heart-lung transplantation overall 2011 ishlt j heart lung transplant. 2011 oct; 30 (10): 1071-1132

HEART-LUNG TRANSPLANTATION

Overall

2011ISHLTISHLTJ Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

0

50

100

150

200

250

300

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

2008

2009

Nu

mb

er

of

Tra

ns

pla

nts

NUMBER OF HEART-LUNG TRANSPLANTS REPORTED BY YEAR

NOTE: 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.

ISHLT 2011ISHLTJ Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

AVERAGE CENTER VOLUMEHeart-Lung Transplants: January 1, 1998 - June 30, 2010

60

35

11 80

5

10

15

20

25

30

35

40

45

50

55

60

1/year 2/year 3/year 4-9/yearAverage number of heart-lung transplants per year

Nu

mb

er

of

ce

nte

rs

0

5

10

15

20

25

30

35

40

45

50

55

60

Number of centers Percentage of transplants

%o

f h

ea

rt-l

un

g t

ran

sp

lan

ts


DISTRIBUTION OF HEART-LUNG TRANSPLANTS BY CENTER VOLUME

Heart-Lung Transplants: January 1, 1998 - June 30, 2010

0

5

10

15

20

25

30

35

40

1 2 3 4-9

Average number of heart-lung transplants per year

Pe

rce

nta

ge

of

he

art

-lu

ng

tra

ns

pla

nts


DISTRIBUTION OF HEART-LUNG TRANSPLANTS BY LUNG CENTER VOLUME

Lung Transplants: January 1, 1998 - June 30, 2010

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


HEART-LUNG TRANSPLANTATIONKaplan-Meier Survival for All Ages (Transplants: January 1982 - June 2009)

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 21 22

Years

Su

rviv

al (

%)

Half-life = 4.8 yearsConditional Half-life = 12 years

N=3,957

N at risk at 22 years = 48



Adult Recipients


Acquired heart disease

5%

Congenital heart disease

36%

COPD/Alpha-16%

CF14%

IPAH28%

Re-transplant2%

Other6%

IPF4%

DIAGNOSIS IN ADULT HEART-LUNG TRANSPLANTS (January 1982 - June 2010)

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


DIAGNOSIS IN ADULT HEART-LUNG TRANSPLANTS (Transplants: January 1982 - June 2010)

Diagnosis N (%)

Congenital Heart Disease 1,116 (35.9%)

Idiopathic Pulmonary Arterial Hypertension 857 (27.5%)

Cystic Fibrosis 444 (14.3%)

Acquired Heart Disease 150 ( 4.8%)

COPD/Emphysema 132 ( 4.2%)

Idiopathic Pulmonary Fibrosis 113 ( 3.6%)

Alpha-1 60 ( 1.9%)

Sarcoidosis 50 ( 1.6%)

Re-Transplant: Not Obliterative Bronchiolitis 36 ( 1.2%)

Re-Transplant: Obliterative Bronchiolitis 28 ( 0.9%)

Bronchiectasis 24 ( 0.8%)

Obliterative Bronchiolitis (not Re-Transplant) 22 ( 0.7%)

Other 80 ( 2.6%)


DIAGNOSIS IN ADULT HEART-LUNG TRANSPLANTS BY ERA (Transplants: January 1982 - June 2010)

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1982-1995(N=1,651)

1996-1999(N=549)

2000-6/2010(N=912)

% o

f T

ran

sp

lan

ts

Other

Sarcoidosis

Re-TX

IPAH

IPF

CF

COPD/Alpha-1

Congenital Heart Disease

Acquired Heart Disease

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


ADULT HEART-LUNG TRANSPLANTATIONMajor Indications 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

2008

2009

Transplant Year

% o

f T

ran

spla

nts

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


ADULT HEART-LUNG TRANSPLANTATIONMajor Indications 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

2008

2009

Transplant Year

Nu

mb

er

of

Tra

ns

pla

nts

Congenital Heart Disease IPAH Cystic Fibrosis

COPD/Alpha-1 Retransplant Acquired Heart Disease


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 2010


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 2010


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



HEART-LUNG TRANSPLANTATIONKaplan-Meier Survival for Adult Recipients

(Transplants: January 1982 - June 2009)

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 21 22

Years

Su

rviv

al

(%)

Half-life = 5 YearsConditional Half-life = 12 Years

N=3,303

N at risk at 22 years = 42


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

(Transplants: January 1982 - June 2009)

0

20

40

60

80

100

0 1 2 3 4 5 6 7 8 9 10

Years

1982-1995 (N=1,940)

1996-1999 (N=572)

2000-6/2009 (N=791)

Su

rviv

al

(%)

P-value comparing all: 0.2944

Half-life (Years): 1982-1995 = 4.8; 1996-1999 = 5.0; 2000-6/2009 = 5.5 Conditional Half-life (Years): 1982-1995 = 13; 1996-1999 = 11; 2000-6/2009 = 10


ADULT HEART-LUNG TRANSPLANTATIONKaplan-Meier Survival By Diagnosis (Transplants: January 1990 – June 2009)

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 = 294)Eisenmenger's Syndrome (N = 588)IPAH (N = 578)

Congenital vs. Eisenmenger's: p = 0.0103Congenital vs. IPAH: p = 0.0350Eisenmenger's vs. IPAH: p = 0.3050

HALF-LIFE Congenital: 3.7 Years; Eisenmenger's: 6.5 Years; IPAH: 5.0 Years


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

(Transplants: January 1990 – June 2009)

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 = 163)

Eisenmenger's Syndrome (N = 399)

IPAH (N = 409)

HALF-LIFE Congenital Years: 13.6;Eisenmenger's: 11.4 Years; IPAH: 10.1 Years



ADULT HEART-LUNG RECIPIENTS Cross-Sectional Analysis

Functional Status of Surviving Recipients (Follow-ups: April 1994 – June 2010)

0%

20%

40%

60%

80%

100%

1 Year (N = 264) 3 Years (N = 212) 5 Years (N = 181)

No Activity Limitations Performs with Some Assistance Requires Total Assistance


ADULT HEART-LUNG RECIPIENTS Functional Status of Surviving Recipients

US Recipients Only(Follow-ups: March 2005 - June 2010)

0%

20%

40%

60%

80%

100%


10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


ADULT HEART-LUNG RECIPIENTSEmployment Status of Surviving Recipients

(Follow-ups: April 1994 – June 2010)

0%

20%

40%

60%

80%

100%


Working (FT/PTstatus unknown)

Retired

Not Working

Working Part Time

Working Full Time


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

(Follow-ups: April 1994 - June 2010)

0%

20%

40%

60%

80%

100%

Up to 1 Year (N = 415) Between 2 and 3 Years (N =301)

Between 4 and 5 Years (N =246)

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


0

10

20

30

40

50

60

70

Any Induction (N =166)

Polyclonal ALG/ATG(N = 64)

OKT3 (N = 5) IL-2R Antagonist (N =82)

% o

f p

ati

en

tsADULT HEART-LUNG RECIPIENTS

Induction ImmunosuppressionFor transplants between January 2001 through June 2010

ISHLT 2011 Analysis is limited to patients who were alive at the time of the discharge

ISHLTJ Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

0

10

20

30

40

50

60

70

80

90

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

% o

f p

ati

en

ts

Any Induction Polyclonal ALG/ATG

OKT3 IL-2R Antagonist

ADULT HEART-LUNG RECIPIENTSInduction Immunosuppression (Transplants: January 2000 - December 2009)



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 2009)

Any Induction Polyclonal ALG/ATG OKT3 IL-2R Antagonist



0

20

40

60

80

100

Cyclosporine Tacrolimus Sirolimus MMF Azathioprine Prednisone

% o

f P

atie

nts

Year 1 (N = 181) Year 5 (N = 115)

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

For follow-ups between January 2001 through June 2010

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


0%

20%

40%

60%

80%

100%

Year 1 (N = 181) Year 5 (N = 115)

% o

f P

ati

en

ts

Other

None

Tacrolimus

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 2010

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


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 58.5% (N = 386)

Renal Dysfunction 18.4% (N = 412)

Abnormal Creatinine < 2.5 mg/dl 12.1% Creatinine > 2.5 mg/dl 2.9% Chronic Dialysis 3.2% Renal Transplant 0.2%

Hyperlipidemia 26.4% (N = 406)

Diabetes 19.1% (N = 414)

Coronary Artery Vasculopathy 3.1% (N = 327)

Bronchiolitis Obliterans Syndrome 8.5% (N = 388)


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 87.6% (N = 137)

Renal Dysfunction 26.3% (N = 160)

Abnormal Creatinine < 2.5 mg/dl 18.8% Creatinine > 2.5 mg/dl 6.3% Chronic Dialysis 1.3% Renal Transplant 0.0%

Hyperlipidemia 68.8% (N = 144)

Diabetes 26.1% (N = 153)

Coronary Artery Vasculopathy 7.2% (N = 83)

Bronchiolitis Obliterans Syndrome 27.9% (N = 129)


Freedom from Coronary Artery Vasculopathy and Bronchiolitis Obliterans Syndrome

For Adult Heart-Lung Recipients (Follow-ups: April 1994-June 2010)

40

50

60

70

80

90

100

0 1 2 3 4 5 6 7

Years

Freedom from Coronary Artery Vasculopathy

Freedom from Bronchiolitis Obliterans Syndrome

% F

ree

fro

m C

AV

an

d B

ron

ch

iolit

is

Ob

lite

ran

s S

yn

dro

me


Freedom from Coronary Artery Vasculopathy For Adult Heart-Lung Recipients By Diagnosis Type

(Follow-ups: April 1994-June 2010)

50

60

70

80

90

100

0 1 2 3 4

Years

% F

ree

fro

m C

AV

Heart (N=186)

Lung (N=54)

Heart/Lung (N=79)

P-value comparing all = 0.4542


Freedom from Bronchiolitis Obliterans Syndrome For Adult Heart-Lung Recipients By Diagnosis Type

(Follow-ups: April 1994-June 2010)

50

60

70

80

90

100

0 1 2 3 4

Years

Heart (N=215)

Lung (N=64)

Heart/Lung (N=102)

% F

ree

fro

m B

ron

ch

iolit

is O

blit

era

ns

S

yn

dro

me

P-value comparing all = 0.7620


Freedom from Severe Renal Dysfunction*For Adult Heart-Lung Recipients (Follow-ups: April 1994-June 2010)

50

60

70

80

90

100

0 1 2 3 4 5 6 7 8

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


MALIGNANCY POST-HEART-LUNG TRANSPLANT FOR ADULTSCumulative Prevalence in Survivors (Follow-ups: April 1994-June 2010)

Malignancy/Type 1-Year Survivors

5-Year Survivors

10-Year Survivors

No Malignancy 394 (93.8%) 143 (88.8%) 43 (86%)

Malignancy (all types combined) 26 (6.2%) 18 (11.2%) 7 (14%)

Malignancy Type*

Skin 2 5 7

Lymph 18 6 0

Other 4 5 0

Type Not Reported 2 2 0

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


Freedom from MalignancyFor Adult Heart-Lung Recipients (Follow-ups: April 1994- June 2010)

50

60

70

80

90

100

0 1 2 3 4 5 6 7 8 9

Years

% F

ree

fro

m M

alig

na

nc

y

All malignancyLymphSkinOther


ADULT HEART-LUNG TRANSPLANT RECIPIENTS: Cause of Death (Deaths: January 1992 - June 2010)

CAUSE OF DEATH 0-30 Days

(N = 321)

31 Days - 1 Year (N = 249)

>1 Year - 3 Years (N = 223)

>3 Years - 5 Years (N = 151)

>5 Years

(N = 391)

BRONCHIOLITIS 0 6 (2.4%) 50 (22.4%) 32 (21.2%) 66 (16.9%)

ACUTE REJECTION 3 (0.9%) 8 (3.2%) 4 (1.8%) 1 (0.7%) 2 (0.5%)

LYMPHOMA 0 8 (3.2%) 11 (4.9%) 8 (5.3%) 11 (2.8%)

MALIGNANCY, OTHER 0 4 (1.6%) 12 (5.4%) 5 (3.3%) 30 (7.7%)

CMV 0 1 (0.4%) 0 1 (0.7%) 1 (0.3%)

INFECTION, NON-CMV 52 (16.2%) 80 (32.1%) 67 (30.0%) 42 (27.8%) 96 (24.6%)

GRAFT FAILURE 92 (28.7%) 54 (21.7%) 34 (15.2%) 27 (17.9%) 54 (13.8%)

CARDIOVASCULAR 25 (7.8%) 11 (4.4%) 20 (9.0%) 13 (8.6%) 45 (11.5%)

TECHNICAL 71 (22.1%) 9 (3.6%) 2 (0.9%) 1 (0.7%) 3 (0.8%)

OTHER 78 (24.3%) 68 (27.3%) 23 (10.3%) 21 (13.9%) 83 (21.2%)


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

(Deaths: January 1992 - June 2010)

0

10

20

30

40

50

0-30 Days (N =321)

31 Days – 1Year (N =241)

>1 Year – 3Years (N = 223)

>3 Years – 5Years (N = 151)

>5 Years (N =391 )

Bronchiolitis Infection (non-CMV) Graft Failure

Cardiovascular Technical

Pe

rce

nta

ge

of

De

ath

s



Pediatric Recipients


AGE DISTRIBUTION OF PEDIATRIC HEART-LUNGRECIPIENTS (Transplants: January 1982 - June 2010)

0

50

100

150

200

250

300

350

400

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

Recipient Age (Years)

Nu

mb

er o

f T

ran

spla

nts


AGE DISTRIBUTION FOR DONORS OF PEDIATRIC HEART-LUNG RECIPIENTS (Transplants: January 1982 - June 2010)

372

108

56 6370

50

100

150

200

250

300

350

400

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

Donor Age (Years)

Nu

mb

er o

f T

ran

spla

nts


AGE DISTRIBUTION OF PEDIATRIC HEART-LUNG RECIPIENTS

By Year of Transplant

05

101520253035404550556065

1984

1985

1986

1987

1988

1989

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

12-17 Years1-11 Years

<1 Year

Nu

mb

er o

f T

ran

spla

nts

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


AGE DISTRIBUTION OF PEDIATRIC HEART-LUNG RECIPIENTS

By Era of Transplant

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1982-1995 1996-6/2010

12-17 Years

1-11 Years

<1 Year

Per

cen

tag

e o

f T

ran

spla

nts


NUMBER OF CENTERS REPORTING PEDIATRIC HEART-LUNG TRANSPLANTS

NEED TO UPDATE

0

5

10

15

20

25

30

1984

1985

1986

1987

1988

1989

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

Transplant Year

# P

edia

tric

Tra

nsp

lan

t C

ente

rs


NUMBER OF CENTERS REPORTING PEDIATRIC HEART-LUNG TRANSPLANTS

Stratified by center volume

0

5

10

15

20

25

30

1984

1985

1986

1987

1988

1989

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

Transplant Year

# P

edia

tric

Tra

nsp

lan

t C

ente

rs

1-4/yr 5-9/yr

10-19/yr 20-29/yr


4%

28%22%

13%

2%

4%25%

2%

2%

Acquired Heart Disease

CF

Congenital (other)Eisenmenger's Syndrome

IPF

Other

PPHRetx: Non-OB

Retx: OB

DIAGNOSIS IN PEDIATRIC HEART-LUNG TRANSPLANT RECIPIENTS (Transplants: 1986-2009)

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

2008

2009

% o

f C

as

es

Cystic Fibrosis Congenital IPAH

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

NOTE: Unknown diagnoses were excluded from this tabulation.ISHLT 2011ISHLT

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

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 LOCATIONTransplants between January 2000 and June 2010


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 2010


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



PEDIATRIC HEART-LUNG TRANSPLANTATIONKaplan-Meier Survival By Diagnosis (Transplants: January 1990 – June 2009)

0

25

50

75

100

0 1 2 3 4 5 6 7

Years

Su

rviv

al

(%)

Congenital (N = 94)

Eisenmenger's Syndrome (N = 48)

IPAH (N = 101)

HALF-LIFE Congenital: 2.1 Years; Eisenmenger's: 2.7 Years; IPAH: 4.7 Years



PEDIATRIC HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival (Transplants: January 1982 - June 2009)

0

25

50

75

100

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

Years

Su

rviv

al

(%)

< 1 (N = 21)

1-11 (N = 256) 12-17 (N = 356)

Overall (N = 633)

Half-life <1: 0.4 Years;1-11: 4.2 Years; 12-17: 5.5 Years

0-<1 vs. 1-11: p = 0.0013; 0-<1 vs. 12-17: p < 0.0005; 1-11 vs. 12-17: p = 0.1578


PEDIATRIC HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival by Era (Transplants: January 1982 - June 2009)

0

25

50

75

100

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

1982-1988 (N=120)

1989-1993 (N=223)

1994-1998 (N=138)1999-6/2009 (N=152)

Half-life 1982-1988: 2.6; 1989-1993: 5.5; 1994-1998: 4.4; 1999-6/2009: 4.2

82-88 vs. 89-93: p = 0.0721; 82-88 vs. 94-98: p = 0.7781; 82-88 vs. 99-6/2009: p = 0.1852; 89-93 vs. 94-98: p = 0.0628; 89-93 vs. 99-6/2009: p = 0.5594; 94-98 vs. 99-6/2009: p = 0.5168

Su

rviv

al

(%)


PEDIATRIC HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival by Era (Transplants: January 1982 - June 2009)

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 13Years

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

1994-1998 (N=77) 1999-6/2009 (N=90)

Conditional HALF-LIFE 1982-1988: 13.1; 1989-1993: 14.9; 1994-1998: 8.9; 1999-6/2009: na

82-88 vs. 89-93: p = 0.8445; 82-88 vs. 94-98: p = 0.2269; 82-88 vs. 99-6/2009: p = 0.4863; 89-93 vs. 94-98: p = 0.0518;89-93 vs. 99-6/2009: p = 0.2227; 94-98 vs. 99-6/2009: p = 0.9637

Su

rviv

al

(%)


PEDIATRIC HEART-LUNG TRANSPLANT RECIPIENTS: Cause of Death (Deaths: January 1992 - June 2010)

CAUSE OF DEATH0-30 Days (N = 43)

31 Days - 1 Year (N = 54 )

>1 Year - 3 Years (N = 51 )

>3 Years - 5 Years (N = 28 )

>5 Years (N = 66)

BRONCHIOLITIS 0 2 (3.7%) 23 (45.1%) 10 (35.7%) 13 (19.7%)

ACUTE REJECTION 0 2 (3.7%) 1 (2.0%) 1 (3.6%) 1 (1.5%)

LYMPHOMA 0 2 (3.7%) 2 (3.9%) 1 (3.6%) 2 (3.0%)

MALIGNANCY, OTHER 0 2 (3.7%) 0 1 (3.6%) 4 (6.1%)

CMV 0 2 (3.7%) 0 0 0

INFECTION, NON-CMV 7 (16.3%) 17 (31.5%) 6 (11.8%) 0 18 (27.3%)

GRAFT FAILURE 18 (41.9%) 10 (18.5%) 14 (27.5%) 12 (42.9%) 11 (16.7%)

CARDIOVASCULAR 2 (4.7%) 3 (5.6%) 1 (2.0%) 2 (7.1%) 5 (7.6%)

TECHNICAL 9 (20.9%) 0 0 0 2 (3.0%)

OTHER 7 (16.3%) 14 (25.9%) 4 (7.8%) 1 (3.6%) 10 (15.2%)


PEDIATRIC HEART-LUNG TRANSPLANT RECIPIENTS: Cause of Death (Deaths: April 1994 - June 2010)

CAUSE OF DEATH0-30 Days

(N = 35)31 Days - 1

Year (N = 41)>1 Year - 3

Years (N = 44)>3 Years - 5

Years (N = 25)>5 Years

(N = 66)

BRONCHIOLITIS 0 1 (2.4%) 19 (43.2%) 9 (36.0%) 13 (19.7%)

ACUTE REJECTION 0 1 (2.4%) 1 (2.3%) 1 (4.0%) 1 (1.5%)

LYMPHOMA 0 2 (4.9%) 2 (4.5%) 1 (4.0%) 2 (3.0%)

MALIGNANCY, OTHER 0 2 (4.9%) 0 1 (4.0%) 4 (6.1%)

CMV 0 1 (2.4%) 0 0 0

INFECTION, NON-CMV 4 (11.4%) 14 (34.1%) 6 (13.6%) 0 18 (27.3%)

GRAFT FAILURE 15 (42.9%) 7 (17.1%) 11 (25.0%) 11 (44.0%) 11 (16.7%)

CARDIOVASCULAR 2 (5.7%) 2 (4.9%) 1 (2.3%) 1 (4.0%) 5 (7.6%)

TECHNICAL 7 (20.0%) 0 0 0 2 (3.0%)

OTHER 7 (20.0%) 11 (26.8%) 4 (9.1%) 1 (4.0%) 10 (15.2%)


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

(Deaths: April 1994 - June 2010)

0

10

20

30

40

50

0-30 Days (N =35)

31 Days – 1Year (N =41)

>1 Year – 3Years (N = 44)

>3 Years – 5Years (N = 25)

>5 Years (N =66)

Bronchiolitis Graft Failure Cardiovascular Infection (Non-CMV)

Pe

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nta

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De

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heart-lung transplantation overall 2011 ishlt j heart lung transplant. 2011 oct; 30 (10): 1071-1132

Documents

distribution of heart

number of heart

heart disease150

ishlt transplant registry

bronchiectasis ishlt

adult recipients transplants

year number ishlt

congenital heart disease1