Pediatric Heart-Lung Transplantation Insights 2017
Explore key data on pediatric heart-lung transplantation in 2017, covering donor, recipient, and center characteristics, age distribution, post-transplant outcomes, retransplants, and more. Discover valuable insights from the latest JHLT publication.
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HEART-LUNG TRANSPLANTATION Pediatric Recipients 2017 JHLT. 2017 Oct; 36(10): 1037-1079
Table of Contents Donor, recipient and center characteristics: slides 3-15 Post transplant survival and other outcomes: slides 16-24 Focus theme: slides 25-34 2017 JHLT. 2017 Oct; 36(10): 1037-1079
Donor, Recipient and Center Characteristics 2017 JHLT. 2017 Oct; 36(10): 1037-1079
Pediatric Heart-Lung Transplants Recipient Age Distribution (Transplants: January 1985 June 2016) 500 462 450 400 Number of Transplants 350 300 250 200 135 150 112 100 50 19 0 <1 1-5 Recipient Age (Years) 6-10 11-17 2017 JHLT. 2017 Oct; 36(10): 1037-1079
Pediatric Heart-Lung Transplants Donor Age Distribution (Transplants: January 1985 June 2016) 400 350 350 Number of Transplants 300 250 200 168 150 100 69 44 50 10 1 0 0-10 11-17 18-34 Donor Age (Years) 35-49 50-59 60+ 2017 JHLT. 2017 Oct; 36(10): 1037-1079
Pediatric Heart-Lung Transplants Age Distribution by Year 65 60 11-17 6-10 1-5 <1 55 50 Number of Transplants 45 40 35 30 25 20 15 10 5 0 NOTE: This figure includes only the heart-lung transplants that are reported to the ISHLT Transplant Registry. As such, this should not be construed as evidence that the number of pediatric heart-lung transplants worldwide has declined in recent years. 2017 JHLT. 2017 Oct; 36(10): 1037-1079
Pediatric Heart-Lung Retransplants by Year of Retransplant 6 18 N % 5 15 Number of Retransplants % of transplants 4 12 3 9 2 6 1 3 0 0 Year of Retransplant 2017 Only patients who were less than 18 years old at the time of retransplant are included. JHLT. 2017 Oct; 36(10): 1037-1079
Pediatric Heart-Lung Retransplants (Retransplants: January 1985 June 2016) 10 9 Number of Retransplants 8 7 6 5 4 3 2 1 0 0-<1 month 1-<12 months 12-<36 months 36+ months Time Between Previous and Current Transplant 2017 Analysis includes deceased and living donor transplants. JHLT. 2017 Oct; 36(10): 1037-1079
Pediatric Heart-Lung Transplants Age Distribution by Era of Transplant <1 1-5 6-10 11-17 100% 90% 80% % of Transplants 70% 60% 50% 40% 30% 20% 10% 0% 1985-1999 (N=527) 2000-2007 (N=127) 2008-6/2016 (N=74) 2017 JHLT. 2015 Oct; 34(10): 1255-1263 JHLT. 2017 Oct; 36(10): 1037-1079
Pediatric Heart-Lung Transplants Number of Centers Reporting Transplants by Location (Transplants: January 1984 December 2015) 30 N of Pediatric Transplant Centers Other 25 North America Europe 20 15 10 5 0 Transplant Year 2017 JHLT. 2017 Oct; 36(10): 1037-1079
Pediatric Heart-Lung Transplants Number of Centers Reporting Transplants by Center Volume 30 N of Pediatric Transplant Centers 1-4/yr 5-9/yr 25 10-19/yr 20-29/yr 20 15 10 5 0 Transplant Year 2017 JHLT. 2017 Oct; 36(10): 1037-1079
Pediatric Heart-Lung Transplants Diagnosis Distribution (Transplants: January 1986 December 2015) 34% CF IIP ILD-not IIP IPAH OB PH-not IPAH Retransplant Other Other includes A1ATD, Non CF-bronchiectasis, and LAM/tuberous sclerosis 3% 3% 1% 28% 27% 1% 2% 100 % of Cases CF IPAH PH-not IPAH 75 50 25 0 NOTE: Unknown diagnoses were excluded from this tabulation. 2017 JHLT. 2017 Oct; 36(10): 1037-1079
Pediatric Heart-Lung Transplants Age Distribution by Location (Transplants: January 2000 June 2016) <1 1-5 6-10 11-17 100% 80% % of Transplants 60% 40% 20% 0% Europe North America Other 2017 JHLT. 2017 Oct; 36(10): 1037-1079
Pediatric Heart-Lung Transplants Diagnosis Distribution by Location (Transplants: January 2000 June 2016) CF IPAH PH-not IPAH Other 100% 80% % of Transplants 60% 40% 20% 0% Europe (N=78) North America (N=62) Other (N=17) 2017 JHLT. 2017 Oct; 36(10): 1037-1079
Pediatric Heart-Lung Transplants Donor Age Distribution by Location (Transplants: January 2000 June 2016) 0-10 11-17 18-34 35-49 50-59 60+ 100% 80% % of Donors 60% 40% 20% 0% Europe North America Other 2017 JHLT. 2014 Oct; 33(10): 1025-1033 JHLT. 2015 Oct; 34(10): 1255-1263 JHLT. 2017 Oct; 36(10): 1037-1079
Post Transplant: Survival and Other Outcomes 2017 JHLT. 2017 Oct; 36(10): 1037-1079
Pediatric Heart-Lung Transplants Kaplan-Meier Survival by Diagnosis (Transplants: January 1990 June 2015) 100 CF (N=137) IPAH (N=130) PH-not IPAH (N=149) 75 Survival (%) Median survival (years): CF=3.8; IPAH=4.7; PH-not IPAH=2.6 50 25 No pair-wise comparisons were significant at p<0.05. 0 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Years 2017 JHLT. 2017 Oct; 36(10): 1037-1079
Pediatric Heart-Lung Transplants Kaplan-Meier Survival Conditional on Survival to 1 Year by (Transplants: January 1990 June 2015) Diagnosis 100 CF (N=96) PH-not IPAH (N=91) IPAH (N=99) 75 Median survival (years): CF=6.5; IPAH=7.4; PH-not IPAH=7.6 Survival (%) 50 25 No pair-wise comparisons were significant at p<0.05. 0 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Years 2017 JHLT. 2017 Oct; 36(10): 1037-1079
Pediatric Heart-Lung Transplants Kaplan-Meier Survival by Age Group (Transplants: January 1985 June 2015) 100 <1 (N = 19) 1-5 (N = 111) 75 6-10 (N = 135) No pair-wise comparisons were significant at p<0.05 except all comparisons with <1. 11-17 (N = 454) Survival (%) 50 25 Median survival (years): <1=NA; 1-5=1.6; 6-10=3.4; 11-17=3.3 0 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Years 2017 JHLT. 2017 Oct; 36(10): 1037-1079
Pediatric Heart-Lung Transplants Kaplan-Meier Survival Conditional on Survival to 1 Year by (Transplants: January 1985 June 2015) Age Group 100 No pair-wise comparisons were significant at p<0.05. 1-5 (N = 64) 6-10 (N = 94) 75 11-17 (N = 298) Survival (%) 50 25 Median survival (years): 1-5=7.7; 6-10=7.2; 11-17=8.2 0 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Years 2017 JHLT. 2017 Oct; 36(10): 1037-1079
Pediatric Heart-Lung Transplants Kaplan-Meier Survival by Era (Transplants: January 1985 June 2015) 100 1985-1989 (N=180) 1990-1999 (N=346) 2000-2005 (N=94) 2006-6/2015 (N=99) 75 No pair-wise comparisons were significant at p<0.05. Survival (%) 50 25 Median survival (years): 1985-1989=1.7; 1990-1999=3.0; 2000-2005=4.6; 2006-6/2015=4.3 0 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 Years 2017 JHLT. 2017 Oct; 36(10): 1037-1079
Pediatric Heart-Lung Transplants Kaplan-Meier Survival Conditional on Survival to 1 Year by Era (Transplants: January 1985 June 2015) 100 1985-1989 (N=98) 1990-1999 (N=228) 2000-2005 (N=62) 2006-6/2015 (N=72) 75 No pair-wise comparisons were significant at p<0.05. Survival (%) 50 25 Median survival (years): 1985-1989=10.1; 1990-1999=6.3; 2000-2005=11.2; 2006-6/2015=NA 0 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Years 2017 JHLT. 2017 Oct; 36(10): 1037-1079
Pediatric Heart-Lung Transplants Cause of Death (Deaths: January 2000 June 2016) 0-30 Days (N = 28) 31 Days - 1 Year (N = 19) >1 Year - 3 Years (N = 29) >3 Years - 5 Years (N = 14) >5 Years (N = 60) CAUSE OF DEATH OB/BOS 0 1 (5.3%) 10 (34.5%) 5 (35.7%) 12 (20.0%) ACUTE REJECTION 2 (7.1%) 0 0 1 (7.1%) 1 (1.7%) LYMPHOMA 0 1 (5.3%) 0 0 1 (1.7%) MALIGNANCY, OTHER 0 1 (5.3%) 1 (3.4%) 0 2 (3.3%) INFECTION, NON-CMV 3 (10.7%) 4 (21.1%) 2 (6.9%) 2 (14.3%) 10 (16.7%) GRAFT FAILURE 7 (25.0%) 2 (10.5%) 11 (37.9%) 3 (21.4%) 13 (21.7%) CARDIOVASCULAR 2 (7.1%) 1 (5.3%) 2 (6.9%) 1 (7.1%) 9 (15.0%) TECHNICAL 6 (21.4%) 0 0 1 (7.1%) 0 MULTIPLE ORGAN FAILURE 4 (14.3%) 2 (10.5%) 1 (3.4%) 0 7 (11.7%) OTHER 4 (14.3%) 7 (36.8%) 2 (6.9%) 1 (7.1%) 5 (8.3%) 2017 JHLT. 2017 Oct; 36(10): 1037-1079
Pediatric Heart-Lung Transplants Relative Incidence of Leading Causes of Death (Deaths: January 2000 June 2016) 60 OB/BOS Infection (Non-CMV) Graft Failure Cardiovascular 50 40 % of Deaths 30 20 10 0 0-30 Days (N = 28) 31 Days - 1 Year (N = 19) >1 Year - 3 Years (N = 29) >3 Years - 5 Years (N = 14) >5 Years (N = 60) 2017 JHLT. 2017 Oct; 36(10): 1037-1079
Focus Theme 2017 JHLT. 2017 Oct; 36(10): 1037-1079
Pediatric Heart-Lung Transplants Ischemic Time Distribution by Diagnosis (Transplants: January 2000 June 2016) 0-<2 hours 2-<4 hours 4-<6 hours 6+ hours 100% 80% % of Transplants 60% 40% 20% 0% IPAH PH-not IPAH Other 2017 JHLT. 2017 Oct; 36(10): 1037-1079
Pediatric Heart-Lung Transplants Ischemic Time Distribution by Recipient Age (Transplants: January 2000 June 2016) 0-<2 hours 2-<4 hours 4-<6 hours 6+ hours 100% 80% % of Transplants 60% 40% 20% 0% <6 6-10 11-17 Recipient Age (Years) 2017 JHLT. 2017 Oct; 36(10): 1037-1079
Pediatric Heart-Lung Transplants Ischemic Time Distribution by Recipient Ventilator Support (Transplants: January 2000 June 2016) at Transplant 0-<2 hours 2-<4 hours 4-<6 hours 6+ hours 100% 80% % of Transplants 60% 40% 20% 0% No ventilator support Ventilator support 2017 JHLT. 2017 Oct; 36(10): 1037-1079
Pediatric Heart-Lung Transplants Ischemic Time Distribution by Donor Age (Transplants: January 2000 June 2016) 0-<2 hours 2-<4 hours 4-<6 hours 6+ hours 100% 80% % of Transplants 60% 40% 20% 0% 0-5 6-11 Donor Age (Years) 12-17 18-34 2017 JHLT. 2017 Oct; 36(10): 1037-1079
Pediatric Heart-Lung Transplants Ischemic Time Distribution by Donor Cause of Death (Transplants: January 2000 June 2016) 0-<2 hours 2-<4 hours 4-<6 hours 6+ hours 100% 80% % of Transplants 60% 40% 20% 0% Anoxia Head Trauma Other 2017 JHLT. 2017 Oct; 36(10): 1037-1079
Pediatric Heart-Lung Transplants Ischemic Time Distribution by Era (Transplants: January 2000 June 2016) 0-<2 hours 2-<4 hours 4-<6 hours 6+ hours 100% 80% % of Transplants 60% 40% 20% 0% 2000-2008 2009-6/2016 2017 JHLT. 2017 Oct; 36(10): 1037-1079
Pediatric Heart-Lung Transplants Ischemic Time Distribution by Center Volume (Transplants: January 2000 June 2016) 0-<2 hours 2-<4 hours 4-<6 hours 6+ hours 100% 80% % of Transplants 60% 40% 20% 0% 1 2 Average number of heart-lung transplants per year 2017 JHLT. 2017 Oct; 36(10): 1037-1079
Pediatric Heart-Lung Transplants Kaplan-Meier Survival Within 30 Days by Ischemic Time (Transplants: January 1990 June 2015) 100 75 All pair-wise comparisons were significant at p < 0.05 except 4-<6 vs. 6+ hours. Survival (%) 50 2-<4 hours (N = 102) 25 4-<6 hours (N = 95) 6+ hours (N = 23) 0 0 5 10 15 20 25 30 Days 2017 JHLT. 2017 Oct; 36(10): 1037-1079
Pediatric Heart-Lung Transplants Kaplan-Meier Survival by Ischemic Time (Transplants: January 1990 June 2015) 100 No pair-wise comparisons were significant at p < 0.05. 75 Survival (%) 50 2-<4 hours (N = 102) 25 4-<6 hours (N = 95) 6+ hours (N = 23) 0 0 1 2 3 4 5 6 7 8 9 Years 2017 JHLT. 2017 Oct; 36(10): 1037-1079
