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LUNG TRANSPLANTATION
Pediatric Recipients
ISHLT 2008J Heart Lung Transplant 2008;27: 937-983
RECIPIENT AGE DISTRIBUTION FOR PEDIATRIC LUNG RECIPIENTS - NUMBER
(Transplants: January 1986 - June 2006)
050
100150200250300350400450500550600650700750
1986-1995 (N=303) 1996-6/2006 (N=752)
Nu
mb
er
of
Tra
ns
pla
nts
<1 1-5 6-11 12-17
ISHLT 2008Last updated based on data as of December 2006 J Heart Lung Transplant 2008;27: 937-983
RECIPIENT AGE DISTRIBUTION FOR PEDIATRIC LUNG RECIPIENTS - PERCENTAGE
(Transplants: January 1986 - June 2006)
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
1986-1995 (N=303) 1996-6/2006 (N=752)
% o
f T
ran
sp
lan
ts
12-17
6-11
1-5
<1
ISHLT 2008Last updated based on data as of December 2006 J Heart Lung Transplant 2008;27: 937-983
DONOR TYPE DISTRIBUTION BY YEAR OF TRANSPLANT FOR PEDIATRIC LUNG RECIPIENTS
(Transplants: 1986-2006)
0
10
20
30
40
50
60
70
80
90
1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Transplant Year
Nu
mb
er
of
Tra
ns
pla
nts
Living
Deceased
ISHLT 2008NOTE: This figure includes only the lung transplants that are reported to the ISHLT Transplant Registry. As such, this should not be construed as evidence that the number of lung transplants worldwide has declined in recent years.J Heart Lung Transplant 2008;27: 937-983
DONOR TYPE DISTRIBUTION BY RECIPIENT AGE GROUP WITHIN ERA FOR PEDIATRIC LUNG RECIPIENTS (Transplants: January 1986 - June 2006)
0
50
100
150
200
250
300
350
400
450
500
0-5 years 6-11 years 12-17 years 0-5 years 6-11 years 12-17 years
Recipient Age (Years)
Nu
mb
er
of T
ran
sp
lan
ts
LivingDeceased
1986-1995 1996-6/2006
ISHLT 2008Last updated based on data as of December 2006 J Heart Lung Transplant 2008;27: 937-983
AGE DISTRIBUTION FOR DONORS OF PEDIATRIC
LUNG RECIPIENTS (Transplants: January 1986 - June 2006)
485
178
168
146
39
2
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Donor Age (Years)
Nu
mb
er o
f T
ran
spla
nts
60+
50-59
35-49
18-34
12-17
0-11
ISHLT 2008Last updated based on data as of December 2006 J Heart Lung Transplant 2008;27: 937-983
AGE DISTRIBUTION OF PEDIATRIC LUNG RECIPIENTS
By Year of Transplant
0
20
40
60
80
100
12-17 Years1-11 Years
<1 Year
Nu
mb
er o
f T
ran
spla
nts
1 3 4 6
20
4751
4944
8475
85 86
68 6758
6772
ISHLT 2008
73
7583
J Heart Lung Transplant 2008;27: 937-983
NUMBER OF CENTERS REPORTING PEDIATRIC LUNG TRANSPLANTS
0
10
20
30
40
1986 1987 1988 1989 1990 1991 19921993 1994 1995 1996 1997 1998 19992000 2001 2002 2003 2004 2005 2006
Transplant Year
Nu
mb
er o
f C
ente
rs R
epo
rtin
g
Ped
iatr
ic T
ran
spla
nts
ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
NUMBER OF CENTERS REPORTING PEDIATRIC LUNG TRANSPLANTS BY CENTER VOLUME
0
10
20
30
40
1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Transplant Year
Nu
mb
er o
f C
ente
rs R
epo
rtin
g
Ped
iatr
ic T
ran
spla
nts
20+ transplants
10-19 transplants
5-9 transplants
1-4 transplants
ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
PEDIATRIC LUNG TRANSPLANTATION: Indications (Transplants: January 1990 – June 2006)
DIAGNOSIS AGE: < 1 Year
AGE: 1-5 Years
AGE: 6-11 Years
AGE: 12-17 Years
Cystic Fibrosis 3 3.7% 107 54.9% 441 69.%
Primary Pulmonary Hypertension 10 16.1% 18 22.2% 23 11.8% 53 8.3%
Re-Transplant: Obliterative Bronchiolitis 6 7.4% 8 4.1% 22 3.4%
Congenital Heart Disease 19 30.6% 8 9.9% 2 1.0% 5 0.8%
Idiopathic Pulmonary Fibrosis 7 8.6% 6 3.1% 23 3.6%
Obliterative Bronchiolitis (Not Re-TX) 5 6.2% 9 4.6% 21 3.3%
Re-Transplant: Not OB 3 4.8% 1 1.2% 7 3.6% 16 2.5%
Interstitial Pneumonitis 6 9.7% 11 13.6% 1 0.5% 5 0.8%
Pulmonary Vascular Disease 7 11.3% 4 4.9% 6 3.1% 1 0.2%
Eisenmenger’s Syndrome 1 1.6% 5 6.2% 5 2.6% 6 0.9%
Pulmonary Fibrosis, Other 1 1.6% 1 1.2% 4 2.1% 11 1.7%
Surfactant Protein B Deficiency 9 14.5% 2 2.5%
COPD/Emphysema 1 1.2% 2 1.0% 5 0.8%
Bronchopulmonary Dysplasia 1 1.6% 2 2.5% 6 3.1%
Bronchiectasis 3 1.5% 4 0.6%
Other 5 8.1% 7 8.6% 6 3.1% 26 4.1%
ISHLT 2008 Last updated based on data as of December 2006 J Heart Lung Transplant 2008;27: 937-983
PEDIATRIC LUNG TRANSPLANTATION:Other Indications (Transplants: January 1990 – June 2006)
DIAGNOSIS AGE: < 1 Year
AGE: 1-5 Years
AGE: 6-11 Years
AGE: 12-17 Years
Alpha - 1 - Antitrypsin Deficiency 1 0.2%
ARDS/Pneumonia 1 1.2% 1 0.5%
BOOP 1 0.2%
Dilated Myopathy: Adriamycin 1 0.2%
Graft-Vs-Host Disease (GVHD) 1 1.2% 2 0.3%
Idiopathic Pulmonary Hemosiderosis 2 0.3%
Inhalation Burns/Trauma 1 0.2%
Portopulmonary Hypertension 1 1.2%
Pulmonary Veno-Occlusive Disease 1 0.2%
Restrictive Lung Disease 1 1.2%
Rheumatoid Disease 1 1.2%
Scleroderma 1 0.2%
Secondary Pulmonary Hypertension 2 3.2%
Other Lung Disease 4 0.6%
ISHLT 2008 Last updated based on data as of December 2006 J Heart Lung Transplant 2008;27: 937-983
PEDIATRIC LUNG TRANSPLANTATION: Other Indications (Transplants: January 1990 – June 2006)
DIAGNOSIS(continued)
AGE: < 1 Year
AGE: 1-5 Years
AGE: 6-11 Years
AGE: 12-17 Years
Other – Specify: 3 4.8% 2 2.5% 2 1.0% 3 0.5%
Chronic Interstitial Pneumonia 1
Chronic Lung Disease Unknown Etiology
1
Diaphragmatic Hernia 1
End Stage Interstitial Lung Disease 1
Pulmonary 1
Pulmonary Interstitial Emphysema 1
Respiratory Failure 1
TALC/Pneumoconiosis/Berylliososis 1
Unknown 1 1
ISHLT 2008 Last updated based on data as of December 2006 J Heart Lung Transplant 2008;27: 937-983
PEDIATRIC LUNG TRANSPLANTATION: Other Indications (Transplants: January 1990 – June 2006)
DIAGNOSIS(continued)
AGE: < 1 Year
AGE: 1-5 Years
AGE: 6-11 Years
AGE: 12-17 Years
Lung Disease: Other Specify 2 1.0% 3 0.5%
Miscellaneous Lung: Not Specified 2
Pulmonary Lymphangectasia 1
Not Reported 1 1
Other 1 0.5% 6 0.9%
Congenital Anomaly 1
Langerhans -Histiocytosis 1
Not Reported 1 4
ISHLT 2008 Last updated based on data as of December 2006 J Heart Lung Transplant 2008;27: 937-983
DIAGNOSIS IN PEDIATRIC LUNG RECIPIENTSBY YEAR OF TRANSPLANT
Age: 12-17 Years
0
25
50
75
100
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
% o
f T
ran
spla
nts
PPH Cystic Fibrosis
ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
0%
20%
40%
60%
80%
100%
Europe (N=82) North America (N=338) Other (N=24)
% o
f T
ran
sp
lan
ts
0-5 years 6-11 years 12-17 years
PEDIATRIC LUNG TRANSPLANTS:AGE DISTRIBUTION BY LOCATION Transplants between January 2000 and June 2006
ISHLT 2008 Last updated based on data as of December 2006 J Heart Lung Transplant 2008;27: 937-983
0%
20%
40%
60%
80%
100%
Europe (N=79) North America (N=328) Other (N=23)
% o
f T
ran
sp
lan
ts-
Cystic Fibrosis PPH IPF OB Other Congenital heart disease Re-TX
PEDIATRIC LUNG TRANSPLANTS:DIAGNOSIS DISTRIBUTION BY LOCATION
Transplants between January 2000 and June 2006
ISHLT 2008
NOTE: Unknown diagnoses were excluded from this tabulation.
Total number of transplants reported:Europe = 82North America = 338Other = 24
Last updated based on data as of December 2006 J Heart Lung Transplant 2008;27: 937-983
0%
20%
40%
60%
80%
100%
Europe (N=82) North America (N=327) Other (N=23)
% o
f Do
no
rs
0-5 6-11 12-17 18-34 35-49 50-59 60+
PEDIATRIC LUNG TRANSPLANTS:DONOR AGE DISTRIBUTION BY LOCATION
Transplants between January 2000 and June 2006
ISHLT 2008
NOTE: Transplants with unknown donor age were excluded from this tabulation.
Total number of transplants reported:Europe = 82North America = 338Other = 24
Last updated based on data as of December 2006 J Heart Lung Transplant 2008;27: 937-983
LUNG TRANSPLANTATIONKaplan-Meier Survival by Age Group
(Transplants: January 1990 - June 2006)
0
25
50
75
100
0 1 2 3 4 5 6 7 8 9 10 11 12 13Years
Su
rviv
al (
%)
Adult (N=22,399)
Pediatric (N=1,069)
HALF-LIFE Adult = 5.0 Years; Pediatric = 4.3 Years
P = 0.6539
ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
PEDIATRIC LUNG TRANSPLANTATIONKaplan-Meier Survival by Procedure Type
(Transplants: January 1990 - June 2005)
0
25
50
75
100
0 1 2 3 4 5 6 7 8 9 10 11Years
Su
rviv
al (
%)
Single Lung (N=80)
Bilateral/Double Lung (N=792)
HALF-LIFE Single Lung: 2.2 Years; Bilateral/double Lung: 4.6 Years
P < .0001
ISHLT 2008 Last updated based on data as of December 2006 J Heart Lung Transplant 2008;27: 937-983
PEDIATRIC LUNG TRANSPLANTATIONKaplan-Meier Survival for Congenital Diagnoses (Transplants: January 1990 – June 2005)
0
25
50
75
100
0 1 2 3 4 5Years
Su
rviv
al (
%)
Eisenmenger's Syndrome (N=15)
Other Congenital Heart Disease (N=34)
Eisenmenger's + Other Congenital Heart Disease (N=49)
N at risk = 8
N at risk = 9
N at risk = 11
ISHLT 2008
Eisenmenger’s vs. Other: p = 0.19
Last updated based on data as of December 2006 J Heart Lung Transplant 2008;27: 937-983
PEDIATRIC LUNG TRANSPLANTATIONKaplan-Meier Survival by Age Group
(Transplants: January 1990 - June 2006)
0
25
50
75
100
0 1 2 3 4 5 6 7 8 9 10 11 12
Years
Su
rviv
al (
%)
<1 Year (N=83)
1-11 Years (N=281)
12-17 Years (N=609)
<1 year vs. 1-11 years: p = 0.3215<1 year vs. 12-17 years: p = 0.72001-11 years vs. 12-17 years: p = 0.0330
HALF-LIFE<1 Year: 6.4 Years1-11 Years: 5.9 Years12-17 Years: 4.0 Years
N at risk = 6
N at risk = 10
N at risk = 10
ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
PEDIATRIC LUNG TRANSPLANTATIONConditional Kaplan-Meier Survival by Age Group
(Transplants: January 1990 - June 2006)
0
25
50
75
100
0 1 2 3 4 5 6 7 8 9 10 11 12
Years
Su
rviv
al
(%)
<1 Year (N=44)1-11 Years (N=196)
12-17 Years (N=415)
<1 year vs. 1-11 year: p = 0.5077<1 year vs. 12-17 years: p = 0.07351-11 years vs. 12-17 years: p =0.0623
N at risk = 6
N at risk = 10
N at risk = 10
CONDITIONAL HALF-LIFE<1 Year: 12.1 Years1-11 Years: 10.5 Years12-17 Years: 6.1 Years
ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
PEDIATRIC LUNG TRANSPLANTATION Kaplan-Meier Survival by Era (Transplants: January 1988 - June 2006)
0
20
40
60
80
100
0 1 2 3 4 5 6 7 8 9 10 11 12 13
Years
Su
rviv
al (
%)
1988-1994 (N=221)
1995-2001 (N=523)
2002-6/2006 (N=335)
HALF-LIFEUnconditional 1988-1994: 2.6 Years; 1995-2001: 4.0 Years; 2002-6/2006: naConditional 1988-1994: 7.1 Years; 1995-2001: 7.3 Years; 2002-6/2006: na
1988-1994 vs. 1995-2001: p = 0.03131988-1994 vs. 2002-6/2006: p < 0.00011995-2001 vs. 2002-6/2006: p = 0.0189
N at risk = 17
N at risk = 13
N at risk = 49
ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
PEDIATRIC LUNG TRANSPLANTATIONKaplan-Meier Survival by Donor Type for Recipients Age 12-17 Years
(Transplants: January 1990 - June 2005)
0
25
50
75
100
0 1 2 3 4 5 6 7 8 9 10
Years
Su
rviv
al (
%)
Deceased Donor (N = 546)
Living Donor (N = 72)
p = 0.9149
N at risk = 8
N at risk = 19
HALF-LIFEDeceased: 4.0 YearsLiving: 3.8 Years
ISHLT 2008 Last updated based on data as of December 2006 J Heart Lung Transplant 2008;27: 937-983
0
2
4
6
8
10
12
14
16
18
0-<1 month 1-<12 months 12-<36 months 36+ months Not reported
Nu
mb
er o
f R
e-T
ran
spla
nts
PEDIATRIC LUNG RE-TRANSPLANTS Between January 1994 and June 2006
ISHLT 2008
Time Between Previous and Current Transplant
Last updated based on data as of December 2006 J Heart Lung Transplant 2008;27: 937-983
0
10
20
30
40
50
60
70
80
90
100
0 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5
Years
Su
rviv
al (
%)
N=5 at risk at 5 years
PEDIATRIC LUNG RETRANSPLANTSSurvival for Transplants Performed Between January 1994 and June 2006
ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
PEDIATRIC LUNG RECIPIENTS Functional Status of Surviving Recipients
(Follow-ups: April 1994-June 2006)
0%
20%
40%
60%
80%
100%
1 Year (N = 361) 3 Years (N = 239) 5 Years (N = 142) 7 Years (N=65)
No Activity Limitations Performs with Assistance Total Assistance
ISHLT 2008 Last updated based on data as of December 2006 J Heart Lung Transplant 2008;27: 937-983
PEDIATRIC LUNG RECIPIENTS Rehospitalization Post-transplant of Surviving Recipients
(Follow-ups: April 1994 - June 2006)
0%
20%
40%
60%
80%
100%
Up to 1 Year (N =491)
Between 2 and 3Years (N = 303)
Between 4 and 5Years (N = 184)
Between 6 and 7Years (N = 91)
No Hospitalization Hospitalized, Not Rejection/Not InfectionHospitalized, Rejection Hospitalized, Infection OnlyHospitalized, Rejection + Infection
ISHLT 2008 Last updated based on data as of December 2006 J Heart Lung Transplant 2008;27: 937-983
PEDIATRIC LUNG RECIPIENTS Rehospitalization Post-transplant of Surviving Recipients
(Follow-ups: April 1994 - June 2006)
0%
20%
40%
60%
80%
100%
Up to 1 Year (N =491)
Between 1 and 3Years (N =270)
Between 3 and 5Years (N = 166)
Between 5 and 7Years (N = 84)
No Hospitalization Hospitalized, Not Rejection/Not InfectionHospitalized, Rejection Hospitalized, Infection OnlyHospitalized, Rejection + Infection
ISHLT 2008 Last updated based on data as of December 2006 J Heart Lung Transplant 2008;27: 937-983
0
10
20
30
40
50
60
Any Induction (N = 171) Polyclonal ALG/ATG (N = 46) IL2R-antagonist (N = 123)
% o
f p
ati
en
tsPEDIATRIC LUNG RECIPIENTS
Induction ImmunosuppressionFor transplants between January 2001 and June 2007
ISHLT 2008
Analysis is limited to patients who were alive at the time of the follow-up
J Heart Lung Transplant 2008;27: 937-983
0
10
20
30
40
50
60
70
Any Induction Polyclonal ALG/ATG IL2R-antagonist
% o
f p
ati
en
ts
2001 20022003 20042005 20061/2007-6/2007
PEDIATRIC LUNG RECIPIENTSInduction Immunosuppression (Transplants: January 2001 - June 2007)
ISHLT 2008
Analysis is limited to patients who were alive at the time of the follow-up
J Heart Lung Transplant 2008;27: 937-983
PEDIATRIC LUNG TRANSPLANTATION
Kaplan-Meier Survival Stratified by Induction Use (Transplants: January 2001 - June 2006)
0
25
50
75
100
0 1 2 3 4
Years
Su
rviv
al
(%)
Induction (N = 146)
No Induction (N = 123)
p = 0.9778
ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
0
20
40
60
80
100
Cyclosporine Tacrolimus Rapamycin MMF Azathioprine Prednisone
% o
f P
atie
nts
Year 1 (N = 244) Year 5 (N = 116)
PEDIATRIC LUNG RECIPIENTS Maintenance Immunosuppression at Time of Follow-up
(Follow-ups: January 2001 and June 2007)
NOTE: Different patients are analyzed in Year 1 and Year 5
ISHLT 2008
Analysis is limited to patients who were alive at the time of the follow-up
J Heart Lung Transplant 2008;27: 937-983
0
20
40
60
80
100
CalcineurinInhibitor
CellCycle Prednisone CalcineurinInhibitor
CellCycle Prednisone
% o
f P
ati
en
ts
CyA
TacTac
CyAAZA
AZA
MMFMMF
PEDIATRIC LUNG RECIPIENTS Maintenance Immunosuppression at Time of Follow-up
(Follow-ups: January 2001 and June 2007)
1 Year Follow-up (N = 244) 5 Year Follow-up (N = 116)NOTE: Different patients are analyzed in Year 1 and Year 5
ISHLT 2008
NOTE: 3% of patients were on both calcineurin inhibitors at different point during the year; these patients are not counted in either group. And 1% (2 patients) were on neither drugs during the year. In the 5-year tabulations, 16% were reported to be on both drugs during the year and 1% (1 patient) were reported to be on neither drugs.
Analysis is limited to patients who were alive at the time of the follow-upJ Heart Lung Transplant 2008;27: 937-983
0%
20%
40%
60%
80%
100%
Year 1 (N = 244) Year 5 (N = 116)
% o
f P
ati
en
ts
Other
Tacrolimus + MMF
Tacrolimus + AZA
Cyclosporine + MMF
Cyclosporine + AZA
PEDIATRIC LUNG RECIPIENTS Maintenance Immunosuppression Drug Combinations at Time of Follow-up Report
(Follow-ups: January 2001 and June 2007)
NOTE: Different patients are analyzed in Year 1 and Year 5
ISHLT 2008
Analysis is limited to patients who were alive at the time of the follow-up
J Heart Lung Transplant 2008;27: 937-983
POST-LUNG TRANSPLANT MORBIDITY FOR PEDIATRICS Cumulative Prevalence in Survivors within 1 Year Post-Transplant
(Follow-ups: April 1994 - June 2006)
Outcome Within 1
Year
Total number with known response
Hypertension 39.4% (N = 480)
Renal Dysfunction 8.7% (N=483)
Abnormal Creatinine < 2.5 mg/dl 5.6% Creatinine > 2.5 mg/dl 2.3% Chronic Dialysis 0.6% Renal Transplant 0.2%
Hyperlipidemia 3.6% (N = 496)
Diabetes 25.8% (N = 484)
Bronchiolitis Obliterans 13.5% (N = 446)
ISHLT 2008 Last updated based on data as of December 2006 J Heart Lung Transplant 2008;27: 937-983
POST-LUNG TRANSPLANT MORBIDITY FOR PEDIATRICS Cumulative Prevalence in Survivors within 5 Years Post-Transplant
(Follow-ups: April 1994 - June 2006)
Outcome Within 5
Years Total number with known response
Hypertension 65.0% (N = 123)
Renal Dysfunction 22.6% (N = 124) Abnormal Creatinine < 2.5 mg/dl 15.3% Creatinine > 2.5 mg/dl 4.0% Chronic Dialysis 1.6% Renal Transplant 1.6%
Hyperlipidemia 7.9% (N = 126)
Diabetes 35.5% (N = 124)
Bronchiolitis Obliterans 34.7% (N = 95)
ISHLT 2008 Last updated based on data as of December 2006 J Heart Lung Transplant 2008;27: 937-983
POST-LUNG TRANSPLANT MORBIDITY FOR PEDIATRICS Cumulative Prevalence in Survivors within 7 Years Post-Transplant
(Follow-ups: April 1994 - June 2006)
Outcome Within 7
Years
Total number with known response
Hypertension 74.5% (N = 55)
Renal Dysfunction 36.2% (N = 58) Abnormal Creatinine < 2.5 mg/dl 24.1% Creatinine > 2.5 mg/dl 5.2% Chronic Dialysis 0.0% Renal Transplant 6.9%
Hyperlipidemia 5.2% (N = 58)
Diabetes 31.6% (N = 57)
Bronchiolitis Obliterans 28.6% (N = 35)
ISHLT 2008 Last updated based on data as of December 2006 J Heart Lung Transplant 2008;27: 937-983
Freedom from Bronchiolitis Obliterans For Pediatric Lung Recipients (Follow-ups: April 1994 - June 2007)
0
10
20
30
40
50
60
70
80
90
100
0 1 2 3 4 5 6 7
Years
% F
ree
fro
m B
ron
ch
ioli
tis
Ob
lite
ran
s
ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
FREEDOM FROM BRONCHIOLITIS OBLITERANSFor Pediatric Lung Recipients by Induction Use
(Follow-ups: April 1994 - June 2007)
0
25
50
75
100
0 1 2 3 4 5 6 7
Years
Induction (N = 188)
No Induction (N =394)
p =0.1353
% F
ree
fro
m B
ron
ch
iolit
is O
blit
era
ns
ISHLT 2008 J Heart Lung Transplant 2008;27: 937-983
Freedom from Severe Renal Dysfunction*For Pediatric Lung Recipients (Follow-ups: April 1994 - June 2006)
0
10
20
30
40
50
60
70
80
90
100
0 1 2 3 4 5 6 7Years
% F
ree f
rom
Severe
Ren
al
Dysfu
ncti
on
* Severe renal dysfunction = Creatinine > 2.5 mg/dl (221 μmol/L), dialysis or renal transplant
ISHLT 2008 Last updated based on data as of December 2006 J Heart Lung Transplant 2008;27: 937-983
MALIGNANCY POST-LUNG TRANSPLANTATION FOR PEDIATRICSCumulative Incidence for Survivors (Follow-ups: April 1994 - June 2006)
Malignancy/Type 1-Year Survivors
5-Year Survivors
7-Year Survivors
No Malignancy 469 (94.6%) 111 (88.1%) 51 (87.9%)
Malignancy (all types combined)
27 (5.4%) 15 (11.9%) 7 (12.1%)
Malignancy Type
Lymph 24 14 6
Other 3 1 1
”Other” includes Liver and primitive neuroectodermal tumor.
ISHLT 2008 Last updated based on data as of December 2006 J Heart Lung Transplant 2008;27: 937-983
Freedom from MalignancyFor Pediatric Lung Recipients (Follow-ups: April 1994 - June 2006)
50
60
70
80
90
100
0 1 2 3 4 5 6 7
Years
% F
ree
from
Mal
igna
ncy
All malignancy Lymph Skin Other
ISHLT 2008 Last updated based on data as of December 2006 J Heart Lung Transplant 2008;27: 937-983
PEDIATRIC LUNG TRANSPLANT RECIPIENTS: Cause Of Death(Deaths: January 1992- June 2006)
CAUSE OF DEATH0-30 Days
(N =72 )31 Days - 1 Year
(N = 107)
>1 Year - 3 Years
(N = 111)
>3 Years - 5 Years
(N = 56)
>5 Years
(N = 38)
BRONCHIOLITIS 9 (8.4%) 43 (38.7%) 24 (42.9%) 16 (42.1%)
ACUTE REJECTION 1 (1.4%) 3 (2.8%) 1 (1.8%)
LYMPHOMA 3 (2.8%) 4 (3.6%) 2 (3.6%) 4 (10.5%)
MALIGNANCY, NON-LYMPHOMA
1 (1.8%)
CMV 6 (5.6%)
INFECTION, NON-CMV 9 (12.5%) 44 (41.1%) 23 (20.7%) 13 (23.2%) 3 (7.9%)
GRAFT FAILURE 24 (33.3%) 20 (18.7%) 21 (18.9%) 7 (12.5%) 8 (21.1%)
CARDIOVASCULAR 9 (12.5%) 4 (3.7%) 2 (1.8%)
TECHNICAL 10 (13.9%) 1 (0.9%)
MULTIPLE ORGAN FAILURE
6 (8.3%) 9 (8.4%) 9 (8.1%) 3 (5.4%) 3 (7.9%)
OTHER 13 (18.1%) 8 (7.5%) 9 (8.1%) 5 (8.9%) 4 (10.5%)
ISHLT 2008 Last updated based on data as of December 2006 J Heart Lung Transplant 2008;27: 937-983
PEDIATRIC LUNG TRANSPLANT RECIPIENTS: Other Cause Of Death(Deaths: January 1992- June 2006)
CAUSE OF DEATH0-30 Days
(N =72 )
31 Days - 1 Year
(N = 107)
>1 Year - 3 Years
(N = 111)
>3 Years - 5 Years
(N = 56)
>5 Years
(N = 38)
Graft Failure: Graft Infection 4 (5.6%) 3 2.8%) 4 (3.6%) 2 (5.3%)
Graft Failure: Recurrent Disease 1 (0.9%) 1 (2.6%)
Pulm: Pulmonary Embolism 1 (1.4%) 1 (1.8%)
Cerebrovascular: Hemorrhage (Non-Stroke) 3 4.2%) 3 (2.8%)
Cerebrovascular: Brain Anoxia 1 (1.4%) 1 (0.9%) 1 (0.9%)
Cerebrovascular: Other Specify 3 4.2%)
Hemorrhage: Gastrointestinal 1 (0.9%)
Hemorrhage: Respiratory 1 (0.9%) 1 (1.8%)
Renal Failure 1 (2.6%)
Non-Compliance 1 (0.9%) 1 (1.8%)
Primary Organ Failure 1 (1.4%)
Thromboembolic Disease 1 (0.9%)
Hus Hemolytic Uremic Syndrome 1 (1.8%)
Respiratory Failure 1 (1.8%)
ISHLT 2008 Last updated based on data as of December 2006 J Heart Lung Transplant 2008;27: 937-983