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LUNG TRANSPLANTATION

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simon-mcintosh
128 diapositives · 1.5K Views · Nov 05, 2014

LUNG TRANSPLANTATION. Overall. ISHLT. 2006. J Heart Lung Transplant 2006;25:880-892. 1725. 1599. 1699. 1552. 1472. 1478. 1340. 1450. 1323. 1202. 1079. 908. 706. 415. 192. 89. 15. 48. 15. 1815. NUMBER OF LUNG TRANSPLANTS REPORTED BY YEAR AND PROCEDURE TYPE.

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  1. LUNG TRANSPLANTATION Overall ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  2. 1725 1599 1699 1552 1472 1478 1340 1450 1323 1202 1079 908 706 415 192 89 15 48 15 1815 NUMBER OF LUNG TRANSPLANTS REPORTED BY YEAR AND PROCEDURE TYPE NOTE: This figure includes only the lung transplants that are reported to the ISHLT Transplant Registry. As such, this should not be construed as representing changes in the number of lung transplants performed worldwide. ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  3. AVERAGE CENTER VOLUMELung Transplants: January 1, 1998 - June 30, 2005 ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  4. DISTRIBUTION OF TRANSPLANTS BY CENTER VOLUMELung Transplants: January 1, 1998 - June 30, 2005 ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  5. LUNG TRANSPLANTS:Donor Age by Year of Transplant ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  6. AGE DISTRIBUTION OF LUNG TRANSPLANT RECIPIENTS(1/1985-6/2005) ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  7. AGE DISTRIBUTION OF LUNG TRANSPLANT RECIPIENTS BY ERA ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  8. LUNG TRANSPLANTATION Adult Recipients ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  9. AGE DISTRIBUTION OF ADULT LUNG TRANSPLANT RECIPIENTS(1/1985-6/2005) ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  10. Mean age by era 1985-1995 = 44.9 years 1996-6/2005 = 48.3 years AGE DISTRIBUTION OF ADULT LUNG TRANSPLANT RECIPIENTS BY ERA ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  11. Mean age by era 1985-1994 = 44.6 years 1995-1999 = 47.3 years 2000-6/2005 = 48.8 years AGE DISTRIBUTION OF ADULT LUNG TRANSPLANT RECIPIENTS BY ERA ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  12. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival (Transplants: January 1994 - June 2004) P < 0.0001 ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  13. ADULT LUNG TRANSPLANTATION: Indications(1/1995-6/2005) ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  14. ADULT LUNG TRANSPLANTATION: Distribution of Procedure Type for Major Indications(1990-2004) ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  15. ADULT LUNG TRANSPLANTATIONProcedure Type within Indication, by Year ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  16. ADULT LUNG TRANSPLANTATION: Indications for Single Lung Transplants (Transplants: January 1995 - June 2005) *Other includes: Sarcoidosis: 2.1% Bronchiectasis: 0.4% Congenital Heart Disease: 0.2% LAM: 0.8% OB (non-ReTx): 0.7% Miscellaneous: 4.8% ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  17. ADULT LUNG TRANSPLANTATION: Indications for Bilateral/Double Lung Transplants (Transplants: January 1995 - June 2005) *Other includes: Sarcoidosis: 2.9% Bronchiectasis: 4.8% Congenital Heart Disease: 1.7% LAM: 1.3% OB (non-ReTx): 1.1% Miscellaneous: 0.9% ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  18. ADULT LUNG TRANSPLANTATIONIndications By Year (%) ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  19. ADULT LUNG TRANSPLANTATIONIndications By Year (Number) ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  20. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival by Era (Transplants: January 1988 – June 2004) Survival comparisons by era 1988-94 vs. 1995-99: p = 0.0294 1988-94: vs. 2000-6/03: p <0.0001 1995-99 vs. 2000-6/03: p <0.0001 ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  21. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival by Age Group(Transplants: January 1990 – June 2004) ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  22. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival by Gender(Transplants: January 1994 – June 2004) ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  23. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival By Diagnosis(Transplants: January 1994 – June 2004) Survival comparisons Alpha-1 vs. CF: p = 0.0327 CF vs. IPF: p < 0.0001 Alpha-1 vs. IPF: p <0.0001 CF vs. Sarcoidosis: p = 0.0041 Alpha-1 vs. PPH: p = 0.0032 PPH vs. COPD: p = 0.0162 CF vs. COPD: p < 0.0001 COPD vs. IPF: p <0.0001 Note: Other comparisons are not statistically different. ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  24. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival By Diagnosis Conditional on Survival to 3 Months(Transplants: January 1994 – June 2004) Survival comparisons Alpha-1 vs. IPF: p = 0.0004 Alpha-1 vs. COPD: p = 0.0021 CF vs. COPD: p < 0.0001 CF vs. IPF: p < 0.0001 PPH vs. COPD: p < 0.0001 PPH vs. IPF: p < 0.0001 IPF vs. Sarcoidosis: p = 0.0222 Note: Other comparisons are not statistically different. ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  25. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival By Diagnosis Conditional on Survival to 1 Year(Transplants: January 1994 – June 2004) Survival comparisons Alpha-1 vs. IPF: p = 0.0019 Alpha-1 vs. COPD: p < 0.0001 CF vs. COPD: p < 0.0001 CF vs. IPF: p < 0.0001 PPH vs. COPD: p < 0.0001 PPH vs. IPF: p < 0.0001 COPD vs. Sarcoidosis: p = 0.0002 IPF vs. Sarcoidosis: p = 0.0012 Note: Other comparisons are not statistically different. ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  26. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival By Diagnosis(Transplants: January 1994 – June 2004) ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  27. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival By Diagnosis Conditional on Survival to 3 Months(Transplants: January 1994 – June 2004) ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  28. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival By Diagnosis Conditional on Survival to 1 Year(Transplants: January 1994 – June 2004) ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  29. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival for Eisenmenger’s Syndrome(Transplants: January 1990 – June 2004) N at risk at 5 years = 35 P=0.2787 N at risk at 5 years = 15 ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  30. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival By Procedure Type(Transplants: January 1990 – June 2004)Diagnosis: Alpha-1 Antitrypsin Deficiency P < 0.0001 N at risk at 10 years is 46 for Single Lung and 33 for Double Lung. ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  31. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival By Procedure Type and Age (Transplants: January 1990 – June 2004)Diagnosis: Alpha-1 Antitrypsin Deficiency p = 0.0055 N at risk at 5 years: Single Lung, <50 = 125; Double Lung, <50 = 134; Single Lung, 50+ = 89; Double Lung, 50+ = 48 ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  32. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival by Procedure Type (Transplants: January 1990 – June 2004) Diagnosis: Emphysema/COPD P < 0.0001 ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  33. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival by Procedure Type and Age(Transplants: January 1990 – June 2004) Diagnosis: Emphysema/COPD P < 0.0001 ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  34. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival by Procedure Type(Transplants: January 1990 – June 2004)Diagnosis: Idiopathic Pulmonary Fibrosis P = 0.2038 ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  35. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival by Procedure Type (Transplants: January 1990 – June 2004)Diagnosis: Primary Pulmonary Hypertension P = 0.1801 ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  36. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival by Procedure Type and Era(Transplants: January 1990 – June 2004) Diagnosis: Emphysema/COPD, Single Lung ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  37. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival by Procedure Type and Era(Transplants: January 1990 – June 2004) Diagnosis: Emphysema/COPD, Double Lung ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  38. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival by Procedure Type and Era(Transplants: January 1990 – June 2004) Diagnosis: Idiopathic Pulmonary Fibrosis, Single Lung ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  39. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival by Procedure Type and Era(Transplants: January 1990 – June 2004) Diagnosis: Idiopathic Pulmonary Fibrosis, Double Lung ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  40. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival by Donor CMV status/Recipient CMV status(Transplants: October 1999 – June 2004) ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  41. ADULT LUNG TRANSPLANTS (1995-6/2004)Risk Factors for 1 Year Mortality (N=13,168) *Other = All diagnoses other than COPD, PPH, IPF, cystic fibrosis, pulmonary fibrosis,bronchiectasis,alpha-1 antitrypsin deficiency, and LAM. ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  42. ADULT LUNG TRANSPLANTS (1995-6/2004)Risk Factors for 1 Year Mortality (N=13,168) ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  43. ADULT LUNG TRANSPLANTS (1995-6/2004)Risk Factors for 1 Year Mortality (N=13,168) ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  44. ADULT LUNG TRANSPLANTS(1/1995-6/2004)Risk Factors for 1 Year Mortality ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  45. ADULT LUNG TRANSPLANTS(1/1995-6/2004)Risk Factors for 1 Year MortalityRecipient Age ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  46. ADULT LUNG TRANSPLANTS(1/1995-6/2004)Risk Factors for 1 Year MortalityDonor Age ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  47. ADULT LUNG TRANSPLANTS(1/1995-6/2004)Risk Factors for 1 Year MortalityDonor Weight ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  48. ADULT LUNG TRANSPLANTS(1/1995-6/2004)Risk Factors for 1 Year MortalityPre-Transplant Recipient BMI ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  49. ADULT LUNG TRANSPLANTS(1/1995-6/2004)Risk Factors for 1 Year MortalityCenter volume ISHLT 2006 J Heart Lung Transplant 2006;25:880-892

  50. ADULT LUNG TRANSPLANTS(1/1995-6/2004)Risk Factors for 1 Year Mortality Recipient FEV1 (% predicted) ISHLT 2006 J Heart Lung Transplant 2006;25:880-892