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LUNG TRANSPLANTATION PowerPoint Presentation
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LUNG TRANSPLANTATION

LUNG TRANSPLANTATION

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LUNG TRANSPLANTATION

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  1. LUNG TRANSPLANTATION Overall

  2. 1554 1416 1508 1413 1408 1341 1337 1204 1069 902 686 408 185 80 15 47 13 NUMBER OF LUNG TRANSPLANTS REPORTED BY YEAR AND PROCEDURE TYPE * Numbers may be low due to delayed reporting.

  3. NUMBER OF LUNG TRANSPLANTS REPORTED BY YEAR AND LOCATION * Numbers may be low due to delayed reporting.

  4. LUNG TRANSPLANTS:Donor Age by Year of Transplant

  5. AGE DISTRIBUTION OF LUNG TRANSPLANT RECIPIENTS (1985-2001)

  6. 1985-1996 1997-2001 AGE DISTRIBUTION OF LUNG TRANSPLANT RECIPIENTS BY ERA

  7. LUNG TRANSPLANTATIONActuarial Survival (1990-2000) Double lung: 1/2-life = 4.9 Years; Conditional 1/2-life = 7.9 Years Single lung: 1/2-life = 3.7 Years; Conditional 1/2-life = 5.9 Years All lungs: 1/2-life = 4.1 Years; Conditional 1/2-life = 6.5 Years

  8. LUNG TRANSPLANTATION Adult Recipients

  9. ADULT LUNG TRANSPLANTATION: Indications(1995-2001)

  10. ADULT LUNG TRANSPLANTATION: Indications(1995-2001) Single Lung Transplants Bilateral/Double Lung Transplants

  11. ADULT LUNG TRANSPLANTATIONIndications By Year

  12. ADULT LUNG TRANSPLANTATIONActuarial Survival by Era (1988-2001) Survival comparisons by era 1988-1992 vs. 1993-1997: p = 0.007 1988-1992 vs. 1998-2001: p < 0.0001 1993-1997 vs. 1998-2001: p = 0.003

  13. ADULT LUNG TRANSPLANTATIONActuarial Survival by Age Group(1990-2001) Survival comparisons by age group 18-34 vs. 50-64: p < 0.0001 18-34 vs. 65+: p = 0.0009 35-49 vs. 50-64: p < 0.0001 35-49 vs. 65+: p = 0.0004

  14. ADULT LUNG TRANSPLANTATIONActuarial Survival By Diagnosis(1990-2001)

  15. ADULT LUNG TRANSPLANTATIONActuarial Survival By Procedure Type Diagnosis: Alpha-1 Antitrypsin Deficiency(1990-2001) P = 0.03

  16. ADULT LUNG TRANSPLANTATIONActuarial Survival by Procedure Type Diagnosis: Emphysema/COPD(1990-2001) P < 0.0001

  17. ADULT LUNG TRANSPLANTATIONActuarial Survival by Procedure Type Diagnosis: IPF(1990-2001) P = 0.2

  18. ADULT LUNG TRANSPLANTATIONActuarial Survival by Procedure Type Diagnosis: PPH(1990-2001) P = 0.4

  19. ADULT LUNG TRANSPLANTS (1996-2001)Risk Factors for 1 Year MortalityIn Descending Order of Magnitude N=5,242

  20. ADULT LUNG TRANSPLANTS (1996-2001)Risk Factors for 1 Year MortalityIn Descending Order of Magnitude N=5,242

  21. ADULT LUNG TRANSPLANTS (1996-2001)Risk Factors for 1 Year MortalityContinuous Factors N=5,242

  22. ADULT LUNG TRANSPLANTS (1996-2001)Risk Factors for 1 Year MortalityContinuous Factors N=5,242

  23. ADULT LUNG TRANSPLANTS (1996-2001)Risk Factors for 1 Year MortalityContinuous Factors N=5,242

  24. ADULT LUNG TRANSPLANTS (1996-2001)Factors Not Significant for 1 Year Mortality • Steroid dependency • Ischemia time • % Predicted FeV1 • % Predicted FVC • Transfusions • Diabetes • Weight (donor) • Height (donor) • Donor clinical infection • Donor history of hypertension • Donor given steroids

  25. ADULT LUNG TRANSPLANTS(April 1994-December 1996)Risk Factors for 5 Year MortalityIn Descending Order of Magnitude N=3,098

  26. ADULT LUNG TRANSPLANTS(April 1994-December 1996)Risk Factors for 5 Year MortalityIn Descending Order of Magnitude N=3,098

  27. ADULT LUNG TRANSPLANTS(April 1994-December 1996)Risk Factors for 5 Year MortalityContinuous Factors N=3,098

  28. ADULT LUNG TRANSPLANTS(April 1994-December 1996)Risk Factors for 5 Year MortalityContinuous Factors N=3,098

  29. ADULT LUNG TRANSPLANTS(April 1994-December 1996)Risk Factors for 5 Year MortalityContinuous Factors N=3,098

  30. ADULT LUNG TRANSPLANTS(April 1994-December 1996)Factors Not Significant for 5 Year Mortality • Steroid dependency • Ventilator • Ischemia time • % Predicted FeV1 • % Predicted FVC • Transfusions • Diabetes • Weight (donor) • Height (donor) • Donor clinical infection • Donor history of hypertension • Donor given steroids

  31. ADULT LUNG TRANSPLANTS (April 1994-December 1996)Risk Factors for 5 Year Mortality Conditional on Survival to 1 YearIn Descending Order of Magnitude N=2,285

  32. ADULT LUNG TRANSPLANTS (April 1994-December 1996)Risk Factors for 5 Year Mortality Conditional on Survival to 1 YearContinuous Factors N=2,285

  33. ADULT LUNG RECIPIENTSFunctional Status(April 1994 – December 2001)

  34. ADULT LUNG RECIPIENTSEmployment Status(U.S.: April 1994 – December 2001)

  35. ADULT LUNG RECIPIENTS: Rehospitalization Post-transplant(April 1994 - December 2001)

  36. ADULT LUNG RECIPIENTS Induction ImmunosuppressionFor follow-ups between October 1999 and December 2001

  37. ADULT LUNG RECIPIENTSMaintenance Immunosuppression At Any Time During Follow-up PeriodFor follow-ups between October 1999 and December 2001

  38. ADULT LUNG RECIPIENTSMaintenance ImmunosuppressionAt Time of Follow-upFor follow-ups between October 1999 and December 2001

  39. ADULT LUNG RECIPIENTSMaintenance Immunosuppression at Time of Follow-upFor follow-ups between October 1999 and December 2001 1 Year Follow-up (N = 1,177) 5 Year Follow-up (N = 547)

  40. ADULT LUNG RECIPIENTSMaintenance Immunosuppression at Time of Follow-upFor follow-ups between October 1999 and December 2001

  41. POST-LUNG TRANSPLANT MORBIDITYFor Adult Recipients(April 1994-December 2001)

  42. Freedom from Bronchiolitis Obliterans For Adult Lung Recipients(April 1994-December 2000)

  43. Freedom from Renal Dysfunction*For Adult Lung Recipients(April 1994-December 2000) * Renal dysfunction = Creatinine > 2.5 mg/dl, dialysis or renal transplant

  44. MALIGNANCY POST-LUNG TRANSPLANTATION FOR ADULTSCumulative Incidence for Survivors(April 1994-December 2001)

  45. Freedom from MalignancyFor Adult Lung Recipients(April 1994-December 2000)

  46. ADULT LUNG TRANSPLANT RECIPIENTS: Cause Of Death(1982-2001)

  47. ADULT LUNG TRANSPLANT RECIPIENTS: Cause Of Death(1982-2001) Timing of Death

  48. ADULT LUNG TRANSPLANTS RECIPIENTS: Cause of Death by Era: Deaths in 0-30 Days Year of Transplant

  49. ADULT LUNG TRANSPLANTS RECIPIENTS: Cause of Death by Era: Deaths in 31 Days – 1 Year Year of Transplant

  50. ADULT LUNG TRANSPLANTS RECIPIENTS:Cause of Death by Era: Deaths in >1 Year – 3 Years Year of Transplant