J Heart Lung Transplant 2009;28: 989-1049 HEART-LUNG TRANSPLANTATION Overall ISHLT 2009.

J Heart Lung Transplant 2009;28: 989-1049

HEART-LUNG TRANSPLANTATION

Overall

ISHLT 2009


0

50

100

150

200

250

1982

1983

1984

1985

1986

1987

1988

1989

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

Nu

mb

er

of

Tra

ns

pla

nts

NUMBER OF HEART-LUNG TRANSPLANTS REPORTED BY YEAR

ISHLTNOTE: This figure includes only the heart-lung transplants that are reported to the ISHLT Transplant Registry. As such, this should not be construed as evidence that the number of heart-lung transplants worldwide has declined in recent years.

2009


AVERAGE CENTER VOLUMEHeart-Lung Transplants: January 1, 1998 - June 30, 2008

51

33

7 5 10

5

10

15

20

25

30

35

40

45

50

55

1 2 3 4-9 10+Average number of heart-lung transplants per year

Nu

mb

er

of

ce

nte

rs

0

5

10

15

20

25

30

35

40

Number of centers Percentage of transplants

Pe

rce

nta

ge

of

he

art

-lu

ng

tra

ns

pla

nts

ISHLT

2009


DISTRIBUTION OF HEART-LUNG TRANSPLANTS BY CENTER VOLUME

Heart-Lung Transplants: January 1, 1998 - June 30, 2008

0

5

10

15

20

25

30

35

40

1 2 3 4-9 10+

Average number of heart-lung transplants per year

Pe

rce

nta

ge

of

he

art

-lu

ng

tra

ns

pla

nts

ISHLT

2009


DISTRIBUTION OF HEART-LUNG TRANSPLANTS BY LUNG CENTER VOLUME

Lung Transplants: January 1, 1998 - June 30, 2008

0

5

10

15

20

25

30

35

40

1-4 5-9 10-19 20-29 30-39 40-49 50+

Average number of lung transplants per year

Pe

rce

nta

ge

of

he

art

-lu

ng

tra

ns

pla

nts

ISHLT

2009


HEART-LUNG TRANSPLANTATIONKaplan-Meier Survival for All Ages (Transplants: January 1982 - June 2007)

0

20

40

60

80

100

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

Years

Su

rviv

al (

%)

Half-life = 3.2 yearsConditional Half-life = 8.9 years

N=3,340

N at risk at 20 years = 22

ISHLT

2009



Adult Recipients

ISHLT

2009


Acquired heart disease

3%Congenital

heart disease35%

COPD/Alpha-16%

CF14%

IPAH27%

Re-transplant2%

Other10%

IPF3%

DIAGNOSIS IN ADULT HEART-LUNG TRANSPLANTS (January 1982 - June 2008)

“Other” includes cancer, LAM, OB, sarcoidosis, bronchiectasis

ISHLT

2009


DIAGNOSIS IN ADULT HEART-LUNG TRANSPLANTS (Transplants: January 1982 - June 2008)

Diagnosis N (%)

Congenital Heart Disease 921 (34.9%)

Idiopathic Pulmonary Arterial Hypertension 719 (27.2%)

Cystic Fibrosis 373 (14.1%)

COPD/Emphysema 101 ( 3.8%)

Acquired Heart Disease 77 ( 2.9%)

Idiopathic Pulmonary Fibrosis 76 ( 2.9%)

Alpha-1 53 ( 2.0%)

Sarcoidosis 37 ( 1.4%)

Re-Transplant: Not Obliterative Bronchiolitis 31 ( 1.2%)

Re-Transplant: Obliterative Bronchiolitis 24 ( 0.9%)

Bronchiectasis 20 ( 0.8%)

Obliterative Bronchiolitis (not Re-Transplant)

14 ( 0.5%)

Other 193 ( 7.3%)

ISHLT

2009


DIAGNOSIS IN ADULT HEART-LUNG TRANSPLANTS BY ERA (Transplants: January 1982 - June 2008)

0%

20%

40%

60%

80%

100%

1982-1995 1996-1999 2000-6/2008

% o

f T

ran

sp

lan

ts

Other

Re-TX

IPAH

IPF

CF

Acquired Heart Disease

Congenital Heart Disease

COPD/Alpha-1

“Other” includes OB (non-ReTX), Bronchiectasis, Sarcoidosis

ISHLT

2009


ADULT HEART-LUNG TRANSPLANTATIONIndications By Year (%)

0

20

40

60

80

100

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

Transplant Year

% o

f T

ran

sp

lan

ts

Congenital Heart Disease IPAHCystic Fibrosis COPD/Alpha-1Acquired Heart Disease

ISHLT

2009


ADULT HEART-LUNG TRANSPLANTATIONIndications By Year (Number)

0

25

50

75

100

125

150

175

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

Transplant Year

Nu

mb

er

of

Tra

ns

pla

nts

Congenital Heart Disease IPAH Cystic Fibrosis

COPD/Alpha-1 Acquired Heart Disease

ISHLT

2009


0%

20%

40%

60%

80%

100%

Europe North America Other

% o

f T

ran

spla

nts

18 - 34 years 35 - 49 years 50 - 59 years 60+ years

ADULT HEART-LUNG TRANSPLANTS:AGE DISTRIBUTION BY LOCATION Transplants between January 2000 and June 2008

ISHLT

2009


0%

20%

40%

60%

80%

100%


Acquired heart disease Congenital heart disease Cystic Fibrosis IPF IPAH Other

% o

f T

ran

sp

lan

tsADULT HEART-LUNG TRANSPLANTS:DIAGNOSIS DISTRIBUTION BY LOCATION

Transplants between January 2000 and June 2008

ISHLT

2009


0%

20%

40%

60%

80%

100%


% o

f D

on

ors

6-11 12-17 18-34 35-49 50-59 60+

ADULT HEART-LUNG TRANSPLANTS:DONOR AGE DISTRIBUTION BY LOCATION


ISHLT

2009


HEART-LUNG TRANSPLANTATIONKaplan-Meier Survival for Adult Recipients

(Transplants: January 1982 - June 2007)

0

20

40

60

80

100

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

Years

Su

rviv

al

(%)

Half-life = 3.5 YearsConditional Half-life = 9.2 Years

N=2,712

N at risk at 20 years = 18

ISHLT

2009


HEART-LUNG TRANSPLANTATIONKaplan-Meier Survival for Adult Recipients by Era

(Transplants: January 1982 - June 2007)

0

20

40

60

80

100

0 1 2 3 4 5 6 7 8 9 10

Years

1982-1995 (N=1,647)

1996-1999 (N=498)

2000-6/2007 (N=567)

Su

rviv

al

(%)

P-value comparing all: 0.0003

Half-life (Years): 1982-1995 = 3.0; 1996-1999 = 3.4; 2000-6/2007 =6.0 Conditional Half-life (Years): 1982-1995 = 8.8; 1996-1999 = 9.6; 2000-6/2007 = n/a

ISHLT

2009


ADULT HEART-LUNG TRANSPLANTATIONKaplan-Meier Survival By Diagnosis (Transplants: January 1990 – June 2007)

0

25

50

75

100

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15Years

Su

rviv

al (

%)

Other Congenital (N = 176)Eisenmenger's Syndrome (N = 571)IPAH (N = 480)

Congenital vs. Eisenmenger's: p = 0.0011Congenital vs. IPAH: p = 0.0372Eisenmenger's vs. IPAH: p = 0.0740

HALF-LIFE Congenital: 1.2 Years; Eisenmenger's: 6.1 Years; IPAH: 3.9 Years

ISHLT

2009


ADULT HEART-LUNG TRANSPLANTATIONKaplan-Meier Survival By Diagnosis Conditional on Survival to 1 Year

(Transplants: January 1990 – June 2007)

0

25

50

75

100

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15Years

Su

rviv

al

(%)

Other Congenital (N = 88)Eisenmenger's Syndrome (N = 380)IPAH (N = 314)

HALF-LIFE Congenital Years: n.a.;Eisenmenger's: 10.6 Years; IPAH: 9.6 Years


ISHLT

2009


ADULT HEART-LUNG RECIPIENTS Functional Status of Surviving Recipients

(Follow-ups: April 1994 – June 2008)

0%

20%

40%

60%

80%

100%

1 Year (N = 263) 3 Years (N = 212) 5 Years (N = 180) 7 Years (N = 149)

No Activity Limitations Performs with Some Assistance Requires Total Assistance

ISHLT

2009


ADULT HEART-LUNG RECIPIENTS Functional Status of Surviving Recipients

For the Same Patients(Follow-ups: April 1994 – June 2008)

0%

20%

40%

60%

80%

100%

1 Year (N = 102) 3 Years (N = 102) 5 Years (N = 102)

No Activity Limitations Performs with Some Assistance

ISHLT

2009


ADULT HEART-LUNG RECIPIENTSEmployment Status of Surviving Recipients

(Follow-ups: April 1994 – June 2008)

0%

20%

40%

60%

80%

100%

1 Year (N = 308) 3 Years (N = 224) 5 Years (N = 199) 7 Years (N = 153)

Working (FT/PTstatus unknown)

Retired

Not Working

Working Part Time

Working Full Time

ISHLT

2009


ADULT HEART-LUNG RECIPIENTS: Rehospitalization Post-transplant of Surviving Recipients

(Follow-ups: April 1994 - June 2008)

0%

20%

40%

60%

80%

100%

Up to 1 Year (N = 375)

Between 2 and 3 Years (N = 273)



No Hospitalization Hospitalized, Not Rejection/Not InfectionHospitalized, Rejection Only Hospitalized, Infection OnlyHospitalized, Rejection and Infection

ISHLT

2009


0

10

20

30

40

50

60

70

Any Induction (N =132)

Polyclonal ALG/ATG(N = 58)

OKT3 (N = 5) IL2R-antagonist (N =59)

% o

f p

ati

en

tsADULT HEART-LUNG RECIPIENTS

Induction ImmunosuppressionFor transplants between January 2001 through June 2008

ISHLT

Analysis is limited to patients who were alive at the time of the follow-up2009


0

10

20

30

40

50

60

70

80

90

Any Induction Polyclonal ALG/ATG OKT3 IL2R-antagonist

% o

f p

ati

en

ts

2000 2001 2002 20032004 2005 2006 2007

ADULT HEART-LUNG RECIPIENTSInduction Immunosuppression (Transplants: January 2000 - December 2007)

ISHLT



0

10

20

30

40

50

60

70

80

90

% o

f p

ati

en

ts

ADULT HEART-LUNG RECIPIENTSInduction Immunosuppression (Transplants: January 2000 - December 2007)

ISHLT

Any Induction Polyclonal ALG/ATG OKT3 IL2R-antagonist



0

20

40

60

80

100

Cyclosporine Tacrolimus Rapamycin MMF Azathioprine Prednisone

% o

f P

atie

nts

Year 1 (N = 143) Year 5 (N = 91)

ADULT HEART-LUNG RECIPIENTSMaintenance Immunosuppression at Time of Follow-up

For follow-ups between January 2001 through June 2008

NOTE: Different patients are analyzed in Year 1 and Year 5

ISHLT



0%

20%

40%

60%

80%

100%

Year 1 (N = 143) Year 5 (N = 91)

% o

f P

ati

en

ts

Other

Tacrolimus + MMF

Tacrolimus + AZA

Cyclosporine + MMF

Cyclosporine + AZA

ADULT HEART-LUNG RECIPIENTSMaintenance Immunosuppression Drug Combinations at Time of Follow-up

For follow-ups between January 2001 through June 2008

NOTE: Different patients are analyzed in Year 1 and Year 5

ISHLT



POST-HEART-LUNG TRANSPLANT MORBIDITY FOR ADULTS Cumulative Prevalence in Survivors within 1 Year Post-Transplant


Outcome Within 1

Year Total number with known response

Hypertension 57.2% (N = 360)

Renal Dysfunction 18.1% (N = 371)

Abnormal Creatinine < 2.5 mg/dl 11.6% Creatinine > 2.5 mg/dl 2.7% Chronic Dialysis 3.5% Renal transplant 0.3%

Hyperlipidemia 24.1% (N = 381)

Diabetes 17.9% (N = 375)

Coronary Artery Vasculopathy 3.0% (N = 303)

Bronchiolitis Obliterans Syndrome 8.7% (N = 355)

ISHLT

2009


POST-HEART-LUNG TRANSPLANT MORBIDITY FOR ADULTS Cumulative Prevalence in Survivors within 5 Years Post-Transplant


Outcome Within 5

Years

Total number with known response

Hypertension 88.6% (N = 123)

Renal Dysfunction 28.1% (N = 135)

Abnormal Creatinine < 2.5 mg/dl 20.0% Creatinine > 2.5 mg/dl 7.4% Chronic Dialysis 0.7% Renal Transplant 0.0%

Hyperlipidemia 66.4% (N = 131)

Diabetes 20.9% (N = 129)

Coronary Artery Vasculopathy 8.2% (N = 73)

Bronchiolitis Obliterans Syndrome 27.1% (N = 107)

ISHLT

2009


Freedom from Coronary Artery Vasculopathy For Adult Heart-Lung Recipients (Follow-ups: April 1994-June 2008)

50

60

70

80

90

100

0 1 2 3 4 5 6 7

Years

% F

ree

fro

m C

AV

ISHLT

2009


Freedom from Bronchiolitis Obliterans Syndrome For Adult Heart-Lung Recipients (Follow-ups: April 1994-June 2008)

40

50

60

70

80

90

100

0 1 2 3 4 5 6 7Years

% F

ree

fro

m B

ron

ch

iolit

is O

blit

era

ns

S

yn

dro

me

ISHLT

2009


Freedom from Severe Renal Dysfunction*For Adult Heart-Lung Recipients (Follow-ups: April 1994-June 2008)

50

60

70

80

90

100

0 1 2 3 4 5 6

Years

% F

ree

fro

m S

ev

ere

Re

na

l Dy

sfu

nc

tio

n

*Severe renal dysfunction = Creatinine > 2.5 mg/dl (221 μmol/L), dialysis or renal transplant

ISHLT

2009


MALIGNANCY POST-HEART-LUNG TRANSPLANT FOR ADULTSCumulative Prevalence in Survivors (Follow-ups: April 1994-June 2008)

Malignancy/Type 1-Year Survivors

5-Year Survivors

10-Year Survivors

No Malignancy 352 (93.1%) 119 (88.8%) 32 (84.2%)

Malignancy (all types combined) 26 (6.9%) 15 (11.2%) 6 (15.8%)

Malignancy Type*

Skin 2 4 6

Lymph 18 6 0

Other 4 3 0

Type Not Reported 2 2 0

ISHLT

* Recipients may have experienced more than one type of malignancy so sum of individual malignancy types may be greater than total number with malignancy.

2009


Freedom from MalignancyFor Adult Heart-Lung Recipients (Follow-ups: April 1994- June 2008)

50

60

70

80

90

100

0 1 2 3 4 5 6 7

Years

% F

ree

fro

m M

alig

na

nc

y

All malignancyLymphSkinOther

ISHLT

2009


ADULT HEART-LUNG TRANSPLANT RECIPIENTS: Cause of Death (Deaths: January 1992 - June 2008)

CAUSE OF DEATH 0-30 Days

(N = 282)

31 Days - 1 Year (N = 217)

>1 Year - 3 Years (N = 187)

>3 Years - 5 Years (N = 134)

>5 Years

(N = 274)

BRONCHIOLITIS 0 4 (1.8%) 39 (20.9%) 26 (19.4%) 43 (15.7%)

ACUTE REJECTION 3 (1.1%) 6 (2.8%) 2 (1.1%) 1 (0.7%) 1 (0.4%)

LYMPHOMA 0 8 (3.7%) 10 (5.3%) 5 (3.7%) 5 (1.8%)

MALIGNANCY, OTHER 0 3 (1.4%) 7 (3.7%) 4 (3.0%) 16 (5.8%)

CMV 0 1 (0.5%) 0 1 (0.7%) 0

INFECTION, NON-CMV 51 (18.1%) 76 (35.0%) 60 (32.1%) 43 (32.1%) 80 (29.2%)

GRAFT FAILURE 82 (29.1%) 52 (24.0%) 31 (16.6%) 25 (18.7%) 54 (19.7%)

CARDIOVASCULAR 24 (8.5%) 9 (4.1%) 12 (6.4%) 9 (6.7%) 18 (6.6%)

TECHNICAL 57 (20.2%) 6 (2.8%) 1 (0.5%) 1 (0.7%) 0

OTHER 65 (23.0%) 52 (24.0%) 25 (13.4%) 19 (14.2%) 57 (20.8%)

ISHLT

2009


ADULT HEART-LUNG TRANSPLANT RECIPIENTS: Relative Incidence of Leading Causes of Death

(Deaths: January 1992 - June 2008)

0

10

20

30

40

50

0-30 Days (N =282)

31 Days – 1Year (N =217)

>1 Year – 3Years (N = 187)

>3 Years – 5Years (N = 134)

>5 Years (N =274 )

Bronchiolitis Infection (non-CMV) Graft Failure

Cardiovascular Technical

Pe

rce

nta

ge

of

De

ath

s

ISHLT

2009



Pediatric Recipients

ISHLT

2009


AGE DISTRIBUTION OF PEDIATRIC HEART-LUNGRECIPIENTS (Transplants: January 1982 - June 2008)

0

50

100

150

200

250

300

350

<1 1-5 yrs 6-11 yrs 12-17 yrs

Recipient Age (Years)

Nu

mb

er o

f T

ran

spla

nts

ISHLT

2009


AGE DISTRIBUTION FOR DONORS OF PEDIATRIC HEART-LUNG RECIPIENTS (Transplants: January 1982 - June 2008)

347

97

52 3260

50

100

150

200

250

300

350

0-11 yrs 12-17 yrs 18-34 35-49 50-59

Donor Age (Years)

Nu

mb

er o

f T

ran

spla

nts

ISHLT

2009


AGE DISTRIBUTION OF PEDIATRIC HEART-LUNG RECIPIENTS

By Year of Transplant

0

5

10

15

20

25

30

35

40

45

50

1984

1985

1986

1987

1988

1989

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

12-17 Years1-11 Years

<1 Year

Nu

mb

er o

f T

ran

spla

nts

ISHLT

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 pediatric heart-lung transplants worldwide has declined in recent years.

2009


AGE DISTRIBUTION OF PEDIATRIC HEART-LUNG RECIPIENTS

By Era of Transplant

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1982-1995 1996-6/2008

12-17 Years

1-11 Years

<1 Year

Per

cen

tag

e o

f T

ran

spla

nts

ISHLT

2009


NUMBER OF CENTERS REPORTING PEDIATRIC HEART-LUNG TRANSPLANTS

ISHLT

NEED TO UPDATE

0

5

10

15

20

25

1984

1985

1986

1987

1988

1989

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

Transplant Year

# P

edia

tric

Tra

nsp

lan

t C

ente

rs

2009


NUMBER OF CENTERS REPORTING PEDIATRIC HEART-LUNG TRANSPLANTS

Stratified by center volume

0

5

10

15

20

25

1984

1985

1986

1987

1988

1989

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

Transplant Year

# P

edia

tric

Tra

nsp

lan

t C

ente

rs

1-4/yr 5-9/yr

10-19/yr 20-29/yr

ISHLT

2009


5%

22%

22%

14%

1%

6%26%

2%

2%

Acquired Heart Disease

CF

Congenital (other)Eisenmenger's Syndrome

IPF

Other

IPAHRetx: Non-OB

Retx: OB

DIAGNOSIS IN PEDIATRIC HEART –LUNG TRANSPLANT RECIPIENTS (Transplants: 1986-2007)

0

25

50

75

100

1986

1987

1988

1989

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

% o

f C

as

es

Cystic Fibrosis Congenital IPAH

“Other” includes Bronchiectasis, Alpha-1, and OB (non-ReTX)

ISHLT

2009NOTE: Unknown diagnoses were excluded from this tabulation.


0%

20%

40%

60%

80%

100%


% o

f T

ran

sp

lan

ts

0-5 years 6-11 years 12-17 years

PEDIATRIC HEART-LUNG TRANSPLANTS:AGE DISTRIBUTION BY LOCATION Transplants between January 2000 and June 2008

ISHLT

2009


0%

20%

40%

60%

80%

100%


Congenital heart disease Cystic Fibrosis IPAH Other

% o

f T

ran

sp

lan

tsPEDIATRIC HEART-LUNG TRANSPLANTS:

DIAGNOSIS DISTRIBUTION BY LOCATION Transplants between January 2000 and June 2008

ISHLT

2009


0%

20%

40%

60%

80%

100%


% o

f D

on

ors

0-5 6-11 12-17 18-34 35-49

PEDIATRIC HEART-LUNG TRANSPLANTS:DONOR AGE DISTRIBUTION BY LOCATION


ISHLT

2009


PEDIATRIC HEART-LUNG TRANSPLANTATIONKaplan-Meier Survival By Diagnosis (Transplants: January 1990 – June 2007)

0

25

50

75

100

0 1 2 3 4 5 6 7 8

Years

Su

rviv

al

(%)

Congenital (N = 77)

Eisenmenger's Syndrome (N = 50)

IPAH (N = 90)

HALF-LIFE Congenital: 1.8 Years; Eisenmenger's: 2.6 Years; IPAH: 4.0 Years


ISHLT

2009


PEDIATRIC HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival (Transplants: January 1982 - June 2007)

0

25

50

75

100

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

Years

Su

rviv

al

(%)

< 1 (N = 20)

1-11 (N = 216) 12-17 (N = 299)

Overall (N = 535)

Half-life <1: 0.2 Years;1-11: 3.0 Years; 12-17: 3.5 Years

0-<1 vs. 1-11: p = 0.0003; 0-<1 vs. 12-17: p < 0.0001; 1-11 vs. 12-17: p = 0.1141

ISHLT

2009


PEDIATRIC HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival by Era (Transplants: January 1982 - June 2007)

0

25

50

75

100

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14Years

1982-1988 (N=110)

1989-1993 (N=178)

1994-1998 (N=125)1999-6/2007 (N=122)

Half-life 1982-1988: 1.9; 1989-1993: 3.0; 1994-1998: 3.2; 1999-6/2007: 3.8

82-88 vs. 89-93: p = 0.4833; 82-88 vs. 94-98: p = 0.6399; 82-88 vs. 99-6/2007: p = 0.0413; 89-93 vs. 94-98: p = 0.9949; 89-93 vs. 99-6/2007: p = 0.1750; 94-98 vs. 99-6/2007: p = 0.1864

Su

rviv

al

(%)

ISHLT

2009


PEDIATRIC HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival by Era (Transplants: January 1982 - June 2007)

Conditional on Survival to 1 Year

0

20

40

60

80

100

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14Years

1982-1988 (N=61) 1989-1993 (N=111)

1994-1998 (N=78) 1999-6/2007 (N=80)

Conditional HALF-LIFE 1982-1988: 8.0; 1989-1993: 7.2; 1994-1998: 6.1; 1999-6/2007: n/a

82-88 vs. 89-93: p = 0.5948; 82-88 vs. 94-98: p = 0.4329; 82-88 vs. 99-6/2007: p = 0.9180; 89-93 vs. 94-98: p = 0.9559;89-93 vs. 99-6/2007: p = 0.6423; 94-98 vs. 99-6/2007: p = 0.6062

Su

rviv

al

(%)

ISHLT

2009


PEDIATRIC HEART-LUNG TRANSPLANT RECIPIENTS: Cause of Death (Deaths: January 1992 - June 2008)

CAUSE OF DEATH 0-30 Days (N = 37)

31 Days - 1 Year (N = 49 )

>1 Year - 3 Years (N = 45 )

>3 Years - 5 Years (N = 31 )

>5 Years (N = 43)

BRONCHIOLITIS 2 (4.1%) 21 (46.7%) 10 (32.3%) 8 (18.6%)

ACUTE REJECTION 2 (4.1%) 1 (2.2%)

LYMPHOMA 2 (4.1%) 1 (2.2%) 1 (3.2%) 2 (4.7%)

MALIGNANCY, OTHER 1 (3.2%)

CMV 2 (4.1%)


GRAFT FAILURE 16 (43.2%) 9 (18.4%) 14 (31.1%) 14 (45.2%) 11 (25.6%)

CARDIOVASCULAR 2 (5.4%) 3 (6.1%) 1 (2.2%) 2 (6.5%) 3 (7.0%)

TECHNICAL 6 (16.2%)

ISHLT

2009


PEDIATRIC HEART-LUNG TRANSPLANT RECIPIENTS: Cause of Death (Deaths: April 1994 - June 2008)

CAUSE OF DEATH 0-30 Days (N = 31)

31 Days - 1 Year (N = 35)

>1 Year - 3 Years (N = 39)

>3 Years - 5 Years (N = 27)

>5 Years

(N = 43)

BRONCHIOLITIS 1 (2.9%) 18 (46.2%) 9 (33.3%) 8 (18.6%)

ACUTE REJECTION 1 (2.9%) 1 (2.6%)

LYMPHOMA 2 (5.7%) 1 (2.6%) 1 (3.7%) 2 (4.7%)

MALIGNANCY, OTHER 1 (3.7%)

CMV 1 (2.9%)


GRAFT FAILURE 14 (45.2%) 6 (17.1%) 11 (28.2%) 12 (44.4%) 11 (25.6%)

CARDIOVASCULAR 2 (6.5%) 2 (5.7%) 1 (2.6%) 1 (3.7%) 3 (7.0%)

TECHNICAL 4 (12.9%)

ISHLT

2009


PEDIATRIC HEART-LUNG TRANSPLANT RECIPIENTS: Relative Incidence of Leading Causes of Death

(Deaths: April 1994 - June 2008)

0

10

20

30

40

50

0-30 Days (N =31)

31 Days – 1Year (N =35)

>1 Year – 3Years (N = 39)

>3 Years – 5Years (N = 27)

>5 Years (N =43 )

Bronchiolitis Graft Failure Cardiovascular Infection (non-CMV)

Pe

rce

nta

ge

of

De

ath

s

ISHLT

2009

J Heart Lung Transplant 2009;28: 989-1049 HEART-LUNG TRANSPLANTATION Overall ISHLT 2009.

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Transcript of J Heart Lung Transplant 2009;28: 989-1049 HEART-LUNG TRANSPLANTATION Overall ISHLT 2009.