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HEART TRANSPLANTATION

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  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