J Heart Lung Transplant 2009;28: 989-1049 LUNG TRANSPLANTATION Pediatric Recipients ISHLT 2009.

J Heart Lung Transplant 2009;28: 989-1049

LUNG TRANSPLANTATION

Pediatric Recipients

ISHLT 2009


RECIPIENT AGE DISTRIBUTION FOR PEDIATRIC LUNG RECIPIENTS - NUMBER

(Transplants: January 1986 - June 2008)

0

100

200

300

400

500

600

700

800

900

1000

1986-1995 (N=306) 1996-6/2008 (N=972)

Nu

mb

er

of

Tra

ns

pla

nts

<1 1-5 6-11 12-17

ISHLT Analysis includes living donor transplants 2009


RECIPIENT AGE DISTRIBUTION FOR PEDIATRIC LUNG RECIPIENTS - PERCENTAGE


0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1986-1995 (N=306) 1996-6/2008 (N=972)

% o

f T

ran

sp

lan

ts

12-17

6-11

1-5

<1



DONOR TYPE DISTRIBUTION BY YEAR OF TRANSPLANT FOR PEDIATRIC LUNG RECIPIENTS

(Transplants: 1986-2007)

0

10

20

30

40

50

60

70

80

90

100

1986 1987 1988 1989 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

Living

Deceased

ISHLTNOTE: This figure includes only the lung transplants that are reported to the ISHLT Transplant Registry. As such, the presented data may not mirror the changes in the number of lung transplants performed worldwide.

Analysis includes living donor transplants

2009


DONOR TYPE DISTRIBUTION BY RECIPIENT AGE GROUP WITHIN ERA FOR PEDIATRIC LUNG RECIPIENTS (Transplants: January 1986 - June 2008)

0

100

200

300

400

500

600

700

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

Recipient Age (Years)

Nu

mb

er

of

Tra

ns

pla

nts

LivingDeceased

1986-1995 1996-6/2008



AGE DISTRIBUTION FOR DONORS OF PEDIATRIC

LUNG RECIPIENTS (Transplants: January 1986 - June 2008)

553

239

188

131

47

4

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Donor Age (Years)

Nu

mb

er

of

Tra

ns

pla

nts

60+

50-59

35-49

18-34

12-17

0-11

ISHLT 2009


AGE DISTRIBUTION OF PEDIATRIC LUNG RECIPIENTS

By Year of Transplant

1 3 4 6

20

48 51 48

82

73

86 87

67 6762

6973

77

87 8793

43

0

20

40

60

80

100

12-17 Years

1-11 Years

<1 Year

Nu

mb

er o

f T

ran

spla

nts

ISHLT

Analysis includes living donor transplants 2009

NOTE: This figure includes only the pediatric lung transplants that are reported to the ISHLT Transplant Registry. Therefore, these numbers should not be interpreted as the rate of change in pediatric lung procedures performed worldwide.


NUMBER OF CENTERS REPORTING PEDIATRIC LUNG TRANSPLANTS

0

10

20

30

40

1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

Transplant Year

Nu

mb

er

of

Ce

nte

rs R

ep

ort

ing

P

ed

iatr

ic T

ran

sp

lan

ts

ISHLT



NUMBER OF CENTERS REPORTING PEDIATRIC LUNG TRANSPLANTS BY CENTER VOLUME

0

10

20

30

40

1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

Transplant Year

Nu

mb

er

of

Ce

nte

rs R

ep

ort

ing

P

ed

iatr

ic T

ran

sp

lan

ts

20+ transplants

10-19 transplants

5-9 transplants

1-4 transplants

ISHLT



PEDIATRIC LUNG TRANSPLANTATION: Indications (Transplants: January 1990 – June 2008)

DIAGNOSIS AGE: < 1 Year

AGE: 1-5 Years

AGE: 6-11 Years

AGE: 12-17 Years

Cystic Fibrosis 2 2.4% 5 5.1% 124 53.0% 547 69.2%

Idiopathic Pulmonary Arterial Hypertension

11 13.4% 22 22.2% 25 10.7% 60 7.6%

Re-Transplant: Obliterative Bronchiolitis 6 6.1% 8 3.4% 25 3.2%

Congenital Heart Disease 21 25.6% 8 8.1% 4 1.7% 10 1.3%

Idiopathic Pulmonary Fibrosis 4 4.9% 8 8.1% 10 4.3% 26 3.3%

Obliterative Bronchiolitis (Not Re-TX) 9 9.1% 10 4.3% 29 3.7%

Re-Transplant: Not OB 3 3.7% 2 2.0% 7 3.0% 18 2.3%

Interstitial Pneumonitis 6 7.3% 11 11.1% 1 0.4% 5 0.6%

Pulmonary Vascular Disease 8 9.8% 5 5.1% 7 3.0% 1 0.2%

Eisenmenger’s Syndrome 1 1.2% 5 5.1% 5 2.1% 6 0.8%

Pulmonary Fibrosis, Other 1 1.2% 1 1.0% 7 3.0% 11 1.4%

Surfactant Protein B Deficiency 11 13.4% 4 4.0%

COPD/Emphysema 5 6.1% 2 2.0% 2 0.9% 6 0.8%

Bronchopulmonary Dysplasia 2 2.4% 2 2.0% 6 2.6%

Bronchiectasis 4 1.7% 9 1.1%

Other 7 8.5% 9 9.1% 14 6.0% 39 4.9%

ISHLT



PEDIATRIC LUNG TRANSPLANTATION:Other Indications (Transplants: January 1990 – June 2006)

DIAGNOSIS AGE: < 1 Year

AGE: 1-5 Years

AGE: 6-11 Years

AGE: 12-17 Years

Alpha - 1 - Antitrypsin Deficiency 1 0.2%

ARDS/Pneumonia 1 1.2% 1 0.5%

BOOP 1 0.2%

Dilated Myopathy: Adriamycin 1 0.2%

Graft-Vs-Host Disease (GVHD) 1 1.2% 2 0.3%

Idiopathic Pulmonary Hemosiderosis 2 0.3%

Inhalation Burns/Trauma 1 0.2%

Portopulmonary Hypertension 1 1.2%

Pulmonary Veno-Occlusive Disease 1 0.2%

Restrictive Lung Disease 1 1.2%

Rheumatoid Disease 1 1.2%

Scleroderma 1 0.2%

Secondary Pulmonary Hypertension 2 3.2%

Other Lung Disease 4 0.6%

ISHLT Last updated based on data as of December 2006



PEDIATRIC LUNG TRANSPLANTATION: Other Indications (Transplants: January 1990 – June 2006)

DIAGNOSIS(continued)

AGE: < 1 Year

AGE: 1-5 Years

AGE: 6-11 Years

AGE: 12-17 Years

Other – Specify: 3 4.8% 2 2.5% 2 1.0% 3 0.5%

Chronic Interstitial Pneumonia 1

Chronic Lung Disease Unknown Etiology

1

Diaphragmatic Hernia 1

End Stage Interstitial Lung Disease 1

Pulmonary 1

Pulmonary Interstitial Emphysema 1

Respiratory Failure 1

TALC/Pneumoconiosis/Berylliososis 1

Unknown 1 1




PEDIATRIC LUNG TRANSPLANTATION: Other Indications (Transplants: January 1990 – June 2006)

DIAGNOSIS(continued)

AGE: < 1 Year

AGE: 1-5 Years

AGE: 6-11 Years

AGE: 12-17 Years

Lung Disease: Other Specify 2 1.0% 3 0.5%

Miscellaneous Lung: Not Specified 2

Pulmonary Lymphangectasia 1

Not Reported 1 1

Other 1 0.5% 6 0.9%

Congenital Anomaly 1

Langerhans -Histiocytosis 1

Not Reported 1 4




DIAGNOSIS IN PEDIATRIC LUNG RECIPIENTSBY YEAR OF TRANSPLANT

Age: 12-17 Years

0

25

50

75

100

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

% o

f T

ran

sp

lan

ts

IPAH Cystic Fibrosis

ISHLT



0%

20%

40%

60%

80%

100%

Europe (N=181) North America (N=443) Other (N=35)

% o

f T

ran

sp

lan

ts

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

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

ISHLT



0%

20%

40%

60%

80%

100%


% o

f T

ran

sp

lan

ts-

Cystic Fibrosis IPAH IPF OB Other Congenital heart disease Re-TX

PEDIATRIC LUNG TRANSPLANTS:DIAGNOSIS DISTRIBUTION BY LOCATION

Transplants between January 2000 and June 2008

ISHLT

NOTE: Unknown diagnoses were excluded from this tabulation.

Total number of transplants reported:Europe = 171North America = 443Other = 35

Analysis includes living donor transplants

2009


0%

20%

40%

60%

80%

100%


% o

f D

on

ors

0-5 6-11 12-17 18-34 35-49 50-59 60+

PEDIATRIC LUNG TRANSPLANTS:DONOR AGE DISTRIBUTION BY LOCATION

Transplants between January 2000 and June 2008

ISHLT

NOTE: Transplants with unknown donor age and living donor transplants were excluded from this tabulation.

Total number of transplants reported:Europe = 181North America = 443Other = 352009


LUNG TRANSPLANTATIONKaplan-Meier Survival by Age Group


0

25

50

75

100

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

Su

rviv

al

(%)

Adult (N=25,234)

Pediatric (N=1,071)

HALF-LIFE Adult = 5.2 Years; Pediatric = 4.5 Years

P = 0.9674

ISHLT

2009


PEDIATRIC LUNG TRANSPLANTATIONKaplan-Meier Survival by Procedure Type


0

25

50

75

100

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

Su

rviv

al

(%)

Single Lung (N=70)

Bilateral/Double Lung (N=1,000)

HALF-LIFE Single Lung: 2.4 Years; Bilateral/double Lung: 4.7 Years

P < .0001

ISHLT

2009


PEDIATRIC LUNG TRANSPLANTATIONKaplan-Meier Survival for Congenital Diagnoses

(Transplants: January 1990 – June 2007)

0

25

50

75

100

0 1 2 3 4 5Years

Su

rviv

al

(%)

Eisenmenger's Syndrome (N=15)

Other Congenital Heart Disease (N=41)

Eisenmenger's + Other Congenital Heart Disease (N=56)

N at risk = 7

N at risk = 12

N at risk = 16

Eisenmenger’s vs. Other: p = 0.4444

ISHLT

2009


PEDIATRIC LUNG TRANSPLANTATIONKaplan-Meier Survival by Age Group


0

25

50

75

100

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

Years

Su

rviv

al

(%)

<1 Year (N=79)

1-11 Years (N=308)

12-17 Years (N=684)

<1 year vs. 1-11 years: p = 0.2992<1 year vs. 12-17 years: p = 0.96421-11 years vs. 12-17 years: p = 0.0652

HALF-LIFE<1 Year: 6.4 Years1-11 Years: 5.7 Years12-17 Years: 4.2 Years

N at risk = 9N at risk = 13

N at risk = 14

ISHLT

2009


PEDIATRIC LUNG TRANSPLANTATIONConditional Kaplan-Meier Survival by Age Group


0

25

50

75

100

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

Years

Su

rviv

al

(%)

<1 Year (N=48)1-11 Years (N=220)

12-17 Years (N=472)

<1 year vs. 1-11 year: p = 0.5558<1 year vs. 12-17 years: p = 0.12221-11 years vs. 12-17 years: p =0.0952

N at risk = 9

N at risk = 13

N at risk = 14

CONDITIONAL HALF-LIFE<1 Year: 8.8 Years1-11 Years: 10.5 Years12-17 Years: 6.1 Years

ISHLT

2009


PEDIATRIC LUNG TRANSPLANTATION Kaplan-Meier Survival by Era (Transplants: January 1988 - June 2007)

0

20

40

60

80

100

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

Years

Su

rviv

al

(%)

1988-1994 (N=208)

1995-2001 (N=450)

2002-6/2007 (N=423)

HALF-LIFEUnconditional 1988-1994: 2.8 Years; 1995-2001: 4.5 Years; 2002-6/2007: 4.8Conditional 1988-1994: 7.1 Years; 1995-2001: 6.9 Years; 2002-6/2007: na

1988-1994 vs. 1995-2001: p = 0.04271988-1994 vs. 2002-6/2007: p = 0.00041995-2001 vs. 2002-6/2007: p = 0.1545

N at risk = 26

N at risk = 15

N at risk = 15

ISHLT

2009


PEDIATRIC LUNG TRANSPLANTATIONKaplan-Meier Survival by Donor Type for Recipients Age 12-17 Years


0

25

50

75

100

0 1 2 3 4 5 6 7 8 9 10

Years

Su

rviv

al (

%)

Deceased Donor (N = 684)

Living Donor (N = 75)

p = 0.3990

N at risk = 9

N at risk = 30

HALF-LIFEDeceased: 4.2 YearsLiving: 3.7 Years

ISHLT

2009


0

2

4

6

8

10

12

14

16

18

0-<1 month 1-<12 months 12-<36 months 36+ months Not reported

Nu

mb

er o

f R

e-T

ran

spla

nts

PEDIATRIC LUNG RE-TRANSPLANTS Between January 1994 and June 2008

ISHLTTime Between Previous and Current Transplant

2009


0

10

20

30

40

50

60

70

80

90

100

0 1 2 3 4 5

Years

Su

rviv

al

(%)

N at risk at 5 years = 7

PEDIATRIC LUNG RETRANSPLANTSSurvival for Transplants Performed Between January 1994 and June 2007

ISHLT

2009


PEDIATRIC LUNG RECIPIENTS Functional Status of Surviving Recipients

(Follow-ups: April 1994-June 2008)

0%

20%

40%

60%

80%

100%

1 Year (N = 325) 3 Years (N = 205) 5 Years (N = 127) 7 Years (N=56)

No Activity Limitations Performs with Assistance Total Assistance

ISHLT

2009


PEDIATRIC 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 = 82) 3 Years (N = 82) 5 Years (N = 82)

No Activity Limitations Performs with Assistance Total Assistance

ISHLT

2009


PEDIATRIC 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 =537)

Between 2 and 3Years (N = 312)



No Hospitalization Hospitalized, Not Rejection/Not InfectionHospitalized, Rejection Hospitalized, Infection OnlyHospitalized, Rejection + Infection

ISHLT

2009


PEDIATRIC LUNG RECIPIENTS Rehospitalization Post-transplant of Surviving Recipients


0%

20%

40%

60%

80%

100%

Up to 1 Year (N =537)




No Hospitalization Hospitalized, Not Rejection/Not InfectionHospitalized, Rejection Hospitalized, Infection OnlyHospitalized, Rejection + Infection

ISHLT

2009


0

10

20

30

40

50

60

Any Induction (N = 189) Polyclonal ALG/ATG (N = 49) IL2R-antagonist (N = 137)

% o

f p

ati

en

tsPEDIATRIC LUNG RECIPIENTS

Induction ImmunosuppressionFor transplants between January 2001 and 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

Any Induction Polyclonal ALG/ATG IL2R-antagonist

% o

f p

ati

en

ts

2001 20022003 20042005 20062007 1/2008-6/2008

PEDIATRIC LUNG RECIPIENTSInduction Immunosuppression (Transplants: January 2001 - June 2007)

ISHLT



PEDIATRIC LUNG TRANSPLANTATIONKaplan-Meier Survival Stratified by Induction Use


0

25

50

75

100

0 1 2 3 4 5

Years

Su

rviv

al

(%)

Induction (N = 166)

No Induction (N = 125)

p = 0.8009

ISHLT

2009


0

20

40

60

80

100

Cyclosporine Tacrolimus Rapamycin MMF Azathioprine Prednisone

% o

f P

atie

nts

Year 1 (N = 272) Year 5 (N = 117)

PEDIATRIC LUNG RECIPIENTS Maintenance Immunosuppression at Time of Follow-up

(Follow-ups: January 2001 – June 2008)

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

ISHLT



0

20

40

60

80

100

CalcineurinInhibitor

CellCycle Prednisone CalcineurinInhibitor

CellCycle Prednisone

% o

f P

ati

en

ts

CyA

TacTac

CyAAZA

AZA

MMFMMF

PEDIATRIC LUNG RECIPIENTS Maintenance Immunosuppression at Time of Follow-up


1 Year Follow-up (N = 272) 5 Year Follow-up (N = 117)NOTE: Different patients are analyzed in Year 1 and Year 5

ISHLT

NOTE: 4% of patients were on both calcineurin inhibitors at different point during the year; these patients are not counted in either group. And 1% (2 patients) was on neither drugs during the year. In the 5-year tabulations, 13% were reported to be on both drugs during the year and 1% (1 patient) was reported to be on neither drugs.

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

2009


0%

20%

40%

60%

80%

100%

Year 1 (N = 272) Year 5 (N = 117)

% o

f P

ati

en

ts

Other

Tacrolimus + MMF

Tacrolimus + AZA

Cyclosporine + MMF

Cyclosporine + AZA

PEDIATRIC LUNG RECIPIENTS Maintenance Immunosuppression Drug Combinations at Time of Follow-up Report


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

ISHLT



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


Outcome Within 1

Year

Total number with known response

Hypertension 42.8% (N = 523)

Renal Dysfunction 10.5% (N = 531)

Abnormal Creatinine < 2.5 mg/dl 7.5% Creatinine > 2.5 mg/dl 2.1% Chronic Dialysis 0.6% Renal Transplant 0.4%

Hyperlipidemia 4.8% (N = 541)

Diabetes 27.1% (N = 531)

Bronchiolitis Obliterans Syndrome 14.0% (N = 501)

ISHLT

2009


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


Outcome Within 5

Years Total number with known response


Renal Dysfunction 21.6% (N = 134) Abnormal Creatinine < 2.5 mg/dl 14.9% Creatinine > 2.5 mg/dl 3.7% Chronic Dialysis 2.2% Renal Transplant 0.7%


Diabetes 33.1% (N = 133)


ISHLT

2009


POST-LUNG TRANSPLANT MORBIDITY FOR PEDIATRICS Cumulative Prevalence in Survivors within 7 Years Post-Transplant


Outcome Within 7

Years

Total number with known response


Renal Dysfunction 34.80% (N = 66)

Abnormal Creatinine < 2.5 mg/dl 22.7% Creatinine > 2.5 mg/dl 4.5% Chronic Dialysis 0.0% Renal Transplant 7.6%


Diabetes 34.4% (N = 61)


ISHLT

2009


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

0

10

20

30

40

50

60

70

80

90

100

0 1 2 3 4 5 6 7

Years

% F

ree

fro

m B

ron

ch

iolit

is O

blit

era

ns

S

yn

dro

me

ISHLT

2009


Freedom from Bronchiolitis Obliterans Syndrome For Pediatric Lung Recipients by Induction Use


0

25

50

75

100

0 1 2 3 4 5 6 7

Years

Induction (N = 183)

No Induction (N =293)

p =0.6595

% 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 Pediatric Lung Recipients (Follow-ups: April 1994 - June 2008)

0

10

20

30

40

50

60

70

80

90

100

0 1 2 3 4 5 6 7

Years

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

% F

ree

fro

m S

ev

ere

Re

na

l Dy

sfu

nc

tio

n

ISHLT

2009


MALIGNANCY POST-LUNG TRANSPLANTATION FOR PEDIATRICSCumulative Incidence for Survivors (Follow-ups: April 1994 - June 2008)

Malignancy/Type 1-Year Survivors

5-Year Survivors

7-Year Survivors

No Malignancy 511 (94.1%) 119 (86.9%) 60 (89.6%)

Malignancy (all types combined)

32 (5.9%) 18 (13.1%) 7 (10.4%)

Malignancy Type

Lymph 29 18 7

Other 2 1 0

”Other” includes Liver and primitive neuroectodermal tumor.

ISHLT

2009


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

50

60

70

80

90

100

0 1 2 3 4 5 6 7

Years

All malignancy Lymph Skin Other% F

ree

fro

m M

alig

na

nc

y

ISHLT

2009


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

CAUSE OF DEATH0-30 Days

(N =67)31 Days - 1 Year

(N = 118)

>1 Year - 3 Years

(N = 136)

>3 Years - 5 Years

(N = 68)

>5 Years

(N = 51)

BRONCHIOLITIS 11 (9.3%) 53 (39.0%) 28 (41.2%) 22 (43.1%)

ACUTE REJECTION 2 (3.0%) 3 (2.5%) 1 (1.5%)

LYMPHOMA 6 (5.1%) 4 (2.9%) 2 (2.9%) 4 (7.8%)

MALIGNANCY, NON-LYMPHOMA

1 (0.7%) 1 (1.8%)

CMV 5 (4.2%)

INFECTION, NON-CMV 10 (14.9%) 41 (34.7%) 24 (17.6%) 15 (22.1%) 5 (9.8%)

GRAFT FAILURE 20 (29.9%) 22 (18.6%) 35 (25.7%) 11 (16.2%) 12 (23.5%)

CARDIOVASCULAR 10 (14.9%) 6 (5.1%) 2 (1.5%)

TECHNICAL 10 (14.9%) 3 (2.5%)

MULTIPLE ORGAN FAILURE

5 (7.5%) 8 (6.8%) 7 (5.1%) 3 (4.4%) 3 (5.9%)

OTHER 10 (14.9%) 13 (11.0%) 10 (7.4%) 8 (11.8%) 5 (9.8%)

ISHLT

2009


PEDIATRIC LUNG TRANSPLANT RECIPIENTS: Other Cause Of Death(Deaths: January 1992- June 2006)

CAUSE OF DEATH0-30 Days

(N =72)

31 Days - 1 Year

(N = 107)

>1 Year - 3 Years

(N = 111)

>3 Years - 5 Years

(N = 56)

>5 Years

(N = 38)

Graft Failure: Graft Infection 4 (5.6%) 3 2.8%) 4 (3.6%) 2 (5.3%)

Graft Failure: Recurrent Disease 1 (0.9%) 1 (2.6%)

Pulm: Pulmonary Embolism 1 (1.4%) 1 (1.8%)

Cerebrovascular: Hemorrhage (Non-Stroke) 3 4.2%) 3 (2.8%)

Cerebrovascular: Brain Anoxia 1 (1.4%) 1 (0.9%) 1 (0.9%)

Cerebrovascular: Other Specify 3 4.2%)

Hemorrhage: Gastrointestinal 1 (0.9%)

Hemorrhage: Respiratory 1 (0.9%) 1 (1.8%)

Renal Failure 1 (2.6%)

Non-Compliance 1 (0.9%) 1 (1.8%)

Primary Organ Failure 1 (1.4%)

Thromboembolic Disease 1 (0.9%)

Hus Hemolytic Uremic Syndrome 1 (1.8%)

Respiratory Failure 1 (1.8%)


2009


PEDIATRIC 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 = 67)

31 Days – 1Year (N = 118)

>1 Year – 3Years (N =136)

>3 Years – 5Years (N = 68)

>5 Years (N = 51 )

Bronchiolitis Infection (non-CMV)

Graft Failure Cardiovascular

Multiple Organ Failure

Pe

rce

nta

ge

of

De

ath

s

ISHLT

2009


N=738

VARIABLE N Relative

Risk P-value

95% Confidence Interval

On ventilator 108 3.62 <0.0001 2.41 5.42

Year of Transplant: 1990-98 vs. 1999-6/2007 346 1.94 <0.0001 1.42 2.64

Pediatric transplant volume >5 transplants within 1 year

312 0.71 0.0475 0.51 1.00

ISHLT

PEDIATRIC LUNG TRANSPLANT RECIPIENTS (1/1990-6/2007) Risk Factors For 1 Year Mortality/Graft Failure

2009


N=527

VARIABLE N Relative

Risk P-value

95% Confidence Interval

On ventilator 81 2.46 <0.001 1.73 3.50

Year of Transplant: 1990-98 vs. 1999-6/2003 346 1.48 0.0018 1.16 1.89

Age: 1-11 Year vs. 12-17 Years 180 0.76 0.0465 0.58 1.00

Age: <1 Year vs. 12-17 Years 54 0.55 0.0104 0.35 0.87

ISHLT

PEDIATRIC LUNG TRANSPLANT RECIPIENTS (1/1990-6/2003) Risk Factors For 5 Year Mortality/Graft Failure

2009

J Heart Lung Transplant 2009;28: 989-1049 LUNG TRANSPLANTATION Pediatric Recipients ISHLT 2009.

Documents

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