html5-img
1 / 237

HEART TRANSPLANTATION

HEART TRANSPLANTATION. Adult Recipients. 2013. JHLT. 2013 Oct; 32(10): 951-964. Table of Contents. Donor and recipient characteristics: slides 3-24 Survival slides: slides 25-61 Immunosuppression: slides 62-80 Morbidity: slides 81-106 Multivariable analyses: slides 107-195

weldon
Download Presentation

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 Adult Recipients 2013 JHLT. 2013 Oct; 32(10): 951-964

  2. Table of Contents • Donor and recipient characteristics: slides 3-24 • Survival slides: slides 25-61 • Immunosuppression: slides 62-80 • Morbidity: slides 81-106 • Multivariable analyses: slides 107-195 • 2013 focus theme: age: slides 196-237 2013 JHLT. 2013 Oct; 32(10): 951-964

  3. Donor and Recipient Characteristics: • Diagnosis: slides 4-6 • Recipient and donor characteristics: slides 7-24 2013 JHLT. 2013 Oct; 32(10): 951-964

  4. Adult Heart TransplantsDiagnosis 2013 JHLT. 2013 Oct; 32(10): 951-964

  5. Adult Heart TransplantsDiagnosis: Cardiomyopathy vs. CAD by Location 2013 JHLT. 2013 Oct; 32(10): 951-964

  6. Adult Heart TransplantsDiagnosis by Location(Transplants: January 2006 – June 2012) 2013 JHLT. 2013 Oct; 32(10): 951-964

  7. Adult Heart TransplantsDonor and Recipient Characteristics Continuous factors are expressed as median (5th-95th percentiles) 2013 1 Based on 4/1994-2000 transplants. JHLT. 2013 Oct; 32(10): 951-964

  8. Adult Heart TransplantsDonor and Recipient Characteristics (Cont’d) Continuous factors are expressed as median (5th-95th percentiles) 2013 1 Based on 4/1994-2000 transplants. 2 Based on 7/2004-2005 transplants. JHLT. 2013 Oct; 32(10): 951-964

  9. Adult Heart TransplantsDonor and Recipient Characteristics Continuous factors are expressed as median (5th-95th percentiles) (Cont’d) 1 PRA was collected as a single percentage outside of US. Until mid-2004 PRA was collected in US as a single percentage. After this date, PRA was collected separately for Class I and Class II. 2 Based on US 2001-6/2004 transplants and non US 2001 - 2005 transplants. 3 Based on non US transplants. 4 Based on US transplants. 5 Based on 4/1994-2000 transplants. 2013 JHLT. 2013 Oct; 32(10): 951-964

  10. Adult Heart TransplantsDonor and Recipient Characteristics (Cont’d) 2013 JHLT. 2013 Oct; 32(10): 951-964

  11. Adult Heart TransplantsDonor and Recipient Characteristics (Cont’d) 1 Based on 4/1994-2000 transplants. 2 Based on 11/1999-2000 transplants. 3 Based on 2005 transplants. 4 Based on 5/1995-2000 transplants. 2013 JHLT. 2013 Oct; 32(10): 951-964

  12. Adult Heart TransplantsRecipient Gender By Location (Transplants: January 2006 – June 2012) 2013 JHLT. 2013 Oct; 32(10): 951-964

  13. Adult Heart TransplantsDonor Gender By Location (Transplants: January 2006 – June 2012) 2013 JHLT. 2013 Oct; 32(10): 951-964

  14. Adult Heart Transplants PRA Distribution(Transplants: January 2006 – June 2012) If Class I and Class II values were reported separately, the higher of the two values was used. 2013 JHLT. 2013 Oct; 32(10): 951-964

  15. Adult Heart Transplants% of Patients Bridged with Mechanical Circulatory Support* (Transplants: January 2000 – December 2011) 2013 * LVAD, RVAD, TAH. ECMO is excluded. JHLT. 2013 Oct; 32(10): 951-964

  16. Adult Heart Transplants% of Patients Bridged with Mechanical Circulatory Support* by Year and Device Type 2013 * LVAD, RVAD, TAH. ECMO is excluded. JHLT. 2013 Oct; 32(10): 951-964

  17. Adult Heart Transplants Number and % of Combined Organ Transplants Reported By Year and Type of Transplant 2013 JHLT. 2013 Oct; 32(10): 951-964

  18. Adult Heart TransplantsRecipient BMI Distribution By Location (Transplants: January 2006 – June 2012) 2013 JHLT. 2013 Oct; 32(10): 951-964

  19. Adult Heart TransplantsRecipient BMI Distribution By Diagnosis (Transplants: January 2006 – June 2012) 2013 JHLT. 2013 Oct; 32(10): 951-964

  20. Adult Heart TransplantsRecipient Diabetes Mellitus Distribution By Location (Transplants: January 2006 – June 2012) 2013 JHLT. 2013 Oct; 32(10): 951-964

  21. Adult Heart TransplantsRecipient Diabetes Mellitus Distribution By Diagnosis (Transplants: January 2006 – June 2012) 2013 JHLT. 2013 Oct; 32(10): 951-964

  22. Adult Heart TransplantsRecipient Cigarette History By Location (Transplants: January 2006 – June 2012) 2013 JHLT. 2013 Oct; 32(10): 951-964

  23. Adult Heart TransplantsRecipient Cigarette and COPD History By Diagnosis (Transplants: January 2006 – June 2012) 2013 JHLT. 2013 Oct; 32(10): 951-964

  24. Adult Heart TransplantsIschemic time Distribution By Location (Transplants: January 2006 – June 2012) 2013 JHLT. 2013 Oct; 32(10): 951-964

  25. Survival Analyses: • by era: slides 26-27 and 37-41 • by gender: slides 28-31 • by diagnosis: slides 32-41 • by PVR: slides 42-45 • by BMI: slide 46 • by comorbidities: slides 47-49 • by VAD usage: slides 50-53 • by re-transplant: slide 54 • by employment status at 1 year post transplant: slide 55 • by age: see slides 210-217 in the age theme section • by immunosuppression: see slides 66, 72 and 79 in the immunosuppression section • Cause of death: slides 56-61 2013 JHLT. 2013 Oct; 32(10): 951-964

  26. Adult Heart TransplantsKaplan-Meier Survival by Era (Transplants: January 1982 – June 2011) All pair-wise comparisons were significant at p < 0.0001 except 2002-2005 vs. 2006-6/2011 (p = 0.9749) 2013 JHLT. 2013 Oct; 32(10): 951-964

  27. Adult Heart TransplantsKaplan-Meier Survival by Era Conditional on Survival to 1 Year (Transplants: January 1982 – June 2011) All pair-wise comparisons were significant at p < 0.001 except 1992-2001 vs. 2006-6/2011 (p=0.9440) and 2002-2005 vs. 2006-6/2011 (p=0.0569) 2013 JHLT. 2013 Oct; 32(10): 951-964

  28. Adult Heart TransplantsKaplan-Meier Survival by Recipient Gender(Transplants: January 1982 – June 2011) p < 0.0001 2013 JHLT. 2013 Oct; 32(10): 951-964

  29. Adult Heart TransplantsKaplan-Meier Survival by Recipient Gender Conditional on Survival to 1 Year (Transplants: January 1982 – June 2011) p < 0.0001 2013 JHLT. 2013 Oct; 32(10): 951-964

  30. Adult Heart TransplantsKaplan-Meier Survival by Donor/Recipient Gender(Transplants: January 1982 – June 2011) All pair-wise comparisons with male/female were significant at p < 0.0001. No other pair-wise comparisons were significant at p < 0.05 2013 JHLT. 2013 Oct; 32(10): 951-964

  31. Adult Heart TransplantsKaplan-Meier Survival by Donor/Recipient Gender Conditional on Survival to 1 Year(Transplants: January 1982 – June 2011) All pair-wise comparisons were significant at p < 0.05 except male/male vs. female/male and female/male vs. female/female 2013 JHLT. 2013 Oct; 32(10): 951-964

  32. Adult Heart TransplantsKaplan-Meier Survival by Diagnosis(Transplants: January 1982 – June 2011) Median survival (years): Cardiomyopathy= 11.6; CAD=9.4; Congenital=14.4; Retransplant=6.3; Valvular=10.9 All pair-wise comparisons were significant at p < 0.01 except cardiomyopathy vs. congenital (p=0.9113). 2013 JHLT. 2013 Oct; 32(10): 951-964

  33. Adult Heart TransplantsKaplan-Meier Survival by Diagnosis Conditional on Survival to 1 Year (Transplants: January 1982 – June 2011) Median survival (years): Cardiomyopathy=14.2; CAD=11.9; Congenital=21.2; Retransplant=10.8; Valvular=14.6 All pair-wise comparisons were significant at p < 0.0001 except cardiomyopathy vs. valvular (p = 0.9665) and CAD vs. retransplant (p = 0.0659) 2013 JHLT. 2013 Oct; 32(10): 951-964

  34. Adult Heart TransplantsKaplan-Meier Survival Within 1 Year by Diagnosis(Transplants: January 2006 – June 2011) All pair-wise comparisons were significant at p < 0.05 except cardiomyopathy vs. CAD, congenital vs. retransplant, congenital vs. valvular, retransplant vs. valvular 2013 JHLT. 2013 Oct; 32(10): 951-964

  35. Adult Heart TransplantsKaplan-Meier Survival by Diagnosis(Transplants: January 2003 – June 2011) All pair-wise comparisons with cardiomyopathy are significant at p < 0.02. No other pair-wise comparisons were significant at p < 0.05. 2013 JHLT. 2013 Oct; 32(10): 951-964

  36. Adult Heart TransplantsKaplan-Meier Survival by Diagnosis Conditional on Survival to 1 Year (Transplants: January 2003 – June 2011) No pair-wise comparisons are significant at p < 0.05 except cardiomyopathy vs. CAD, CAD vs. congenital and congenital vs. retransplant 2013 JHLT. 2013 Oct; 32(10): 951-964

  37. Adult Heart TransplantsKaplan-Meier Survival by Era (Transplants: January 1982 – June 2011)Diagnosis: Cardiomyopathy All comparisons were significant at p < 0.0001 except 2002-2005 vs. 2006-6/2011 (p=0.9689) 2013 JHLT. 2013 Oct; 32(10): 951-964

  38. Adult Heart TransplantsKaplan-Meier Survival by Era (Transplants: January 1982 – June 2011)Diagnosis: Coronary Artery Disease 2013 JHLT. 2013 Oct; 32(10): 951-964

  39. Adult Heart TransplantsKaplan-Meier Survival by Era (Transplants: January 1982 – June 2011)Diagnosis: Congenital No pair-wise comparisons were significant at p < 0.05 2013 JHLT. 2013 Oct; 32(10): 951-964

  40. Adult Heart TransplantsKaplan-Meier Survival by Era (Transplants: January 1982 – June 2011)Diagnosis: Retransplant 2013 JHLT. 2013 Oct; 32(10): 951-964

  41. Adult Heart TransplantsKaplan-Meier Survival by Era (Transplants: January 1982 – June 2011)Diagnosis: Valvular No pair-wise comparisons were significant at p < 0.05 except 1982-1991 vs. 1992-2001 (p = 0.0197) 2013 JHLT. 2013 Oct; 32(10): 951-964

  42. Adult Heart TransplantsKaplan-Meier Survival by PVR (Transplants: January 2003 – June 2011) 1-<3 vs. 3-<5: p = 0.0006 No other pair-wise comparisons were significant at p < 0.05 2013 JHLT. 2013 Oct; 32(10): 951-964

  43. Adult Heart TransplantsKaplan-Meier Survival by Donor/Recipient Weight Ratio (Transplants: January 2003 – June 2011)For recipients with PVR: 1–<3 wood units No pair-wise comparisons were significant at p < 0.05 2013 JHLT. 2013 Oct; 32(10): 951-964

  44. Adult Heart TransplantsKaplan-Meier Survival by Donor/Recipient Weight Ratio (Transplants: January 2003 – June 2011)For recipients with PVR: 3–<5 wood units No pair-wise comparisons were significant at p < 0.05 2013 JHLT. 2013 Oct; 32(10): 951-964

  45. Adult Heart TransplantsKaplan-Meier Survival by Donor/Recipient Weight Ratio (Transplants: January 2003 – June 2011)For recipients with PVR: 5+ wood units No pair-wise comparisons were significant at p < 0.05 2013 JHLT. 2013 Oct; 32(10): 951-964

  46. Adult Heart TransplantsKaplan-Meier Survival by BMI Group(Transplants: January 2006 – June 2011) No pair-wise comparisons were significant at p < 0.05 except 18.5<25 vs. 25-<30 (p < 0.0001) 2013 JHLT. 2013 Oct; 32(10): 951-964

  47. Adult Heart TransplantsKaplan-Meier Survival by Recipient Diabetes Mellitus (Transplants: January 2003 – June 2011) p < 0.0001 2013 JHLT. 2013 Oct; 32(10): 951-964

  48. Adult Heart TransplantsKaplan-Meier Survival by Recipient Cigarette History (Transplants: July 2004 – June 2011) p = 0.2024 2013 JHLT. 2013 Oct; 32(10): 951-964

  49. Adult Heart TransplantsKaplan-Meier Survival by Recipient COPD History (Transplants: January 2003 – June 2011) p = 0.7302 2013 JHLT. 2013 Oct; 32(10): 951-964

  50. Adult Heart TransplantsKaplan-Meier Survival by VAD usage (Transplants: April 1994 – June 2011) Pulsatile vs. Continuous: p=0.0127 Pulsatile vs. No LVAD/No Inotropes: p = 0.0032 No other pair-wise comparisons were significant at p < 0.05 2013 JHLT. 2013 Oct; 32(10): 951-964

More Related