1 / 114

HEART TRANSPLANTATION

HEART TRANSPLANTATION. Overall. ISHLT. 2007. J Heart Lung Transplant 2007;26: 769-781. NUMBER OF HEART TRANSPLANTS REPORTED BY YEAR.

Télécharger la présentation

HEART TRANSPLANTATION

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. HEART TRANSPLANTATION Overall ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  2. NUMBER OF HEART TRANSPLANTS REPORTED BY YEAR 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 hearts transplanted worldwide has declined in recent years. ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  3. AVERAGE CENTER VOLUMEHeart Transplants: January 1, 1992 - June 30, 1996and January 1, 2002 – June 30, 2006 ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  4. DISTRIBUTION OF TRANSPLANTS BY CENTER VOLUMEHeart Transplants: January 1, 1992 - June 30, 1996and January 1, 2002 – June 30, 2006 ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  5. HEART TRANSPLANTS:Donor Age by Year of Transplant ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  6. AGE DISTRIBUTIONOF HEART RECIPIENTS(1/1982-6/2006) % of Transplants ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  7. AGE DISTRIBUTION OF HEART TRANSPLANT RECIPIENTS BY ERA P < 0.0001 ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  8. HEART TRANSPLANTATIONKaplan-Meier Survival(1/1982-6/2005) HEART TRANSPLANTATIONKaplan-Meier Survival(1/1982-6/2005) N at risk at 22 years: 33 ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  9. HEART TRANSPLANTATION Adult Recipients ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  10. DIAGNOSIS IN ADULT HEART TRANSPLANTS ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  11. ADULT HEART TRANSPLANTS:RECIPIENT AGE DISTRIBUTION BY LOCATIONTransplants between January 2000 and June 2006 ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  12. ADULT HEART TRANSPLANTS:DONOR AGE DISTRIBUTION BY LOCATIONTransplants between January 2000 and June 2006 ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  13. ADULT HEART TRANSPLANTATIONKaplan-Meier Survival by Era (Transplants: 1/1982 – 6/2005) Survival (%) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  14. ADULT HEART TRANSPLANTATIONKaplan-Meier Survival by Age Group(Transplants: 1/1982-6/2005) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  15. ADULT HEART TRANSPLANTATIONKaplan-Meier Survival by Age Group(Transplants: 1/1998-6/2005) HALF-LIFE 18-34: NA; 35-49: NA; 50-59: NA; 60-64: 8.3 years; 65-69: 8.1 years; 70+: 7.3 years ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  16. ADULT HEART TRANSPLANTATION Kaplan-Meier Survival by Diagnosis(Transplants: 1/1982-6/2005) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  17. ADULT HEART TRANSPLANTATION Kaplan-Meier Survival by Diagnosis Conditional on Survival to 1 Year (Transplants: 1/1982-6/2005) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  18. ADULT HEART TRANSPLANTATION Kaplan-Meier Survival by Diagnosis (Transplants: 1/2000-6/2005) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  19. ADULT HEART TRANSPLANTATIONKaplan-Meier Survival by Diagnosis Conditional on Survival to 1 Year (Transplants: 1/2000-6/2005) Cardiomyopathy vs. Re-TX: p = .006; Cardiomyopathy vs. Other: p = .02; CAD vs. Re-TX: p = .03; Congenital vs. Re-TX: p = .01; Valvular vs. Other: = .01; Re-TX vs. Other: p = .0003 ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  20. ADULT HEART TRANSPLANTATIONKaplan-Meier Survival by PVR(Transplants: 1/2002-6/2005) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  21. ADULT HEART TRANSPLANTATIONKaplan-Meier Survival by VAD usage(Transplants: 1/1999-6/2005) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  22. ADULT HEART TRANSPLANTATIONKaplan-Meier Survival by VAD usage and Era(Transplants: 1/1999-6/2005) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  23. ADULT HEART TRANSPLANTS1-Year Predicted Survival Model (Transplants: 1/2002-6/2005) Impact of Pre-Transplant VAD Recipient: 54 y.o., Dx=cardiomyopathy, weight=78 kg, PVR=2.2, volume=22/year, bilirubin=0.8, PA systolic=40, creatinine=1.3 mg/dl, ischemia=180 min Donor: 30 y.o., weight = 77 kg ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  24. ADULT HEART RE-TRANSPLANTS1-Year Survival ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  25. ADULT HEART RECIPIENTSFunctional Status of Surviving Recipients(Follow-ups: 1995 - June 2006) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  26. ADULT HEART RECIPIENTSEmployment Status of Surviving Recipients (Follow-ups: 1995 - June 2006) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  27. ADULT HEART RECIPIENTSRehospitalization Post-transplant of Surviving Recipients (Follow-ups: 1995 - June 2006) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  28. ADULT HEART RECIPIENTSInduction Immunosuppression (Transplants: January 2001 – June 2006) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  29. ADULT HEART RECIPIENTSInduction Immunosuppression (Transplants: 1995, 2000 and 2005) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  30. ADULT HEART TRANSPLANTATIONKaplan-Meier Survival by Induction Type(Transplants: 1/2000-6/2005, conditional on survival to 14 days) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  31. ADULT HEART RECIPIENTSMaintenance Immunosuppression at Time of Follow-up(Follow-ups: January 2003 - June 2006) NOTE: Different patients are analyzed in Year 1 and Year 5 ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  32. ADULT HEART RECIPIENTSMaintenance Immunosuppression at Time of 1 Year Follow-up NOTE: Different patients are analyzed in each time frame. ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  33. ADULT HEART RECIPIENTS Maintenance Immunosuppression Drug Combinations at Time of Follow-up(Follow-ups: January 2004 - June 2006) NOTES: Different patients are analyzed in Year 1 and Year 5. In the Year 1 cohort 73.9% of patients were on prednisone; in the Year 5 cohort 56.8% of patients were on prednisone. ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  34. ADULT HEART RECIPIENTS Maintenance Immunosuppression Drug Combinations at Time of Follow-up(Follow-ups: January 2004 - June 2006) ISHLT NOTES: Different patients are analyzed in Year 1 and Year 5. 2007 J Heart Lung Transplant 2007;26: 769-781

  35. ADULT HEART RECIPIENTS Maintenance Immunosuppression Drug Combinations at Time of Follow-upFor the Same Patients(Follow-ups: January 1999 - June 2006) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  36. PERCENTAGE OF ADULT HEART TRANSPLANT RECIPIENTS TREATED FOR REJECTION IN 1ST YEARStratified by Type of Induction (Transplants: January 1, 2000 - June 30, 2005) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  37. NUMBER OF REJECTION EPISODES FOR ADULT HEART TRANSPLANT RECIPIENTS TREATED FOR REJECTION IN 1ST YEARStratified by Type of Induction (Transplants: January 1, 2000 - June 30, 2005) Overall: no induction vs. OKT3 (p = 0.0017); polyclonal vs. OKT3 (p=0.0065); IL2 vs. OKT3 (p=0.0003). 18-44: no induction vs. IL2 (p = 0.037). 45-62: no induction vs. OKT3 (p = 0.0025); IL2 vs. OKT3 (p = 0.0034). 63+: polyclonal vs. OKT3 (p = 0.0228). For females: no induction vs. OKT3 (p = 0.0078); IL2 vs. OKT3 (p = 0.0466). For males: no induction vs. OKT3 (p =0.040); polyclonal vs. OKT3 (p=0.045); IL2 vs. OKT3 (p = 0.0022). ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  38. PERCENTAGE OF ADULT HEART TRANSPLANT RECIPIENTS TREATED FOR REJECTION IN 1ST YEARStratified by Maintenance Immunosuppression (Transplants: January 1, 2000 - June 30, 2005) Overall: p<0.0001 18-44: p<0.0001 Male: p<0.0001 NOTE: There were 1,119 patients with cyclosporine+AZA and 138 with tacrolimus+AZA. These groups were excluded due to small numbers. ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  39. NUMBER OF REJECTION EPISODES FOR ADULT HEART TRANSPLANT RECIPIENTS TREATED FOR REJECTION IN 1ST YEARStratified by Maintenance Immunosuppression (Transplants: January 1, 2000 - June 30, 2005) NOTE: Cyclosporine+AZA and tacrolimus+AZA were excluded due to small numbers. ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  40. ADULT HEART TRANSPLANTATIONKaplan-Meier Survival Stratified by Rejection Within 1st YearConditional on survival to 1 year for transplants: 1/1999-6/2004 ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  41. POST-HEART TRANSPLANT MORBIDITY FOR ADULTSCumulative Prevalence in Survivors at 1 Year Post-Transplant (Follow-ups: April 1994 – December 1997 and January 2002 - June 2006) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  42. POST-HEART TRANSPLANT MORBIDITY FOR ADULTSCumulative Prevalence in Survivors at 5 and 10 Years Post-Transplant (Follow-ups: April 1994 - June 2006) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  43. FREEDOM FROM CARDIAC ALLOGRAFT VASCULOPATHY AND FREEDOM FROM SEVERE RENAL DYSFUNCTION*For Adult Heart Recipients (Follow-ups: April 1994-June 2006) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  44. PATIENT SURVIVAL AFTER REPORT OF CAV AND PATIENT SURVIVAL IN PATIENTS WITHOUT CAV*(Transplants: April 1994-June 2004) ISHLT 2007 * Patients without CAV conditioned on survival to median time of CAV development (514 days) J Heart Lung Transplant 2007;26: 769-781

  45. MALIGNANCY POST-HEART TRANSPLANTATION FOR ADULTSCumulative Prevalence in Survivors(Follow-ups: April 1994 - June 2006) ”Other” includes: prostate (11, 34, 17), adenocarcinoma (7, 4, 2), lung (5, 4, 1), bladder (4, 5, 4), sarcoma (3, 3, 1), breast (2, 8, 3), cervical (2, 4, 0), colon (2, 3, 1), and renal (2, 7, 2). Numbers in parentheses are those reported within 1 year, 5 years and 10 years, respectively. ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  46. FREEDOM FROM MALIGNANCYFor Adult Heart Recipients (Follow-ups: April 1994 - June 2006) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  47. ADULT HEART TRANSPLANT RECIPIENTS: Cause of Death (Deaths: January 1992 - June 2006) ISHLT J Heart Lung Transplant 2007;26: 769-781

  48. ADULT HEART TRANSPLANT RECIPIENTS: Cause of Death from Leading Causes by Era(Deaths: January 1992 - June 2006) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  49. ADULT HEART TRANSPLANT RECIPIENTS: Cumulative Incidence of Leading Causes of Death(Transplants: January 1992 - June 2005) ISHLT 2007 J Heart Lung Transplant 2007;26: 769-781

  50. ISHLT 2007 ADULT HEART TRANSPLANTS(1/2002-6/2005) Risk Factors for 1 Year Mortality * Temporary circulatory support includes ECMO and Abiomed. (N=7,024) J Heart Lung Transplant 2007;26: 769-781

More Related