heart-lung transplantation overall ishlt 2012 j heart lung transplant. 2012 oct; 31(10): 1045-1095

HEART-LUNG TRANSPLANTATION

Overall

ISHLT 2012J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

NUMBER OF HEART-LUNG TRANSPLANTS REPORTED BY YEAR

1982

1984

1986

1988

1990

1992

1994

1996

1998

2000

2002

2004

2006

2008

2010

0

50

100

150

200

250

300

Nu

mb

er

of

Tra

ns

pla

nts

ISHLT 2012

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.J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

AVERAGE CENTER VOLUMEHeart-Lung Transplants: January 1, 2000 - June 30, 2011

1/year 2/year 3/year 4-9/year0

5

10

15

20

25

30

35

40

45

50

55

60

0

5

10

15

20

25

30

35

40

45

50

55

60

55

41

4 7

Number of centers Percentage of transplants

Average number of heart-lung transplants per year

Nu

mb

er

of

Ce

nte

rs

% o

f H

ea

rt-L

un

g T

ran

sp

lan

ts


DISTRIBUTION OF HEART-LUNG TRANSPLANTS BY LUNG CENTER VOLUME

Heart-Lung Transplants: January 1, 2000 - June 30, 2011

1-4 5-9 10-19 20-29 30-39 40-49 50+0

5

10

15

20

25

30

35

40

Average number of lung transplants per year

% o

f H

ea

rt-L

un

g T

ran

sp

lan

ts


HEART-LUNG TRANSPLANTATION Kaplan-Meier Survival for All Ages(Transplants: January 1982 - June 2010)

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 230

20

40

60

80

100

Years

Su

rviv

al (

%)

N = 4,225

Half-life = 3.2 yearsConditional Half-life = 9.7 years f

N at risk at 23 years = 22



Adult Recipients


DIAGNOSIS IN ADULT HEART-LUNG TRANSPLANTS (Transplants: January 1982 - June 2011)

Acquired heart disease

5%

Congenital heart disease36%

COPD/Alpha-16%

CF14%

IPF4%

IPAH28%

Re-transplant2%

Sarcoidosis2%

Other4%

ISHLT 2012

“Other” includes cancer, LAM, OB, bronchiectasis

J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

DIAGNOSIS IN ADULT HEART-LUNG TRANSPLANTS (Transplants: January 1982 - June 2011)

ISHLT 2012

Diagnosis N (%)

Congenital Heart Disease 1,134 (35.7%)

Idiopathic Pulmonary Arterial Hypertension 877 (27.6%)

Cystic Fibrosis 448 (14.1%)

Acquired Heart Disease 160 (5.0%)

COPD/Emphysema 133 (4.2%)

Idiopathic Pulmonary Fibrosis 115 (3.6%)

Alpha-1 61 (1.9%)

Sarcoidosis 52 (1.6%)

Re-Transplant: Not Obliterative Bronchiolitis 36 (1.1%)

Re-Transplant: Obliterative Bronchiolitis 22 (0.7%)

Bronchiectasis 30 (0.9%)

Obliterative Bronchiolitis (not Re-Transplant) 24 (0.8%)

Other 88 (2.8%)


DIAGNOSIS IN ADULT HEART-LUNG TRANSPLANTS BY ERA (Transplants: January 1982 - June 2011)

ISHLT 2012

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1982-1991 (N=959)

1992-2001 (N=1,453)

2002-6/2011 (N=768)

Other

Sarcoidosis

Re-TX

IPF

COPD/Alpha-1

Acquired Heart Disease

CF

IPAH

Congenital Heart Disease

% o

f T

ran

sp

lan

ts

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


ADULT HEART-LUNG TRANSPLANTSMajor Indications By Year (%)

ISHLT 2012

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

0

10

20

30

40

50

60

70

80

90

100

Congenital Heart Disease IPAH Cystic Fibrosis

COPD/Alpha-1 Retransplant Acquired Heart Disease

Transplant Year

% o

f T

ran

sp

lan

ts


ADULT HEART-LUNG TRANSPLANTSMajor Indications By Year (Number)

ISHLT 2012

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

0

20

40

60

80

100

120

140

160

180

Congenital Heart Disease IPAH Cystic Fibrosis

COPD/Alpha-1 Retransplant Acquired Heart Disease

Transplant Year

Nu

mb

er

of

Tra

ns

pla

nts


ADULT HEART-LUNG TRANSPLANTSAge Distribution By Location

(Transplants: January 2000 - June 2011)

ISHLT 2012

Europe North America Other0%

20%

40%

60%

80%

100%

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

% o

f T

ran

sp

lan

ts


ADULT HEART-LUNG TRANSPLANTSDiagnosis Distribution By Location(Transplants: January 2000 - June 2011)

ISHLT 2012


20%

40%

60%

80%

100%

Congenital heart disease IPAH Cystic Fibrosis Acquired heart disease IPF Other

% o

f T

ran

sp

lan

ts


ADULT HEART-LUNG TRANSPLANTS Donor Age Distribution By Location


ISHLT 2012


20%

40%

60%

80%

100%

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

% o

f D

on

ors


ADULT HEART-LUNG TRANSPLANTS Kaplan-Meier Survival


0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 220

25

50

75

100

Years

Su

rviv

al (

%)

N = 3,544

Half-life = 3.3 yearsConditional Half-life = 10.0 years f

N at risk at 23 years = 18


ADULT HEART-LUNG TRANSPLANTS Kaplan-Meier Survival by Era


0 1 2 3 4 5 6 7 8 9 100

25

50

75

100

1982-1991 (N=1,210)1992-2001 (N=1,588)

Years

Su

rviv

al (

%)

p-value comparing all < 0.0001

Half-life (Years): 1982-1991 = 1.9; 1992-2001 = 3.7; 2002-6/2010 = 6.1 Conditional Half-life (Years): 1982-1991 = 8.9; 1992-2001 = 10.0; 2002-6/2010 = NA


ADULT HEART-LUNG TRANSPLANTSKaplan-Meier Survival By Diagnosis


0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 150

25

50

75

100

Other Congenital (N = 319)

Eisenmenger's Syndrome (N = 621)

IPAH (N = 638)

Years

Su

rviv

al (

%)

Congenital vs. Eisenmenger's: p = 0.0248Congenital vs. IPAH: p = 0.0788Eisenmenger's vs. IPAH: p = 0.4168

HALF-LIFE Congenital: 2.8 Years; Eisenmenger's: 5.5 Years; IPAH: 4.5 Years


ADULT HEART-LUNG TRANSPLANTSKaplan-Meier Survival By Diagnosis Conditional on Survival

to 1 Year (Transplants: January 1990 - June 2010)

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 150

25

50

75

100Other Congenital (N = 178)


IPAH (N = 431)

Years

Su

rviv

al (

%)




ADULT HEART-LUNG RECIPIENTS Cross-Sectional Analysis

Functional Status of Surviving Recipients (Follow-ups: April 1994 – June 2011)

ISHLT 2012

1 Year (N = 264) 3 Years (N = 213) 5 Years (N = 181)0%

20%

40%

60%

80%

100%

No Activity Limitations Performs with Some AssistanceRequires Total Assistance


ADULT HEART-LUNG RECIPIENTS Functional Status of Surviving Recipients

US Recipients Only(Follow-ups: March 2005 – June 2011)

ISHLT 2012

0%

20%

40%

60%

80%

100%

1 Year (N = 145) 2 Years (N = 107)

3 Years (N = 94)

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


ADULT HEART-LUNG RECIPIENTS Employment Status of Surviving Recipients

(Follow-ups: April 1994 – June 2011)

ISHLT 2012

0%

20%

40%

60%

80%

100%

1 Year (N = 348)3 Years (N =

246)5 Years (N =

220)

Working (FT/PT sta-tus unknown)

Retired

Not Working

Working Part Time

Working Full Time


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


ISHLT 2012

0%

20%

40%

60%

80%

100%

Up to 1 Year (N = 441)

Between 2 and 3 Years (N = 314)

Between 4 and 5 Years (N = 258)

No Hospitalization Hospitalized, Not Rejection/Not Infection

Hospitalized, Rejection Only Hospitalized, Infection Only

Hospitalized, Rejection and Infection


ADULT HEART-LUNG RECIPIENTS Induction Immunosuppression

(Transplants: January 2001 – June 2011)

ISHLT 2012

Any Induction (N=174)

Polyclonal ALG/ATG

(N=66)

OKT3 (N=5) IL-2R Antagonist (N=87)

0

10

20

30

40

50

60

70

% o

f P

ati

en

ts

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



(Transplants: January 2000 – December 2010)

ISHLT 2012

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 20100

10

20

30

40

50

60

70

80

90

100

Any Induction Polyclonal ALG/ATG

OKT3 IL-2R Antagonist

% o

f P

ati

en

ts




(Transplants: January 2000 – December 2010)

ISHLT 2012

2000

2002

2004

2006

2008

2010

2000

2002

2004

2006

2008

2010

2000

2002

2004

2006

2008

2010

2000

2002

2004

2006

2008

2010

0

10

20

30

40

50

60

70

80

90

% o

f P

ati

en

ts

Any Induction Polyclonal ALG/ATG

OKT3 IL-2R Antagonist



ADULT HEART-LUNG RECIPIENTS Maintenance Immunosuppression at Time of Follow-up

(Follow-ups: January 2001 – June 2011)

ISHLT 2012

Cyclosporine Tacrolimus Sirolimus/Everolimus

MMF/MPA Azathioprine Prednisone0

10

20

30

40

50

60

70

80

90

100

Year 1 (N = 206) Year 5 (N = 130)

% o

f P

ati

en

ts

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

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


ADULT HEART-LUNG RECIPIENTS Maintenance Immunosuppression Drug Combinations at

Time of Follow-up (Follow-ups: January 2001 – June 2011)

ISHLT 2012

0%

20%

40%

60%

80%

100%

Year 1 (N = 206)

Year 5 (N = 130)

Other

None

Sirolimus/Everolimus + Calcineurin + Cellcycle

Sirolimus/Everolimus + Calcineurin

Tacrolimus

Tacrolimus + MMF/MPA

Tacrolimus + AZA

Cyclosporine + MMF/MPA

Cyclosporine + AZA

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

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


POST-HEART-LUNG TRANSPLANT MORBIDITY FOR ADULTSCumulative Morbidity Rates in Survivors within 1 Year Post-Transplant

(Follow-ups: April 1994 - June 2011)

ISHLT 2012

Outcome Within 1 Year

Total number with known response

Hypertension 59.0% (N = 405)

Renal Dysfunction 18.7% (N = 439)

Abnormal Creatinine < 2.5 mg/dl 11.8%

Creatinine > 2.5 mg/dl 3.0%

Chronic Dialysis 3.6%

Renal Transplant 0.2%

Hyperlipidemia 26.7% (N = 427)

Diabetes 19.0% (N = 441)

Coronary Artery Vasculopathy 3.2% (N = 348)

Bronchiolitis Obliterans Syndrome 8.4% (N = 415)


POST-HEART-LUNG TRANSPLANT MORBIDITY FOR ADULTSCumulative Morbidity Rates in Survivors within 5 Years Post-Transplant

(Follow-ups: April 1994 - June 2011)

ISHLT 2012

Outcome Within 5 Years

Total number with known response

Hypertension 88.1% (N = 143)

Renal Dysfunction 46.2% (N = 169)

Abnormal Creatinine < 2.5 mg/dl 32.5%

Creatinine > 2.5 mg/dl 10.1%

Chronic Dialysis 2.4%

Renal Transplant 1.2%

Hyperlipidemia 69.3% (N = 150)

Diabetes 28.1% (N = 167)

Coronary Artery Vasculopathy 8.0% (N = 87)

Bronchiolitis Obliterans Syndrome 26.4% (N = 140)


Freedom from Coronary Artery Vasculopathy and Bronchiolitis Obliterans Syndrome

For Adult Heart-Lung Recipients (Follow-ups: April 1994 – June 2011)

0 1 2 3 4 5 6 7 840

50

60

70

80

90

100

Freedom from Coronary Artery Vasculopathy

Freedom from Bronchiolitis Obliterans Syndrome

Years

% 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


0 1 2 3 450

60

70

80

90

100

Heart (N=195)

Lung (N=56)

Heart/Lung (N=89)

Years

% F

ree

fro

m C

AV

p-value comparing all = 0.5290


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


0 1 2 3 450

60

70

80

90

100

Heart (N=226)

Lung (N=69)

Heart/Lung (N=111)

Years

% F

ree

fro

m B

ron

ch

iolit

is O

blit

-e

ran

s S

yn

dro

me

p-value comparing all = 0.8796


Freedom from Severe Renal Dysfunction*For Adult Heart-Lung Recipients (Follow-ups: April 1994 – June 2011)

0 1 2 3 4 5 6 7 8 950

60

70

80

90

100

Years

% F

ree

from

Sev

ere

Ren

al D

ysfu

nct

ion

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


MALIGNANCY POST-HEART-LUNG TRANSPLANT FOR ADULTSCumulative Morbidity Rates in Survivors


ISHLT 2012

Malignancy/Type 1-Year Survivors

5-Year Survivors

10-Year Survivors

No Malignancy 421 (94.2%) 155 (88.6%) 50 (83.3%)

Malignancy (all types combined) 26 (5.8%) 20 (11.4%) 10 (16.7%)

Malignancy Type*

Skin 2 7 9

Lymphoma 18 6 0

Other 4 5 2

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


0 1 2 3 4 5 6 7 8 9 1050

60

70

80

90

100

All malignancy

Lymphoma

Skin

Other

Years

% F

ree

fro

m M

alig

na

nc

y


ADULT HEART-LUNG TRANSPLANT RECIPIENTSCause of Death (Deaths: January 1992 – June 2011)

ISHLT 2012

CAUSE OF DEATH 0-30 Days (N = 385)

31 Days - 1 Year (N = 311)

>1 Year - 3 Years (N = 250)

>3 Years - 5 Years (N = 160)

>5 Years (N = 393)

BRONCHIOLITIS 0 11 (3.5%) 62 (24.8%) 36 (22.5%) 80 (20.4%)

ACUTE REJECTION 7 (1.8%) 9 (2.9%) 5 (2.0%) 2 (1.3%) 3 (0.8%)

LYMPHOMA 0 11 (3.5%) 15 (6.0%) 8 (5.0%) 11 (2.8%)

MALIGNANCY, OTHER 1 (0.3%) 4 (1.3%) 10 (4.0%) 5 (3.1%) 23 (5.9%)

CMV 0 2 (0.6%) 0 1 (0.6%) 1 (0.3%)

INFECTION, NON-CMV 68 (17.7%) 109 (35.0%) 74 (29.6%) 44 (27.5%) 97 (24.7%)

GRAFT FAILURE 109 (28.3%) 67 (21.5%) 34 (13.6%) 26 (16.3%) 54 (13.7%)

CARDIOVASCULAR 28 (7.3%) 12 (3.9%) 19 (7.6%) 14 (8.8%) 34 (8.7%)

TECHNICAL 86 (22.3%) 10 (3.2%) 3 (1.2%) 3 (1.9%) 3 (0.8%)

OTHER 86 (22.3%) 76 (24.4%) 28 (11.2%) 21 (13.1%) 87 (22.1%)


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

(Deaths: January 1992 – June 2011)

0-30 Days (N = 385)

31 Days – 1 Year (N = 311)

>1 Year – 3 Years (N = 250)

>3 Years – 5 Years (N = 160)

>5 Years (N = 393)

0

10

20

30

40

50 Bronchiolitis Infection (non-CMV) Graft Failure Cardiovascular

Technical

% o

f D

ea

ths



Pediatric Recipients


AGE DISTRIBUTION OF PEDIATRIC HEART-LUNG RECIPIENTS (Transplants: January 1982 - June 2011)

<1 1-5 6-11 12-170

50

100

150

200

250

300

350

400

21

105

381

165

Recipient Age (Years)

Nu

mb

er

of

Tra

ns

pla

nts


AGE DISTRIBUTION FOR DONORS OF PEDIATRIC HEART-LUNG RECIPIENTSTransplants: January 1982 - June 2011

0-11 12-17 18-34 35-49 50-590

50

100

150

200

250

300

350

400376

109

56 39

6

Donor Age (Years)

Nu

mb

er

of

Tra

ns

pla

nts


AGE DISTRIBUTION OF PEDIATRIC HEART-LUNG RECIPIENTS BY YEAR

1984

1986

1988

1990

1992

1994

1996

1998

2000

2002

2004

2006

2008

2010

0

5

10

15

20

25

30

35

40

45

50

55

60

65

12-17 Years

1-11 Years

<1 Year

Nu

mb

er

of

Tra

ns

pla

nts

ISHLT 2012

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.J Heart Lung Transplant. 2012 Oct; 31(10): 1045-1095

AGE DISTRIBUTION OF PEDIATRIC HEART-LUNG RECIPIENTS BY ERA OF TRANSPLANT

ISHLT 2012

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1982-1996 1997-6/2011

12-17 Years

1-11 Years

<1 Year

% o

f T

ran

sp

lan

ts


NUMBER OF CENTERS REPORTING PEDIATRIC HEART-LUNG TRANSPLANTS

1984

1986

1988

1990

1992

1994

1996

1998

2000

2002

2004

2006

2008

2010

0

5

10

15

20

25

30

Transplant Year

N o

f P

ed

iatr

ic T

ran

sp

lan

t C

en

ters


NUMBER OF CENTERS REPORTING PEDIATRIC HEART-LUNG TRANSPLANTS

Stratified by center volume

1984

1986

1988

1990

1992

1994

1996

1998

2000

2002

2004

2006

2008

2010

0

5

10

15

20

25

30

1-4/yr 5-9/yr

10-19/yr 20-29/yr

Transplant Year

N o

f P

ed

iatr

ic T

ran

sp

lan

t C

en

ters


DIAGNOSIS IN PEDIATRIC HEART-LUNG TRANSPLANT RECIPIENTS (Transplants: 1986-2010)

ISHLT 2012

1986

1987

1988

1989

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

0

25

50

75

100Cystic Fibrosis Congenital IPAH

% o

f C

as

es

NOTE: Unknown diagnoses were excluded from this tabulation.

4%

28%22%

12%

2%24%

2% 2%4%

Acquired Heart DiseaseCFCongenital (other)Eisenmenger's SyndromeIPFIPAHRetx: Non-OBRetx: OBOther

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


PEDIATRIC HEART-LUNG TRANSPLANTSAge Distribution By Location


ISHLT 2012


20%

40%

60%

80%

100%

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

% o

f T

ran

sp

lan

ts


PEDIATRIC HEART-LUNG TRANSPLANTSDiagnosis Distribution By Location(Transplants: January 2000 – June 2011)

ISHLT 2012


20%

40%

60%

80%

100%

Congenital heart disease Cystic Fibrosis IPAH Other

% o

f T

ran

sp

lan

ts


PEDIATRIC HEART-LUNG TRANSPLANTS Donor Age Distribution By Location


ISHLT 2012


20%

40%

60%

80%

100%

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

% o

f D

on

ors


PEDIATRIC HEART-LUNG TRANSPLANTSKaplan-Meier Survival By Diagnosis


0 1 2 3 4 5 6 7 80

25

50

75

100Congenital (N = 97)


IPAH (N = 107)

Years

Su

rviv

al (

%)




PEDIATRIC HEART-LUNG TRANSPLANTSKaplan-Meier Survival (Transplants: January 1982 - June 2010)

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 170

25

50

75

100< 1 (N = 21)

1-11 (N = 264)

12-17 (N = 375)

Overall (N = 660)

Years

Su

rviv

al (

%)

0-<1 vs. 1-11: p = 0.0004 0-<1 vs. 12-17: p = 0.0001 1-11 vs. 12-17: p = 0.1218

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


PEDIATRIC HEART-LUNG TRANSPLANTSKaplan-Meier Survival by Era (Transplants: January 1982 - June 2010)

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 150

25

50

75

1001982-1989 (N = 182)

1990-1996 (N = 267)

1997-2003 (N = 135)

2004-6/2010 (N = 76)

Years

Su

rviv

al (

%)

No pair-wise comparisons are significant at <0.05 except 1982-1989 vs. 2004-6/2010 (p = 0.0212)

Half-life 1982-1989: 1.9; 1990-1996: 3.3; 1997-2003: 3.0; 2004-6/2010: NA


PEDIATRIC HEART-LUNG TRANSPLANTSKaplan-Meier Survival by Era (Transplants: January 1982 - June 2010)

Conditional on Survival to 1 Year

0 1 2 3 4 5 6 7 8 9 10 11 12 130

25

50

75

1001982-1989 (N = 100) 1990-1996 (N = 178)

1997-2003 (N = 82) 2004-6/2010 (N = 58)

Years

Su

rviv

al (

%)

No pair-wise comparisons are significant at <0.05 except 1990-1996 vs. 1997-2003 (p = 0.0131)

Conditional HALF-LIFE 1982-1989: 9.6; 1990-1996: 6.4; 1997-2003: 13.8; 2004-6/2010: NA


PEDIATRIC HEART-LUNG TRANSPLANT RECIPIENTSCause of Death (Deaths: January 1992 – June 2011)

ISHLT 2012

CAUSE OF DEATH 0-30 Days (N = 48)

31 Days - 1 Year (N = 59)

>1 Year - 3 Years(N = 55)

>3 Years - 5 Years (N = 39)

>5 Years(N = 62)

BRONCHIOLITIS 0 3 (5.1%) 27 (49.1%) 16 (41.0%) 18 (29.0%)

ACUTE REJECTION 0 2 (3.4%) 1 (1.8%) 2 (5.1%) 1 (1.6%)

LYMPHOMA 0 3 (5.1%) 2 (3.6%) 1 (2.6%) 2 (3.2%)

MALIGNANCY, OTHER 0 1 (1.7%) 0 1 (2.6%) 0

CMV 0 2 (3.4%) 0 0 0


GRAFT FAILURE 18 (37.5%) 12 (20.3%) 13 (23.6%) 12 (30.8%) 12 (19.4%)

CARDIOVASCULAR 3 (6.3%) 3 (5.1%) 2 (3.6%) 2 (5.1%) 3 (4.8%)

TECHNICAL 11 (22.9%) 0 3 (5.5%) 2 (5.1%) 0

OTHER 8 (16.7%) 15 (25.4%) 3 (5.5%) 2 (5.1%) 10 (16.1%)


PEDIATRIC HEART-LUNG TRANSPLANT RECIPIENTSCause of Death (Deaths: April 1994 – June 2011)

ISHLT 2012

CAUSE OF DEATH0-30 Days(N = 39)

31 Days - 1 Year (N = 44)

>1 Year - 3 Years (N = 44)


>5 Years (N = 62)

BRONCHIOLITIS 0 1 (2.3%) 21 (47.7%) 14 (41.2%) 18 (29.0%)

ACUTE REJECTION 0 1 (2.3%) 1 (2.3%) 2 (5.9%) 1 (1.6%)

LYMPHOMA 0 3 (6.8%) 2 (4.5%) 1 (2.9%) 2 (3.2%)

MALIGNANCY, OTHER 0 1 (2.3%) 0 1 (2.9%) 0

CMV 0 1 (2.3%) 0 0 0


GRAFT FAILURE 15 (38.5%) 9 (20.5%) 10 (22.7%) 11 (32.4%) 12 (19.4%)

CARDIOVASCULAR 3 (7.7%) 2 (4.5%) 2 (4.5%) 1 (2.9%) 3 (4.8%)

TECHNICAL 9 (23.1%) 0 1 (2.3%) 1 (2.9%) 0

OTHER 8 (20.5%) 11 (25.0%) 3 (6.8%) 2 (5.9%) 10 (16.1%)


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

(Deaths: April 1994 – June 2011)

0-30 Days(N = 39)

31 Days - 1 Year (N =44)

>1 Year - 3 Years (N = 44)


>5 Years(N = 62)

0

10

20

30

40

50

60 Bronchiolitis Infection (Non-CMV) Graft Failure Cardiovascular

% o

f D

ea

ths


heart-lung transplantation overall ishlt 2012 j heart lung transplant. 2012 oct; 31(10): 1045-1095

Documents

distribution of heart

number of heart

heart disease160

location transplants

era transplants

ages transplants

congenital heart disease1

ishlt transplant registry