.03631.02 -1.96 Prior sternotomy1661.380.00041.15 -1.64 Ventilator1181.300.04461.01 -1.67 PRA 10%901.280.03921.01 -1.63 Recipient history of diabetes2541.240.00641.06 -1.45 Hospitalized (including ICU)3921.230.00831.05 -1.43 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (7/1994-6/2000) Risk Factors for 10 Year Mortality (N=4,663) ISHLT 2011 TRANSPLANT CHARACTERISTICSN Relative Risk P-value 95% Confidence Interval Donor CMV +/ Recipient CMV -8261.22<.00011.11 -1.33 Not ABO identical3891.160.01731.03 -1.31 Transplant year = 1994/1996 vs. 1999- 2000 1,7951.150.00201.05 -1.25 HLA mismatches, per mismatch 0 MM (N=6) 1 MM (N=19) 2 MM (N=143) 3 MM (N=474) 4 MM (N=1,081) 5 MM (N=2,188) 6 MM (N=752) 1.060.00011.03 -1.10 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (7/1994-6/2000) Borderline Significant Risk Factors for 10 Year Mortality (N=4,663) ISHLT 2011 CHARACTERISTICSN Relative Risk P-value 95% Confidence Interval Recipient on dialysis111.940.06470.96 -3.91 Donor cause of death = anoxia1970.860.08160.72 -1.02 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (7/1994-6/2000) Risk Factors for 10 Year Mortality ISHLT 2011 Continuous Factors (see figures) Recipient ageTransplant center volume Donor ageRecipient weight Donor HeightRecipient oxygen required at rest (borderline) ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (7/1994-6/2000) Risk Factors for 10 Year Mortality Donor Age ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (7/1994-6/2000) Risk Factors for 10 Year Mortality Recipient Weight ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANTS (7/1994-6/2000) Risk Factors for 10 Year Mortality Donor Height ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG RECIPIENTS Cross-Sectional Analysis Functional Status of Surviving Recipients (Follow-ups: April 1994 – June 2010) ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG RECIPIENTS Functional Status of Surviving Recipients (Follow-ups: March 2005 - June 2010) US Recipients Only ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG RECIPIENTS Employment Status of Surviving Recipients (Follow-ups: April 1994 – June 2010) ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG RECIPIENTS : Rehospitalization Post-transplant of Surviving Recipients (Follow-ups: April 1994 - June 2010) ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG RECIPIENTS Induction Immunosuppression (Transplants: January 2002 - June 2010) Analysis limited to patients receiving prednisone Analysis is limited to patients who were alive at the time of the discharge ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG RECIPIENTS Induction Immunosuppression (Transplants: 1997, 2002 and 1/2010-6/2010) Analysis limited to patients receiving prednisone Analysis is limited to patients who were alive at the time of the discharge ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG RECIPIENTS Induction Immunosuppression (Transplants: January 2000 - December 2009) Analysis limited to patients receiving prednisone Any Induction Polyclonal ALG/ATG IL-2R Antagonist Alemtuzumab Analysis is limited to patients who were alive at the time of the discharge ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

SURVIVAL BY INDUCTION USAGE For Adult Lung Recipients (Transplants: April 1994-June 2009) Conditional on survival to 14 days ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

SURVIVAL BY INDUCTION USAGE For Adult Lung Recipients (Transplants: January 2000-June 2009) Conditional on survival to 14 days ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG RECIPIENTS Maintenance Immunosuppression at Time of Follow-up For follow-ups between January 2002 through June 2010 Analysis limited to patients receiving prednisone NOTE: Different patients are analyzed in Year 1 and Year 5 Analysis is limited to patients who were alive at the time of the follow-up ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG RECIPIENTS Maintenance Immunosuppression at Time of 1 Year Follow-up (Follow-ups: 2000, 2003, 7/2009 – 6/2010) Analysis limited to patients receiving prednisone NOTE: Different patients are analyzed in each time frame. Analysis is limited to patients who were alive at the time of the follow-up ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG RECIPIENTS Maintenance Immunosuppression at Time of Follow-up For follow-ups between January 2002 through June 2010 Analysis limited to patients receiving prednisone 1 Year Follow-up (N = 8,457)5 Year Follow-up (N = 3,534) NOTE: Different patients are analyzed in Year 1 and Year 5 Analysis is limited to patients who were alive at the time of the follow-up ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG RECIPIENTS Maintenance Immunosuppression Drug Combinations at Time of Follow-up For follow-ups between January 2002 through June 2010 Analysis limited to patients receiving prednisone Analysis is limited to patients who were alive at the time of the follow-up ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG RECIPIENTS Kaplan-Meier Survival by Maintenance Immunosuppression Combinations Conditional on Survival to 1 Year (Transplants: January 2000-June 2009) Analysis limited to patients receiving prednisone ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG RECIPIENTS Kaplan-Meier Survival by Maintenance Immunosuppression Combinations Conditional on Survival to 1 Year (Transplants: January 2000-June 2009) Analysis limited to patients receiving prednisone Diagnosis: COPD/Emphysema ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG RECIPIENTS Kaplan-Meier Survival by Maintenance Immunosuppression Combinations Conditional on Survival to 1 Year (Transplants: January 2000-June 2009) Analysis limited to patients receiving prednisone Diagnosis: Idiopathic Pulmonary Fibrosis ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG RECIPIENTS Kaplan-Meier Survival by Maintenance Immunosuppression Combinations Conditional on Survival to 1 Year (Transplants: January 2000-June 2009) Analysis limited to patients receiving prednisone Diagnosis: Cystic Fibrosis ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

PERCENTAGE OF ADULT LUNG TRANSPLANT RECIPIENTS Experiencing Rejection between Transplant Discharge and 1-Year Follow-Up (Follow-ups: July 1, 2004 - June 30, 2010) Analysis is limited to patients who were alive at the time of the follow-up Overall: N = 7,049 18-34: N = 961 35-49: N = 1,215 50-59: N = 2,352 60-65: N = 1,880 66+: N = 641 Female: N = 3,083 Male: N = 3,966 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. ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

PERCENTAGE OF ADULT LUNG TRANSPLANT RECIPIENTS Experiencing Rejection between Transplant Discharge and 1-Year Follow-Up Stratified by Type of Induction (Follow-ups: July 1, 2004 - June 30, 2010) No induction: N = 3,157 Polyclonal: N = 686 IL-2R Antagonist: N = 2,682 Alemtuzumab: N = 477 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. 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. ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

PERCENTAGE OF ADULT LUNG TRANSPLANT RECIPIENTS Experiencing Rejection between Transplant Discharge and 1-Year Follow-Up Stratified by Type of Induction (Follow-ups: July 1, 2004 - June 30, 2010) 18-34: no induct vs. IL-2R (p=0.0478); poly vs. IL-2R (p=0.0030); IL-2R vs. Alemtuzumab (p=0.0080) 35-49: no induct vs. Alemtuzumab (p=0.0069); IL-2R vs. Alemtuzumab (p=0.0027) 50-59: no induct vs. IL-2R (p=0.0079) 60-65: no induct vs. IL-2R (p=0.0327) 66+: no induct vs. poly (p=0.0007); poly vs. IL-2R (p=0.0004); poly vs. Alemtuzumab (p=0.0011) 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. 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. ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

PERCENTAGE OF ADULT LUNG TRANSPLANT RECIPIENTS Experiencing Rejection between Transplant Discharge and 1-Year Follow-Up Stratified by Type of Induction (Follow-ups: July 1, 2004 - June 30, 2010) Female: no induct vs. IL2R (p=0.0324); IL-2R vs. Alemtuzumab (p=0.0065) Male: no induct vs.IL-2R (p=0.0016); poly vs. IL-2R (p = 0.0084) 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. 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. ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

PERCENTAGE OF ADULT LUNG TRANSPLANT RECIPIENTS Experiencing Rejection between Transplant Discharge and 1-Year Follow-Up Stratified by Maintenance Immunosuppression (Follow-ups: July 1, 2004 - June 30, 2010) Cyclosporine + MMF: N = 418 Cyclosporine + AZA: N = 610 Tacrolimus + MMF: N = 3,474 Tacrolimus + AZA: N = 1,755 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. 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. ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

PERCENTAGE OF ADULT LUNG TRANSPLANT RECIPIENTS Experiencing Rejection between Transplant Discharge and 1-Year Follow-Up Stratified by Maintenance Immunosuppression (Follow-ups: July 1, 2004 - June 30, 2010) 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. 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. ISHLT 2011 All age groups: all comparisons with CyA + AZA are significant at 0.05 except 66+: CyA + AZA vs. CyA + MMF (p=0.0576) 35-49: CyA + MMF vs. TAC + MMF( p=0.0399); CyA + MMF vs. TAC + AZA (p=0.0493) 50-59: CyA + MMF vs. TAC + MMF (p=0.0021); TAC + MMF vs. TAC + AZA (p=0.0273) 60-65: CyA + MMF vs. TAC + MMF (p=0.0046); TAC + MMF vs. TAC + AZA (p=0.0007) >65: TAC + MMF vs. TAC + AZA (p=0.0225) ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

PERCENTAGE OF ADULT LUNG TRANSPLANT RECIPIENTS Experiencing Rejection between Transplant Discharge and 1-Year Follow-Up Stratified by Maintenance Immunosuppression (Follow-ups: July 1, 2004 - June 30, 2010) Females: all comparisons are statistically significant at 0.001 except CyA + MMF vs. TAC + AZA (p=0.2541) Males: all comparisons were statistically significant at 0.02 except CyA + MMF vs. TAC + AZA (p=0.0927) 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. 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. ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

PERCENTAGE OF ADULT LUNG TRANSPLANT RECIPIENTS Experiencing Rejection between Transplant Discharge and 3-Year Follow-Up Stratified by Maintenance Immunosuppression (Follow-ups: July 1, 2004 - June 30, 2010) Cyclosporine + MMF: N = 222 Cyclosporine + AZA: N = 349 Tacrolimus + MMF: N = 1,391 Tacrolimus + AZA: N = 889 Analysis is limited to patients with rejection or no rejection reported on all three annual follow-ups through 3 years 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. ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

PERCENTAGE OF ADULT LUNG TRANSPLANT RECIPIENTS Experiencing Rejection between Transplant Discharge and 3-Year Follow-Up Stratified by Maintenance Immunosuppression (Follow-ups: July 1, 2004 - June 30, 2010) Analysis is limited to patients with rejection or no rejection reported on all three annual follow-ups through 3 years 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. ISHLT 2011 All age groups and genders: all comparisons with CyA + AZA are significant at 0.01 except 35-49: CyA + AZA vs. CyA+ MMF (p=0.1019), 66+: CyA + AZA vs. CyA + MMF (p=0.0883) and 66+: CyA + AZA vs. TAC + AZA (p=0.0965) ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

POST-LUNG TRANSPLANT MORBIDITY FOR ADULTS Cumulative Prevalence in Survivors within 1 Year Post-Transplant (Follow-ups: April 1994 - June 2010) ISHLT 2011 Outcome Follow-ups: April 1994 – June 2000 Follow-ups: July 2000 – June 2010 Within 1 Year Total N with known response Within 1 Year Total N with known response Hypertension49.3%(N = 3,739)53.5%(N = 9,119) Renal Dysfunction23.2%(N = 3,675)24.1%(N = 10,455) Abnormal Creatinine < 2.5 mg/dl12.8%17.9% Creatinine > 2.5 mg/dl8.6%4.5% Chronic Dialysis1.8%1.6% Renal Transplant0.0%0.1% Hyperlipidemia13.2%(N = 3,880)29.3%(N = 9,694) Diabetes16.9%(N = 3,700)29.5%(N = 10,374) Bronchiolitis Obliterans Syndrome10.7%(N = 3,435)9.1%(N = 9,845) ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

POST-LUNG TRANSPLANT MORBIDITY FOR ADULTS Cumulative Prevalence in Survivors within 1 and 5 Years Post-Transplant (Follow-ups: April 1994 - June 2010) ISHLT 2011 Outcome Within 1 Year Total N with known response Within 5 Years Total N with known response Hypertension52.3%(N = 12,858)83.7%(N = 3,678) Renal Dysfunction23.9%(N = 14,130)33.3%(N = 4,439) Abnormal Creatinine < 2.5 mg/dl16.6%22.7% Creatinine > 2.5 mg/dl5.6%7.7% Chronic Dialysis1.6%2.5% Renal Transplant0.1%0.4% Hyperlipidemia24.7%(N = 13,574)57.5%(N = 4,012) Diabetes26.2%(N = 14,074)39.6%(N = 4,137) Bronchiolitis Obliterans Syndrome9.5%(N = 13,280)37.9%(N = 3,487) ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

POST-LUNG TRANSPLANT MORBIDITY FOR ADULTS Cumulative Prevalence in Survivors within 10 Years Post-Transplant (Follow-ups: April 1994 - June 2010) ISHLT 2011 Outcome Within 10 YearsTotal N with known response Renal Dysfunction39.7%(N = 765) Abnormal Creatinine < 2.5 mg/dl26.3% Creatinine > 2.5 mg/dl4.8% Chronic Dialysis6.5% Renal Transplant2.1% Bronchiolitis Obliterans Syndrome58.1%(N = 482) ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

FREEDOM FROM BRONCHIOLITIS OBLITERANS SYNDROME For Adult Lung Recipients (Follow-ups: April 1994-June 2010) Conditional on Survival to 14 days ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

FREEDOM FROM BRONCHIOLITIS OBLITERANS SYNDROME STRATIFIED BY AGE GROUP For Adult Lung Recipients (Follow-ups: April 1994-June 2010) Conditional on Survival to 14 days ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

FREEDOM FROM BRONCHIOLITIS OBLITERANS SYNDROME STRATIFIED BY DIAGNOSIS For Adult Lung Recipients (Follow-ups: April 1994-June 2010) Conditional on Survival to 14 days ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

FREEDOM FROM BRONCHIOLITIS OBLITERANS SYNDROME STRATIFIED BY INDUCTION USE For Adult Lung Recipients (Follow-ups: April 1994-June 2010) Conditional on Survival to 14 days ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

FREEDOM FROM BRONCHIOLITIS OBLITERANS SYNDROME STRATIFIED BY INDUCTION USE For Adult Lung Recipients (Follow-ups: April 1994-June 2010) Conditional on Survival to 1 Year ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

FREEDOM FROM BRONCHIOLITIS OBLITERANS SYNDROME Stratified by Donor CMV Status/Recipient CMV Status For Adult Lung Recipients (Follow-ups: April 1994-June 2010) Conditional on Survival to 14 days ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

FREEDOM FROM BRONCHIOLITIS OBLITERANS SYNDROME Stratified by Donor CMV Status/Recipient CMV Status For Adult Lung Recipients (Follow-ups: April 1994-June 2010) Conditional on Survival to 1 Year ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

FREEDOM FROM SEVERE RENAL DYSFUNCTION* For Adult Lung Recipients (Follow-ups: April 1994-June 2010) ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

FREEDOM FROM SEVERE RENAL DYSFUNCTION* For Adult Lung Recipients (Follow-ups: April 1994-June 2010) Conditional on Survival to 1 Year ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

FREEDOM FROM SEVERE RENAL DYSFUNCTION* by Maintenance Immunosuppression Combinations at Discharge For Adult Lung Recipients (Transplants : January 2000-June 2009) Analysis limited to patients receiving prednisone Conditional on Survival to 14 days ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

MALIGNANCY POST-LUNG TRANSPLANTATION FOR ADULTS Cumulative Prevalence in Survivors (Follow-ups: April 1994 - June 2010) Malignancy/Type1-Year Survivors 5-Year Survivors 10-Year Survivors No Malignancy 14,023 (96.5%)3,925 (86.8%)571 (72.6%) Malignancy (all types combined) 513 (3.5%)597 (13.2%)216 (27.4%) Malignancy Type* Skin 149378143 Lymph 2127234 Other 13116965 Type Not Reported 2190 * 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 malignancies reported include: adenocarcinoma (2; 2; 1), bladder (2; 1; 0), lung (2; 4; 0), breast (1; 5; 2); prostate (0; 5; 1), cervical (1; 1; 0); liver (1; 1; 1); colon (1; 1; 0). Numbers in parentheses represent the number of reported cases within each time period. ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

FREEDOM FROM MALIGNANCY For Adult Lung Recipients (Follow-ups: April 1994-June 2010) ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

FREEDOM FROM MALIGNANCY For Adult Lung Recipients (Follow-ups: April 1994-June 2010) Conditional on Survival to 1 Year ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANT RECIPIENTS: Cause Of Death (Deaths: January 1992- June 2010) CAUSE OF DEATH 0-30 Days (N = 2,204) 31 Days – 1 Year (N = 3,781) >1 Year – 3 Years (N = 3,425) >3 Years – 5 Years (N = 1,962 ) >5 Years – 10 Years (N = 2,336) >10 Years (N = 675) BRONCHIOLITIS7 (0.3%)180 (4.8%)870 (25.4%)566 (28.8%)572 (24.5%)128 (19.0%) ACUTE REJECTION81 (3.7%)70 (1.9%)55 (1.6%)12 (0.6%)18 (0.8%)5 (0.7%) LYMPHOMA1 (0.0%)92 (2.4%)67 (2.0%)36 (1.8%)58 (2.5%)27 (4.0%) MALIGNANCY, OTHER3 (0.1%)112 (3.0%)226 (6.6%)180 (9.2%)289 (12.4%)78 (11.6%) CMV098 (2.6%)32 (0.9%)6 (0.3%)4 (0.2%)1 (0.1%) INFECTION, NON-CMV442 (20.1%)1,334 (35.3%)786 (22.9%)374 (19.1%)417 (17.9%)120 (17.8%) GRAFT FAILURE597 (27.1%)655 (17.3%)660 (19.3%)364 (18.6%)428 (18.3%)111 (16.4%) CARDIOVASCULAR239 (10.8%)168 (4.4%)141 (4.1%)105 (5.4%)122 (5.2%)62 (9.2%) TECHNICAL207 (9.4%)94 (2.5%)22 (0.6%)11 (0.6%)16 (0.7%)9 (1.3%) OTHER627 (28.4%)978 (25.9%)566 (16.5%)308 (15.7%)412 (17.6%)134 (19.9%) ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANT RECIPIENTS: Relative Incidence of Leading Causes of Death (Deaths: January 1992 - June 2010) ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ADULT LUNG TRANSPLANT RECIPIENTS: Cause Of Death Stratified by Donor CMV Status/Recipient CMV Status (Deaths: January 1992- June 2010) Donor CMV Status/ Recipient CMV Status Cause of Death0-30 Days 31 Days – 1 Year >1 Year – 3 Years >3 Years – 5 Years >5 Years – 10 Years >10 Years D(-)/R(-) (N=1,520) BRONCHIOLITIS1 (0.6%)22 (6.0%)96 (24.7%)74 (31.9%)65 (23.9%)17 (20.5%) INFECTION, NON-CMV31 (17.2%)132 (36.2%)93 (24.0%)44 (19.0%)37 (13.6%)14 (16.9%) GRAFT FAILURE55 (30.6%)68 (18.6%)83 (21.4%)49 (21.1%)54 (19.9%)18 (21.7%) D(-)/R(+) (N=2,281) BRONCHIOLITIS3 (1.1%)27 (5.4%)139 (25.7%)94 (24.8%)120 (26.1%)27 (20.9%) INFECTION, NON-CMV60 (21.7%)201 (40.5%)131 (24.2%)90 (23.7%)76 (16.6%)24 (18.6%) GRAFT FAILURE82 (29.6%)81 (16.3%)106 (19.6%)63 (16.6%)92 (20.0%)22 (17.1%) D(+)/R(-) (N=1,943) BRONCHIOLITIS019 (3.2%)118 (23.0%)67 (25.7%)67 (23.8%)4 (6.5%) INFECTION, NON-CMV42 (17.9%)220 (37.2%)118 (23.0%)45 (17.2%)51 (18.1%)20 (32.3%) GRAFT FAILURE68 (28.9%)116 (19.6%)115 (22.5%)58 (22.2%)69 (24.5%)9 (14.5%) D(+)/R(+) (N=3,466) BRONCHIOLITIS1 (0.2%)44 (5.3%)222 (24.7%)148 (27.3%)133 (22.1%)26 (16.7%) INFECTION, NON-CMV84 (19.3%)305 (36.7%)207 (23.1%)104 (19.2%)105 (17.4%)21 (13.5%) GRAFT FAILURE135 (31.0%)178 (21.4%)169 (18.8%)113 (20.8%)130 (21.6%)33 (21.2%) ISHLT 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

LUNG TRANSPLANTATION Overall 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132.

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LUNG TRANSPLANTATION Overall 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132.

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Presentation on theme: "LUNG TRANSPLANTATION Overall 2011 ISHLT J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132."— Presentation transcript:

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