Pediatric Heart-Lung Transplantation Recipients 2014 Insights
Discover key insights on pediatric heart-lung transplantation recipients in 2014, including donor, recipient, and center characteristics, age distributions, post-transplant outcomes, and retransplant statistics. Explore trends and data analysis to gain a deeper understanding of this complex procedure.
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HEART-LUNG TRANSPLANTATION Pediatric Recipients 2014 JHLT. 2014 Oct; 33(10): 1025-1033
Table of Contents Donor, recipient and center characteristics: slides 3-15 Post transplant survival and other outcomes: slides 16-23 2014 JHLT. 2014 Oct; 33(10): 1025-1033
Donor, Recipient and Center Characteristics 2014 JHLT. 2014 Oct; 33(10): 1025-1033
Pediatric Heart-Lung Transplants Recipient Age Distribution (Transplants: January 1982 June 2013) 500 434 450 400 Number of Transplants 350 300 250 200 150 128 110 100 50 21 0 <1 1-5 Recipient Age (Years) 6-10 11-17 2014 JHLT. 2014 Oct; 33(10): 1025-1033
Pediatric Heart-Lung Transplants Donor Age Distribution (Transplants: January 1982 June 2013) 400 343 350 Number of Transplants 300 250 200 158 150 100 58 40 50 7 1 0 0-10 11-17 18-34 Donor Age (Years) 35-49 50-59 60+ 2014 JHLT. 2014 Oct; 33(10): 1025-1033
Pediatric Heart-Lung Transplants Age Distribution by Year 65 60 11-17 years 6-10 years 1-5 years <1 year 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. 2014 JHLT. 2014 Oct; 33(10): 1025-1033
Pediatric Heart-Lung Retransplants by Year of Retransplant 8 16 N % 7 14 Number of retransplants 6 12 % of retransplants 5 10 4 8 3 6 2 4 1 2 0 0 Year of retransplant Only patients who were less than 18 years old at the time of retransplant are included. 2014 JHLT. 2014 Oct; 33(10): 1025-1033
Pediatric Heart-Lung Retransplants (Retransplants: January 1984 June 2013) 14 12 Number of Retransplants 10 8 6 4 2 0 0-<1 month 1-<12 months 12-<36 months 36+ months Not reported Time Between Previous and Current Transplant 2014 Analysis includes deceased and living donor transplants. JHLT. 2014 Oct; 33(10): 1025-1033
Pediatric Heart-Lung Transplants Age Distribution by Era of Transplant 100% 11-17 years 90% 6-10 years 80% 1-5 years <1 Year 70% % of Transplants 60% 50% 40% 30% 20% 10% 0% 1982-1999 2000-6/2013 2014 JHLT. 2014 Oct; 33(10): 1025-1033
Pediatric Heart-Lung Transplants Number of Centers Reporting Transplants by Location (Transplants: January 1984 December 2012) 30 N of Pediatric Transplant Centers Others 25 North America Europe 20 15 10 5 0 Transplant Year 2014 JHLT. 2014 Oct; 33(10): 1025-1033
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 2014 JHLT. 2014 Oct; 33(10): 1025-1033
Pediatric Heart-Lung Transplants Diagnosis Distribution (Transplants: January 1986 December 2012) 24% Acquired Heart Disease CF Congenital (other) Eisenmenger's Syndrome IPF IPAH Retx: Non-OB Retx: OB Other 2% 2%2% 4% Other includes Bronchiectasis, Alpha-1, and OB (non-Retx). 12% 4% 22% 28% 100 Cystic Fibrosis Congenital IPAH % of Cases 75 50 25 0 NOTE: Unknown diagnoses were excluded from this tabulation. 2014 is reported, so the total percentage of retransplants may be greater. JHLT. 2014 Oct; 33(10): 1025-1033 For some retransplants diagnosis other than retransplant
Pediatric Heart-Lung Transplants Age Distribution by Location (Transplants: January 2000 June 2013) <1 year 1-5 years 6-10 years 11-17 years 100% 80% % of Transplants 60% 40% 20% 0% Europe North America Other 2014 JHLT. 2014 Oct; 33(10): 1025-1033
Pediatric Heart-Lung Transplants Diagnosis Distribution by Location (Transplants: January 2000 June 2013) Congenital heart disease Cystic Fibrosis IPAH Other 100% 80% % of Transplants 60% 40% 20% 0% Europe North America Other 2014 JHLT. 2014 Oct; 33(10): 1025-1033
Pediatric Heart-Lung Transplants Donor Age Distribution by Location (Transplants: January 2000 June 2013) 0-10 years 11-17 years 18-34 years 35-49 years 50-59 years 60+ years 100% 80% % of Donors 60% 40% 20% 0% Europe North America Other 2014 JHLT. 2014 Oct; 33(10): 1025-1033
Post Transplant: Survival and Other Outcomes 2014 JHLT. 2014 Oct; 33(10): 1025-1033
Pediatric Heart-Lung Transplants Kaplan-Meier Survival by Diagnosis (Transplants: January 1990 June 2012) 100 Congenital (N = 98) Eisenmenger's Syndrome (N = 51) IPAH (N = 113) 75 Median survival (years): Congenital=2.4; Eisenmenger's=2.6; IPAH=4.7 Survival (%) 50 25 No pair-wise comparisons were statistically significant at p<0.05. 0 0 1 2 3 4 5 6 7 8 9 10 11 12 13 Years 2014 JHLT. 2014 Oct; 33(10): 1025-1033
Pediatric Heart-Lung Transplants Kaplan-Meier Survival (Transplants: January 1982 June 2012) 100 < 1 (N = 21) 1-5 (N = 105) 6-10 (N = 127) 11-17 (N = 423) 75 Survival (%) Median survival (years): <1=0.2; 1-5=1.4; 6-10=3.6; 11-17=3.5 50 25 <1 vs. 6-10: p=0.0014 <1 vs. 11-17: p=0.0033 All other pair-wise comparisons were not significant at p<0.05. 0 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Years 2014 JHLT. 2014 Oct; 33(10): 1025-1033
Pediatric Heart-Lung Transplants Kaplan-Meier Survival by Era (Transplants: January 1982 June 2012) 100 Median survival (years): 1982-1989=1.9; 1990-1996=3.1; 1997-2003=3.0; 2004-6/2012= 5.3 75 1982-1989 (N = 182) 1990-1996 (N = 270) 1997-2003 (N = 136) 2004-6/2012 (N = 88) Survival (%) 50 25 No pair-wise comparisons were statistically significant at p<0.05. 0 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Years 2014 JHLT. 2014 Oct; 33(10): 1025-1033
Pediatric Heart-Lung Transplants Kaplan-Meier Survival by Era Conditional on Survival to 1 Year (Transplants: January 1982 June 2012) 100 1982-1989 (N = 100) 1997-2003 (N = 82) 1990-1996 (N = 179) 2004-6/2012 (N = 66) 75 No pair-wise comparisons were statistically significant at p<0.05. Survival (%) 50 25 Conditional median survival (years): 1982-1989=10.4; 1990-1996=6.1; 1997-2003=13.8; 2004-6/2012=8.5 0 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Years 2014 JHLT. 2014 Oct; 33(10): 1025-1033
Pediatric Heart-Lung Transplants Cause of Death (Deaths: January 1992 June 2013) 0-30 Days (N = 51) 31 Days - 1 Year (N = 62) >1 Year - 3 Years (N = 59) >3 Years - 5 Years (N = 39) >5 Years (N = 69) CAUSE OF DEATH BRONCHIOLITIS 0 3 (4.8%) 28 (47.5%) 16 (41.0%) 18 (26.1%) ACUTE REJECTION 0 2 (3.2%) 1 (1.7%) 1 (2.6%) 2 (2.9%) LYMPHOMA 0 2 (3.2%) 1 (1.7%) 1 (2.6%) 0 MALIGNANCY, OTHER 0 1 (1.6%) 1 (1.7%) 1 (2.6%) 2 (2.9%) CMV 0 2 (3.2%) 0 0 0 INFECTION, NON-CMV 8 (15.7%) 19 (30.6%) 4 (6.8%) 2 (5.1%) 17 (24.6%) GRAFT FAILURE 17 (33.3%) 12 (19.4%) 15 (25.4%) 12 (30.8%) 13 (18.8%) CARDIOVASCULAR 3 (5.9%) 3 (4.8%) 3 (5.1%) 2 (5.1%) 6 (8.7%) TECHNICAL 11 (21.6%) 0 3 (5.1%) 2 (5.1%) 0 OTHER 12 (23.5%) 18 (29.0%) 3 (5.1%) 2 (5.1%) 11 (15.9%) 2014 JHLT. 2014 Oct; 33(10): 1025-1033
Pediatric Heart-Lung Transplants Cause of Death (Deaths: April 1994 June 2013) 0-30 Days (N = 43) 31 Days - 1 Year (N = 46) >1 Year - 3 Years (N = 48) >3 Years - 5 Years (N = 34) >5 Years (N = 69) CAUSE OF DEATH 0 1 (2.2%) 22 (45.8%) 14 (41.2%) 18 (26.1%) BRONCHIOLITIS 0 1 (2.2%) 1 (2.1%) 1 (2.9%) 2 (2.9%) ACUTE REJECTION 0 2 (4.3%) 1 (2.1%) 1 (2.9%) 0 LYMPHOMA 0 1 (2.2%) 1 (2.1%) 1 (2.9%) 2 (2.9%) MALIGNANCY, OTHER 0 1 (2.2%) 0 0 0 CMV 5 (11.6%) 15 (32.6%) 4 (8.3%) 2 (5.9%) 17 (24.6%) INFECTION, NON-CMV 15 (34.9%) 9 (19.6%) 12 (25.0%) 11 (32.4%) 13 (18.8%) GRAFT FAILURE 3 (7.0%) 2 (4.3%) 3 (6.3%) 1 (2.9%) 6 (8.7%) CARDIOVASCULAR 9 (20.9%) 0 1 (2.1%) 1 (2.9%) 0 TECHNICAL 11 (25.6%) 14 (30.4%) 3 (6.3%) 2 (5.9%) 11 (15.9%) OTHER 2014 JHLT. 2014 Oct; 33(10): 1025-1033
Pediatric Heart-Lung Transplants Relative Incidence of Leading Causes of Death (Deaths: April 1994 June 2013) 60 Bronchiolitis Infection (Non-CMV) Graft Failure Cardiovascular 50 40 % of Deaths 30 20 10 0 0-30 Days (N = 43) 31 Days - 1 Year (N =46) >1 Year - 3 Years (N = 48) >3 Years - 5 Years (N = 34) >5 Years (N = 69) 2014 JHLT. 2014 Oct; 33(10): 1025-1033
