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LUNG TRANSPLANTATION

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  1. LUNG TRANSPLANTATION Overall ISHLT 2009

  2. 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 2009

  3. AVERAGE CENTER VOLUMELung Transplants: January 1, 2000 - June 30, 2008 ISHLT 2009

  4. DISTRIBUTION OF TRANSPLANTS BY CENTER VOLUMELung Transplants: January 1, 2000 - June 30, 2008 ISHLT 2009

  5. LUNG TRANSPLANTS:Transplant Recipient Age by Year of TransplantTransplants: January 1, 1987 – June 30, 2008 ISHLT 2009

  6. AGE DISTRIBUTION OF LUNG TRANSPLANT RECIPIENTS(1/1985-6/2008) ISHLT 2009

  7. AGE DISTRIBUTION OF LUNG TRANSPLANT RECIPIENTS BY ERA ISHLT Transplants with unknown recipient age were excluded from this tabulation. 2009

  8. LUNG TRANSPLANTS:Donor Age by Year of TransplantTransplants: January 1, 1987 – June 30, 2008 ISHLT 2009

  9. DONOR AGE DISTRIBUTION FOR LUNG TRANSPLANTS (1/1985-6/2008) ISHLT 2009

  10. DONOR AGE DISTRIBUTION FOR LUNG TRANSPLANTS BY ERA ISHLT Transplants with unknown donor age were excluded from this tabulation. 2009

  11. LUNG TRANSPLANTATION Adult Recipients ISHLT 2009

  12. AGE DISTRIBUTION OF ADULT LUNG TRANSPLANT RECIPIENTS(1/1985-6/2008) ISHLT 2009

  13. AGE DISTRIBUTION OF ADULT LUNG TRANSPLANT RECIPIENTS BY ERA ISHLT 2009

  14. AGE DISTRIBUTION OF ADULT LUNG TRANSPLANT RECIPIENTS BY ERA ISHLT 2009

  15. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival (Transplants: January 1994 - June 2007) ISHLT 2009

  16. ADULT LUNG TRANSPLANTATION: Indications(1/1995-6/2008) ISHLT 2009

  17. ADULT LUNG TRANSPLANTATION: Distribution of Procedure Type for Major Indications(1992-2007) ISHLT 2009

  18. ADULT LUNG TRANSPLANTATIONProcedure Type within Indication, by Year ISHLT 2009

  19. ADULT LUNG TRANSPLANTATION: Indications for Single Lung Transplants (Transplants: January 1995 - June 2008) *Other includes: Sarcoidosis: 2.1% Bronchiectasis: 0.4% Congenital Heart Disease: 0.2% LAM: 0.8% OB (non-ReTx): 0.5% Miscellaneous: 6.3% ISHLT 2009

  20. ADULT LUNG TRANSPLANTATION: Indications for Bilateral/Double Lung Transplants (Transplants: January 1995 - June 2008) *Other includes: Sarcoidosis: 2.9% Bronchiectasis: 4.5% Congenital Heart Disease: 1.1% LAM: 1.2% OB (non-ReTx): 1.1% Miscellaneous: 7.7% ISHLT 2009

  21. ADULT LUNG TRANSPLANTATIONIndications By Year (%) ISHLT 2009

  22. ADULT LUNG TRANSPLANTATIONIndications By Year (Number) ISHLT 2009

  23. ADULT LUNG TRANSPLANTS:AGE DISTRIBUTION BY LOCATIONTransplants between January 2000 and June 2008 ISHLT 2009

  24. ADULT LUNG TRANSPLANTS:DIAGNOSIS DISTRIBUTION BY LOCATION Transplants between January 2000 and June 2008 ISHLT 2009

  25. ADULT LUNG TRANSPLANTS:DONOR AGE DISTRIBUTION BY LOCATIONTransplants between January 2000 and June 2008 ISHLT 2009

  26. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival by Era (Transplants: January 1988 – June 2007) ISHLT 2009

  27. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival by Age Group(Transplants: January 1990 – June 2007) ISHLT 2009

  28. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival by Gender(Transplants: January 1990 – June 2007) ISHLT 2009

  29. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival By Diagnosis(Transplants: January 1990 – June 2007) Survival comparisons Alpha-1 vs. CF: p < 0.0001Alpha-1 vs. COPD: p < 0.0001 Alpha-1 vs. IPF: p < 0.0001Alpha-1 vs.Sarcoidosis: p = 0.0380 CF vs. COPD: p < 0.0001CF vs. IPF: p < 0.0001 CF vs. IPAH: p < 0.0001 CF vs. Sarcoidosis: p < 0.0001 IPAH vs. IPF: p = 0.0046 COPD vs. IPF: p < 0.0001 Note: Other comparisons are not statistically different. ISHLT 2009

  30. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival By Diagnosis Conditional on Survival to 3 Months(Transplants: January 1990 – June 2007) Survival comparisons Alpha-1 vs. CF: p = 0.0075 Alpha-1 vs. COPD: p < 0.0001 Alpha-1 vs. IPF: p < 0.0001 Alpha-1 vs. IPAH: p = 0.0214 CF vs. COPD: p < 0.0001CF vs. IPF: p < 0.0001 CF vs. Sarcoidosis: p = 0.0131 IPAH vs. COPD: p < 0.0001 IPAH vs. IPF: p < 0.0001 IPAH vs. Sarcoidosis: p = 0.0187 COPD vs. IPF: p = 0.0476 COPD vs. Sarcoidosis: p = 0.0419 IPF vs. Sarcoidosis: p = 0.0116 Note: Other comparisons are not statistically different. ISHLT 2009

  31. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival By Diagnosis Conditional on Survival to 1 Year(Transplants: January 1990 – June 2007) Survival comparisons Alpha-1 vs. CF: p = 0.0354 Alpha-1 vs. COPD: p < 0.0001 Alpha-1 vs. IPF: p < 0.0001 Alpha-1 vs. IPAH: p = 0.0321 CF vs. COPD: p < 0.0001 CF vs. IPF: p < 0.0001 IPAH vs. COPD: p < 0.0001 IPAH vs. IPF: p < 0.0001 COPD vs. Sarcoidosis: p < 0.0001 IPF vs. Sarcoidosis: p = 0.0007 Note: Other comparisons are not statistically different. ISHLT 2009

  32. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival By Diagnosis(Transplants: January 1990 – June 2007) Survival comparisons Alpha-1 vs. CF: p < 0.0001 Alpha-1 vs. COPD: p < 0.0001 Alpha-1 vs. IPF: p < 0.0001 Alpha-1 vs.Sarcoidosis: p = 0.0380 CF vs. COPD: p < 0.0001 CF vs. IPF: p < 0.0001 CF vs. IPAH: p < 0.0001 CF vs. Sarcoidosis: p < 0.0001 IPAH vs. IPF: p = 0.0046 COPD vs. IPF: p < 0.0001 ISHLT 2009

  33. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival By Diagnosis Conditional on Survival to 3 Months(Transplants: January 1990 – June 2007) Survival comparisons Alpha-1 vs. CF: p = 0.0075 Alpha-1 vs. COPD: p < 0.0001 Alpha-1 vs. IPF: p < 0.0001 Alpha-1 vs. IPAH: p = 0.0214 CF vs. COPD: p < 0.0001 CF vs. IPF: p < 0.0001 CF vs. Sarcoidosis: p = 0.0131 IPAH vs. COPD: p < 0.0001 IPAH vs. IPF: p < 0.0001 IPAH vs. Sarcoidosis: p = 0.0187 COPD vs. IPF: p = 0.0476 COPD vs. Sarcoidosis: p = 0.0419 IPF vs. Sarcoidosis: p = 0.0116 ISHLT 2009

  34. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival By Diagnosis Conditional on Survival to 1 Year(Transplants: January 1990 – June 2007) Survival comparisons Alpha-1 vs. CF: p = 0.0354 Alpha-1 vs. COPD: p < 0.0001 Alpha-1 vs. IPF: p < 0.0001 Alpha-1 vs. IPAH: p = 0.0321 CF vs. COPD: p < 0.0001 CF vs. IPF: p < 0.0001 IPAH vs. COPD: p < 0.0001 IPAH vs. IPF: p < 0.0001 COPD vs. Sarcoidosis: p < 0.0001 IPF vs. Sarcoidosis: p = 0.0007 ISHLT 2009

  35. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival for Eisenmenger’s Syndrome(Transplants: January 1990 – June 2007) ISHLT 2009

  36. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival By Procedure Type(Transplants: January 1990 – June 2007)Diagnosis: Alpha-1 Antitrypsin Deficiency ISHLT 2009

  37. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival By Procedure Type and Age (Transplants: January 1990 – June 2007)Diagnosis: Alpha-1 Antitrypsin Deficiency ISHLT 2009

  38. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival by Procedure Type (Transplants: January 1990 – June 2007) Diagnosis: Emphysema/COPD ISHLT 2009

  39. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival by Procedure Type and Age(Transplants: January 1990 – June 2007) Diagnosis: Emphysema/COPD ISHLT 2009

  40. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival by Procedure Type(Transplants: January 1990 – June 2007)Diagnosis: Idiopathic Pulmonary Fibrosis ISHLT 2009

  41. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival by Procedure Type (Transplants: January 1990 – June 2007)Diagnosis: Idiopathic Arterial Pulmonary Hypertension ISHLT 2009

  42. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival by Procedure Type and Era(Transplants: January 1990 – June 2007) Diagnosis: Emphysema/COPD, Single Lung ISHLT 2009

  43. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival by Procedure Type and Era(Transplants: January 1990 – June 2007) Diagnosis: Emphysema/COPD, Double Lung ISHLT 2009

  44. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival by Procedure Type and Era(Transplants: January 1990 – June 2007) Diagnosis: Idiopathic Pulmonary Fibrosis, Single Lung ISHLT 2009

  45. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival by Procedure Type and Era(Transplants: January 1990 – June 2007) Diagnosis: Idiopathic Pulmonary Fibrosis, Double Lung ISHLT 2009

  46. ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival by Donor CMV status/Recipient CMV status(Transplants: October 1999 – June 2007) ISHLT 2009

  47. PERCENTAGE OF ADULT LUNG TRANSPLANT RECIPIENTS EXPERIENCING REJECTION BETWEEN TRANSPLANT DISCHARGE AND 1-YEAR FOLLOW-UP Stratified by Donor/Recipient CMV status (Follow-ups: July 2004 - June 2008) D(-)/R(-): N = 683 D(-)/R(+): N = 848 D(+)/R(-): N = 901 D(+)/R(+): N = 1,532 No comparisons were statistically significant at 0.05 Treated rejection = Recipient was reported to (1) have at least one acute rejection episode that was treated with an anti-rejection agent; or (2) have been hospitalized for rejection. No rejection = Recipient had (i) no acute rejection episodes and (ii) was reported either as not hospitalized for rejection or did not receive anti-rejection agents. ISHLT 2009 Analysis is limited to patients who were alive at the time of the follow-up

  48. PERCENTAGE OF ADULT LUNG TRANSPLANT RECIPIENTS EXPERIENCING REJECTION BETWEEN TRANSPLANT DISCHARGE AND 1-YEAR FOLLOW-UP Stratified by Donor/Recipient CMV status(Follow-ups: July 2004 - June 2008) 66+ Female Male 18-34 35-49 50-59 60-65 50-59: D(+)/R(-) vs. D(+)/R(+) (p=0.009) 60-65: D(-)/R(+) vs. D(+)/R(+) (p=0.034) Treated rejection = Recipient was reported to (1) have at least one acute rejection episode that was treated with an anti-rejection agent; or (2) have been hospitalized for rejection. No rejection = Recipient had (i) no acute rejection episodes and (ii) was reported either as not hospitalized for rejection or did not receive anti-rejection agents. ISHLT 2009 Analysis is limited to patients who were alive at the time of the follow-up

  49. ADULT LUNG TRANSPLANTS (1995-6/2007)Risk Factors for 1 Year Mortality Reference group = COPD/Emphysema, Single lung (N=12,415) ISHLT *Other = All diagnoses other than COPD, IPAH, IPF, cystic fibrosis, pulmonary fibrosis,bronchiectasis,alpha-1 antitrypsin deficiency, retransplant and LAM. 2009

  50. ADULT LUNG TRANSPLANTS (1995-6/2007)Risk Factors for 1 Year Mortality (N=12,415) ISHLT 2009