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HEART TRANSPLANTATION

HEART TRANSPLANTATION

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HEART TRANSPLANTATION

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  1. HEART TRANSPLANTATION Overall ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  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 2006 J Heart Lung Transplant 2006;25:869-79

  3. AVERAGE CENTER VOLUMEHeart Transplants: January 1, 1991 - June 30, 1995and January 1, 2001 – June 30, 2005 ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  4. DISTRIBUTION OF TRANSPLANTS BY CENTER VOLUMEHeart Transplants: January 1, 1991 - June 30, 1995and January 1, 2001 – June 30, 2005 ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  5. HEART TRANSPLANTS:Donor Age by Year of Transplant ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  6. AGE DISTRIBUTIONOF HEART RECIPIENTS(1/1982-6/2005) % of Transplants ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  7. AGE DISTRIBUTION OF HEART TRANSPLANT RECIPIENTS BY ERA P < 0.0001 ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  8. HEART TRANSPLANTATIONKaplan-Meier Survival(1/1982-6/2004) N followed at longest time point: 28,463 ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  9. HEART TRANSPLANTATION Adult Recipients ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  10. DIAGNOSIS IN ADULT HEART TRANSPLANTS ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  11. ADULT HEART TRANSPLANTATIONKaplan-Meier Survival by Era (Transplants: 1/1982 – 6/2004) Survival (%) ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  12. ADULT HEART TRANSPLANTATIONKaplan-Meier Survival by Age Group(Transplants: 1/1982-6/2004) ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  13. ADULT HEART TRANSPLANTATIONKaplan-Meier Survival by Age Group(Transplants: 1/1998-6/2004) ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  14. ADULT HEART TRANSPLANTATION Kaplan-Meier Survival by Diagnosis(Transplants: 1/1982-6/2004) All pair-wise comparisons with Cardiomyopathy are significant at p < 0.05 except for Congenital; Coronary Artery Disease vs. ReTx: p < 0.0001; Coronary Artery Disease vs. Valvular: p = 0.01; Valvular vs. ReTx: p < 0.0001; Congenital vs. ReTx: p < 0.0001; ReTx vs. Other: p < 0.0001 ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  15. ADULT HEART TRANSPLANTATION Kaplan-Meier Survival by Diagnosis Conditional on Survival to 1 Year (Transplants: 1/1982-6/2004) ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  16. ADULT HEART TRANSPLANTATION Kaplan-Meier Survival by Diagnosis (Transplants: 1/1998-6/2004) ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  17. ADULT HEART TRANSPLANTATIONKaplan-Meier Survival by Diagnosis Conditional on Survival to 1 Year (Transplants: 1/1998-6/2004) ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  18. ADULT HEART TRANSPLANTATIONKaplan-Meier Survival by PVR(Transplants: 1/2002-6/2004) ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  19. ADULT HEART TRANSPLANTATIONKaplan-Meier Survival by VAD usage(Transplants: 1/1999-6/2004) Note: Only 42 transplants involving continuous flow devices; too few to analyze. ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  20. ADULT HEART TRANSPLANTATIONKaplan-Meier Survival by VAD usage and Era(Transplants: 1/1999-6/2004) ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  21. ADULT HEART TRANSPLANTS5-Year Predicted Survival Model (Transplants: 1/1997-6/2000) Impact of Pre-Transplant VAD Recipient: 54 y.o. male, Dx=CAD, PRA < 10%, weight=75 kg, height=69 in, PVR=2, volume=25/year, year of tx=99/00, bilirubin=0.9, PA diastolic=23, creatinine=1.2 mg/dl, ischemia=180 min; Donor: 32 y.o. male, COD = MVA, weight = 72 kg, height = 70 in. ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  22. ADULT HEART RE-TRANSPLANTS1-Year Survival ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  23. ADULT HEART RECIPIENTSFunctional Status of Surviving Recipients(Follow-ups: 1995 - June 2005) ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  24. ADULT HEART RECIPIENTSEmployment Status of Surviving Recipients (Follow-ups: 1995 - June 2005) ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  25. ADULT HEART RECIPIENTSRehospitalization Post-transplant of Surviving Recipients (Follow-ups: 1995 - June 2005) ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  26. ADULT HEART RECIPIENTSInduction Immunosuppression (Transplants: January 2001 – June 2005) ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  27. ADULT HEART RECIPIENTSInduction Immunosuppression (Transplants: 1996, 2000 and 2004) ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  28. ADULT HEART TRANSPLANTATIONKaplan-Meier Survival Stratified by Use of Any Induction(Transplants: 1/2000-6/2004, conditional on survival to 14 days) ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  29. ADULT HEART TRANSPLANTATIONKaplan-Meier Survival by Induction Type(Transplants: 1/2000-6/2004, conditional on survival to 14 days) ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  30. ADULT HEART RECIPIENTSMaintenance Immunosuppression at Time of Follow-up(Follow-ups: January 2002 - June 2005) NOTE: Different patients are analyzed in Year 1 and Year 5 ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  31. ADULT HEART RECIPIENTSMaintenance Immunosuppression at Time of 1 Year Follow-up NOTE: Different patients are analyzed in each time frame. ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  32. ADULT HEART RECIPIENTS Maintenance Immunosuppression Drug Combinations at Time of Follow-up(Follow-ups: January 2003 - June 2005) NOTES: Different patients are analyzed in Year 1 and Year 5. In the Year 1 cohort 76.5% of patients were on prednisone; in the Year 5 cohort 61% of patients were on prednisone. ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  33. PERCENTAGE OF ADULT HEART TRANSPLANT RECIPIENTS TREATED FOR REJECTION IN 1ST YEARStratified by Type of Induction (Transplants: January 1, 2000 - June 30, 2004) ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  34. 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, 2004) Overall: no induction vs. OKT3 (p = 0.0021); polyclonal vs. OKT3 (p=0.0077); IL2 vs. OKT3 (p=0.0003). 18-44: no induction vs. IL2 (p = 0.033). 45-62: no induction vs. OKT3 (p = 0.0031); IL2 vs. OKT3 (p = 0.0034). 63+: polyclonal vs. OKT3 (p = 0.0228). For females: no induction vs. OKT3 (p = 0.0082); IL2 vs. OKT3 (p = 0.0493). For males: no induction vs. OKT3 (p =0.046); IL2 vs. OKT3 (p = 0.0021). ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  35. PERCENTAGE OF ADULT HEART TRANSPLANT RECIPIENTS TREATED FOR REJECTION IN 1ST YEARStratified by Maintenance Immunosuppression (Transplants: January 1, 2000 - June 30, 2004) Overall: CyA + MMF vs. TAC + MMF (p<0.0001); CyA + MMF vs. TAC + AZA (p=0.0102); CyA + AZA vs. TAC + MMF (p<0.0001); CyA + AZA vs. TAC + AZA (p=0.0054). 18-44: CyA + MMF vs. TAC + MMF (p=0.0085); CyA + MMF vs. TAC + AZA (p=0.0119); CyA + AZA vs. TAC + MMF (p=0.031); CyA + AZA vs. TAC + AZA (p=0.0108). 45-62: CyA + MMF vs. TAC + MMF (p<0.0001); CyA + AZA vs. TAC + MMF (p<0.0001). 63+: CyA + MMF vs. TAC + MMF (p=0.0395); CyA + AZA vs. TAC + MMF (p=0.0027). For females all comparisons are significant except TAC + MMF vs. TAC + AZA. For males: CyA + MMF vs. TAC + MMF (p<0.0001); CyA + AZA vs. TAC + MMF (p<0.0001) ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  36. NUMBER OF REJECTION EPISODES FOR ADULT HEART TRANSPLANT RECIPIENTS TREATED FOR REJECTION IN 1ST YEARStratified by Maintenance Immunosuppression (Transplants: January 1, 2000 - June 30, 2004) ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  37. ADULT HEART TRANSPLANTATIONKaplan-Meier Survival Stratified by Rejection Within 1st YearConditional on survival to 1 year for transplants: 1/1995-6/2003 ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  38. ADULT HEART TRANSPLANTATIONKaplan-Meier Survival Stratified by Rejection between Transplant Discharge and 1 YearConditional on survival to 1 year for transplants: 1/1995-6/2003 ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  39. POST-HEART TRANSPLANT MORBIDITY FOR ADULTSCumulative Prevalence in Survivors at 1 Year Post-Transplant (Follow-ups: April 1994 – December 1997 and January 2001 - June 2005) ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  40. POST-HEART TRANSPLANT MORBIDITY FOR ADULTSCumulative Prevalence in Survivors at 5 and 8 Years Post-Transplant (Follow-ups: April 1994 - June 2005) ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  41. FREEDOM FROM CARDIAC ALLOGRAFT VASCULOPATHY AND FREEDOM FROM SEVERE RENAL DYSFUNCTION*For Adult Heart Recipients (Follow-ups: April 1994-June 2005) ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  42. FREEDOM FROM CARDIAC ALLOGRAFT VASCULOPATHY Stratified by Rejection Within 1st YearFor Adult Heart Recipients (Transplants: April 1994-June 2003) Conditional on Survival to 1 Year ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  43. PATIENT SURVIVAL AFTER REPORT OF CAV AND PATIENT SURVIVAL IN PATIENTS WITHOUT CAV*(Transplants: April 1994-June 2003) ISHLT 2006 * Patients without CAV conditioned on survival to median time of CAV development (562 days) J Heart Lung Transplant 2006;25:869-79

  44. MALIGNANCY POST-HEART TRANSPLANTATION FOR ADULTSCumulative Prevalence in Survivors(Follow-ups: April 1994 - June 2005) ”Other” includes: prostate (11, 33, 23), adenocarcinoma (7, 3, 2), lung (5, 3, 1), bladder (4, 5, 4), sarcoma (3, 2, 1), breast (2, 7, 4), cervical (2, 4, 1), colon (2, 3, 3), and renal (2, 5, 2). Numbers in parentheses are those reported within 1 year, 5 years and 8 years, respectively. ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  45. FREEDOM FROM MALIGNANCYFor Adult Heart Recipients (Follow-ups: April 1994 - June 2005) ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  46. ADULT HEART TRANSPLANT RECIPIENTS: Cause of Death(Deaths: January 1992 - June 2005) ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  47. ADULT HEART TRANSPLANT RECIPIENTS: Cause of Death from Leading Causes by Era(Deaths: January 1992 - June 2005) ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  48. ADULT HEART TRANSPLANT RECIPIENTS: Cumulative Incidence of Leading Causes of Death(Transplants: January 1992 - June 2004) ISHLT 2006 J Heart Lung Transplant 2006;25:869-79

  49. ISHLT 2006 ADULT HEART TRANSPLANTSRisk Factors for 1 Year Mortality * Temporary circulatory support includes ECMO and Abiomed. Note: All factors were significant at p < 0.05 in at least one of the eras. J Heart Lung Transplant 2006;25:869-79

  50. ISHLT 2006 ADULT HEART TRANSPLANTSRisk Factors for 1 Year Mortality **VAD type collected for only part of era. Only those with known type were included in this group. Note: All factors were significant at p < 0.05 in at least one of the eras. J Heart Lung Transplant 2006;25:869-79