HEART TRANSPLANTATION

1
HEART TRANSPLANTATION

• Pediatric Recipients

ISHLT
2007

J Heart Lung Transplant 200726 796-807
2
AGE DISTRIBUTION OF PEDIATRIC HEART RECIPIENTS
(Transplants January 1996 - June 2006)
Number of Transplants
ISHLT
2007

J Heart Lung Transplant 200726 796-807
3
AGE DISTRIBUTION FOR DONORS OF PEDIATRIC HEART
RECIPIENTS (Transplants January 1996 - June
2006)
Number of Transplants
ISHLT
2007

J Heart Lung Transplant 200726 796-807
4
AGE DISTRIBUTION OF PEDIATRIC HEART
RECIPIENTSBy Year of Transplant
Number of Transplants
NOTE This figure includes only the heart
transplants that are reported to the ISHLT
Transplant Registry. As such, this should not be
construed as evidence that the number of hearts
transplanted worldwide has increased and/or
decreased in recent years.
ISHLT
2007

J Heart Lung Transplant 200726 796-807
5
NUMBER OF CENTERS REPORTING PEDIATRIC HEART
TRANSPLANTS
Number of Pediatric Cases Reporting
ISHLT
2007

J Heart Lung Transplant 200726 796-807
6
AVERAGE CENTER VOLUMEPediatric Heart
Transplants January 1, 1997 - June 30, 2006
ISHLT
2007
J Heart Lung Transplant 200726 796-807
7
DISTRIBUTION OF TRANSPLANTS BY CENTER
VOLUMEPediatric Heart Transplants January 1,
1997 - June 30, 2006
ISHLT
2007
J Heart Lung Transplant 200726 796-807
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PEDIATRIC HEART RE-TRANSPLANTSBy Transplant
YearRetransplants January 1994 December 2005
Year of transplant
ISHLT
2007
J Heart Lung Transplant 200726 796-807
9
PEDIATRIC HEART RE-TRANSPLANTSBy Intertransplant
IntervalRetransplants January 1994 - June 2005
Time Between Previous and Current Transplant
ISHLT
2007
J Heart Lung Transplant 200726 796-807
10
KAPLAN-MEIER SURVIVAL RATES FOR PEDIATRIC HEART
RETRANSPLANTS STRATIFIED BY INTER-TRANSPLANT
INTERVALRetransplants January 1994 - June 2005
Time (years) since most recent transplant
ISHLT
2007
J Heart Lung Transplant 200726 796-807
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KAPLAN-MEIER SURVIVAL RATES FOR PEDIATRIC HEART
RETRANSPLANTS STRATIFIED BY INTER-TRANSPLANT
INTERVALRetransplants January 1994 - June 2005
Time (years) since most recent transplant
ISHLT
2007
J Heart Lung Transplant 200726 796-807
12
DIAGNOSIS IN PEDIATRIC HEART TRANSPLANT
RECIPIENTS (Age lt 1 Year)
1988-1995
1/1996-6/2006
of Cases
ISHLT
2007

J Heart Lung Transplant 200726 796-807
13
DIAGNOSIS IN PEDIATRIC HEART TRANSPLANT
RECIPIENTS (Age 1-10 Years)
1988-1995
1/1996-6/2006
of Cases
ISHLT
2007

J Heart Lung Transplant 200726 796-807
14
DIAGNOSIS IN PEDIATRIC HEART TRANSPLANT
RECIPIENTS (Age 11-17 Years)
1988-1995
1/1996-6/2006
of Cases
ISHLT
2007

J Heart Lung Transplant 200726 796-807
15
PEDIATRIC HEART TRANSPLANTATIONKaplan-Meier
Survival (1/1982-6/2005)
Survival ()
ISHLT
2007

J Heart Lung Transplant 200726 796-807
16
PEDIATRIC HEART TRANSPLANTATIONConditional
Kaplan-Meier Survival (1/1982-6/2005)
Survival ()
ISHLT
2007

J Heart Lung Transplant 200726 796-807
17
PEDIATRIC HEART TRANSPLANTATIONConditional
5-year Kaplan-Meier Survival (1/1982-6/2005)
Survival ()
ISHLT
2007

J Heart Lung Transplant 200726 796-807
18
PEDIATRIC HEART TRANSPLANTATIONConditional
Kaplan-Meier Survival for Recent Era
(1/1999-6/2005)
Survival ()
ISHLT
2007

J Heart Lung Transplant 200726 796-807
19
PEDIATRIC HEART TRANSPLANTATIONKaplan-Meier
Survival by Era (1/1982-6/2005)
Survival ()
ISHLT
2007

J Heart Lung Transplant 200726 796-807
20
PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier
Survival by Era (1/1982-6/2005)Age lt 1 Year
Survival ()
ISHLT
2007

J Heart Lung Transplant 200726 796-807
21
PEDIATRIC HEART TRANSPLANTATIONKaplan-Meier
Survival by Era (1/1982-6/2005)Age 1-10 Years
Survival ()
ISHLT
2007

J Heart Lung Transplant 200726 796-807
22
PEDIATRIC HEART TRANSPLANTATIONKaplan-Meier
Survival by Era (1/1982-6/2005)Age 11-17 Years
Survival ()
ISHLT
2007

J Heart Lung Transplant 200726 796-807
23
PEDIATRIC HEART TRANSPLANTSAGE DISTRIBUTION BY
LOCATION Transplants between January 2000 and
June 2006
ISHLT
2007

J Heart Lung Transplant 200726 796-807
24
PEDIATRIC HEART TRANSPLANTSDIAGNOSIS
DISTRIBUTION BY LOCATION Transplants between
January 2000 and June 2006
ISHLT
2007

J Heart Lung Transplant 200726 796-807
25
PEDIATRIC HEART TRANSPLANTSDONOR AGE
DISTRIBUTION BY LOCATION Transplants between
January 2000 and June 2006
ISHLT
2007

J Heart Lung Transplant 200726 796-807
26
PEDIATRIC HEART TRANSPLANTS (1/1995-6/2005)Risk
Factors For 1 Year Mortality
N3,209
ISHLT
2007
Reference diagnosis cardiomyopathy

J Heart Lung Transplant 200726 796-807
27
PEDIATRIC HEART TRANSPLANTS (1/1995-6/2005)Border
line Significant Risk Factors For 1 Year Mortality
N3,209
ISHLT
2007

J Heart Lung Transplant 200726 796-807
28
PEDIATRIC HEART TRANSPLANTS (1/1995-6/2005) Risk
Factors for 1 Year Mortality
N3,209
ISHLT
2007

J Heart Lung Transplant 200726 796-807
29
PEDIATRIC HEART TRANSPLANTS (1/1995-6/2005) Risk
Factors for 1 Year MortalityDonor Age
ISHLT
2007
N3,209

J Heart Lung Transplant 200726 796-807
30
PEDIATRIC HEART TRANSPLANTS (1/1995-6/2005) Risk
Factors for 1 Year Mortality Pre-Transplant
Bilirubin
ISHLT
2007
N3,209

J Heart Lung Transplant 200726 796-807
31
PEDIATRIC HEART TRANSPLANTS (1/1995-6/2005) Risk
Factors for 1 Year Mortality Pre-Transplant
Creatinine
ISHLT
2007
N3,209

J Heart Lung Transplant 200726 796-807
32
PEDIATRIC HEART TRANSPLANTS (1/1995-6/2005) Risk
Factors for 1 Year MortalityWeight Ratio
ISHLT
2007
N3,209

J Heart Lung Transplant 200726 796-807
33
PEDIATRIC HEART TRANSPLANTS (1/1995-6/2005) Risk
Factors for 1 Year MortalityCenter Volume for
Pediatric Transplants
ISHLT
2007
N3,209

J Heart Lung Transplant 200726 796-807
34
PEDIATRIC HEART TRANSPLANTS (1/1995-6/2005)
Factors Not Significant for 1 Year Mortality
Recipient Factors IV inotropes, sternotomy,
thoracotomy, history of malignancy, height,
recent infection, age Donor Factors Gender,
history of hypertension, height, clinical
infection, history of diabetes Transplant
Factors CMV mismatch, ABO identical/compatible,
ischemia time, HLA mismatch
ISHLT
2007

J Heart Lung Transplant 200726 796-807
35
PEDIATRIC HEART TRANSPLANTS (1/1995-6/2005)
1-Year Predicted Survival Model
ISHLT
2007

36
PEDIATRIC HEART TRANSPLANTS (1/1995-6/2001)Risk
Factors For 5 Year Mortality
ISHLT
N1,896
2007

J Heart Lung Transplant 200726 796-807
37
PEDIATRIC HEART TRANSPLANTS (1/1995-6/2001)Border
line Significant Risk Factors For 5 Year Mortality
ISHLT
N1,896
2007

J Heart Lung Transplant 200726 796-807
38
PEDIATRIC HEART TRANSPLANTS (1/1995-6/2001) Risk
Factors for 5 Year Mortality
ISHLT
N1,896
2007

J Heart Lung Transplant 200726 796-807
39
PEDIATRIC HEART TRANSPLANTS (1/1995-6/2001) Risk
Factors for 5 Year MortalityRecipient Age
ISHLT
N1,896
2007

J Heart Lung Transplant 200726 796-807
40
PEDIATRIC HEART TRANSPLANTS (1/1995-6/2001) Risk
Factors for 5 Year Mortality Pre-Transplant
Bilirubin
ISHLT
2007
N1,896

J Heart Lung Transplant 200726 796-807
41
PEDIATRIC HEART TRANSPLANTS (1/1995-6/2001) Risk
Factors for 5 Year MortalityCenter Volume for
Pediatric Transplants
ISHLT
N1,896
2007

J Heart Lung Transplant 200726 796-807
42
PEDIATRIC HEART TRANSPLANTS (1/1995-6/2001)
Factors Not Significant for 5 Year Mortality
Recipient Factors History of malignancy, PRA,
height, weight, creatinine, diabetes, repeat
transplant, transfusions
ISHLT
2007

J Heart Lung Transplant 200726 796-807
43
PEDIATRIC HEART TRANSPLANTS (1/1995-6/2000)
Factors Not Significant for 5 Year Mortality
Donor Factors Cause of death, history of
hypertension, weight, height, age, clinical
infection Transplant Factors CMV mismatch,
ischemia time, HLA mismatch
ISHLT
2007

J Heart Lung Transplant 200726 796-807
44
PEDIATRIC HEART TRANSPLANTS (1/1995-6/2001)
Conditional 5-Year Predicted Survival Model
ISHLT
2007

45
PEDIATRIC HEART RECIPIENTS Functional Status of
Surviving Recipients(Follow-ups April 1994 -
June 2006)
ISHLT
2007

J Heart Lung Transplant 200726 796-807
46
PEDIATRIC HEART RECIPIENTS Rehospitalization
Post-transplant of Surviving Recipients(Follow-up
s April 1994 - June 2006)
ISHLT
2007

J Heart Lung Transplant 200726 796-807
47
PEDIATRIC HEART RECIPIENTS Induction
Immunosuppression(Transplants January 2001 -
June 2006)
of Patients
ISHLT
2007

J Heart Lung Transplant 200726 796-807
48
PEDIATRIC HEART RECIPIENTSInduction
Immunosuppression (Transplants January 2001 -
June 2006)
Test of increasing trend over time Any induction
p lt 0.0001 Polyclonal p lt 0.0001 IL2 p 0.0722
ISHLT
2007

J Heart Lung Transplant 200726 796-807
49
PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier
Survival by Induction Group (Transplants
January 2000 June 2005) Conditional on Survival
to 14 Days
No comparisons were statistically significant.
Survival ()
ISHLT
2007

J Heart Lung Transplant 200726 796-807
50
PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier
Survival by Induction Group and Treated for
Rejection Between Transplant Discharge and 1-Year
Follow-up (Transplants January 2000 June 2004)
Conditional on Survival to 1 Year
Survival ()
No pair-wise comparisons of survival by induction
were statistically significant within either
rejection grouping.
ISHLT
2007

J Heart Lung Transplant 200726 796-807
51
PEDIATRIC HEART TRANSPLANTATIONKaplan-Meier
Survival by Induction Group (Transplants January
2000 June 2005)Conditional on Survival to 14
DaysAge lt 1 Year
Survival ()
ISHLT
2007

J Heart Lung Transplant 200726 796-807
52
PEDIATRIC HEART TRANSPLANTATIONKaplan-Meier
Survival by Induction Group (Transplants January
2000 June 2005) Conditional on Survival to 14
DaysAge 1-10 Years
Survival ()
No comparisons were statistically significant.
ISHLT
2007

J Heart Lung Transplant 200726 796-807
53
PEDIATRIC HEART TRANSPLANTATION Kaplan-Meier
Survival by Induction Group (Transplants January
2000 June 2005)Conditional on Survival to 14
DaysAge 11-17 Years
Survival ()
ISHLT
2007

J Heart Lung Transplant 200726 796-807
54
PEDIATRIC HEART RECIPIENTS Maintenance
Immunosuppression at Time of Follow-up(Follow-ups
January 2001 - June 2006)
of Patients
NOTE Different patients are analyzed in Year 1
and Year 5
ISHLT
2007

J Heart Lung Transplant 200726 796-807
55
PEDIATRIC HEART RECIPIENTS Maintenance
Immunosuppression at Time of Follow-up for Same
Patients at Each Time Point(Follow-ups January
2001 - June 2006)
of Patients
ISHLT
2007

J Heart Lung Transplant 200726 796-807
56
PEDIATRIC HEART TRANSPLANTATIONKaplan-Meier
Survival Based on Prednisone UseConditional on
Survival to 1 Year (Transplants April 1994 -
June 2005)
Survival ()
p 0.0102
ISHLT
2007

J Heart Lung Transplant 200726 796-807
57
PEDIATRIC HEART TRANSPLANTATIONKaplan-Meier
Survival Based on Prednisone Use for a Recent
EraConditional on Survival to 1 Year
(Transplants January 1998 June 2005)
Survival ()
p 0.1326
ISHLT
2007

J Heart Lung Transplant 200726 796-807
58
PEDIATRIC HEART TRANSPLANTATIONKaplan-Meier
Survival Stratified by Tacrolimus vs.
Cyclosporine Use at Discharge (Transplants
January 1998 - June 2005) Conditional on
Survival to 14 Days
p 0.3486
Survival ()
ISHLT
2007

J Heart Lung Transplant 200726 796-807
59
PEDIATRIC HEART TRANSPLANTATIONKaplan-Meier
Survival Based on Rejection within 1st Year
(Transplants April 1994 - June 2004)
Survival ()
p lt.0001
ISHLT
2007

J Heart Lung Transplant 200726 796-807
60
PEDIATRIC HEART TRANSPLANTATIONKaplan-Meier
Survival Based on Rejection within 1st Year for
Recent Transplants (Transplants January 2000
June 2004)
Survival ()
p 0.0034
ISHLT
2007

J Heart Lung Transplant 200726 796-807
61
PEDIATRIC HEART TRANSPLANTATIONKaplan-Meier
Survival Based on Rejection within 1st
YearStratified by Calcineurin Use at Discharge
(Transplants April 1994 - June 2005)
Survival ()
ISHLT
2007

J Heart Lung Transplant 200726 796-807
62
PEDIATRIC HEART TRANSPLANTATIONKaplan-Meier
Survival Based on Rejection within 1st
YearStratified by Calcineurin Use at Discharge
Age 0-10 Years (Transplants April 1994 - June
2005)
Survival ()
ISHLT
2007

J Heart Lung Transplant 200726 796-807
63
PEDIATRIC HEART TRANSPLANTATIONKaplan-Meier
Survival Based on Rejection within 1st
YearStratified by Calcineurin Use at Discharge
Age 11-17 Years (Transplants April 1994 - June
2005)
Survival ()
ISHLT
2007

J Heart Lung Transplant 200726 796-807
64
PEDIATRIC HEART TRANSPLANTATIONKaplan-Meier
Survival Based on Rejection within 1st Year for
Recent TransplantsStratified by Calcineurin Use
at Discharge (Transplants January 2000 - June
2005)
Survival ()
ISHLT
2007

J Heart Lung Transplant 200726 796-807
65
PEDIATRIC HEART RECIPIENTS Maintenance
Immunosuppression Drug Combinations at Time of
Follow-up(Follow-ups January 2001 - June 2006)
of Patients
NOTE Different patients are analyzed in Year 1
and Year 5
ISHLT
2007

J Heart Lung Transplant 200726 796-807
66
PERCENTAGE OF PEDIATRIC HEART TRANSPLANT
RECIPIENTS TREATED FOR REJECTION IN 1ST
YEARStratified by Induction (Transplants
January 2000 - June 2005)
treated for rejection within 1year
No within age group or gender comparisons were
significant except 1-10 years (p0.005).
ISHLT
2007

J Heart Lung Transplant 200726 796-807
67
NUMBER OF REJECTION EPISODES FOR PEDIATRIC HEART
TRANSPLANT RECIPIENTS TREATED FOR REJECTION IN
1ST YEAR Stratified by Induction (Transplants
January 2000 - June 2005)
Average number of rejection episodes
ISHLT
2007

J Heart Lung Transplant 200726 796-807
68
PERCENTAGE OF PEDIATRIC HEART TRANSPLANT
RECIPIENTS TREATED FOR REJECTION IN 1ST
YEARStratified by Type of Induction
(Transplants January 2000 - June 2005)
treated for rejection within 1year
Overall No induction vs. OKT3 (p 0.0032)
polyclonal vs. OKT3 (p 0.024) IL2 vs. OKT3 (p
0.035). 1-10 No induction vs. polyclonal (p
0.0047) 11-17 No induction vs. OKT3 (p
0.0097) polyclonal vs. OKT3 (p 0.028) IL2R
vs. OKT3 (p 0.013) Female No induction vs.
OKT3 (p 0.015) polyclonal vs. OKT3 (p 0.041)
ISHLT
2007

J Heart Lung Transplant 200726 796-807
69
NUMBER OF REJECTION EPISODES FOR PEDIATRIC HEART
TRANSPLANT RECIPIENTS TREATED FOR REJECTION IN
1ST YEAR Stratified by Type of Induction
(Transplants January 2000 - June 2005)
Average number of rejection episodes
ISHLT
2007

J Heart Lung Transplant 200726 796-807
70
PERCENTAGE OF PEDIATRIC HEART TRANSPLANT
RECIPIENTS TREATED FOR REJECTION IN 1ST
YEARStratified by Maintenance Immunosuppression
and Induction (Transplants January 2000 - June
2005)
treated for rejection within 1year
Overall CyA induction vs. TAC no induction
p 0.0179 lt1 CyA no induction vs. TAC no
induction p 0.047 1-10 years CyA induction
vs. TAC induction p 0.017 CyA induction
vs. TAC no induction p 0.0003 CyA no
induction vs. CyA induction 0.011. No other
age group differences were significant.
ISHLT
2007

J Heart Lung Transplant 200726 796-807
71
NUMBER OF REJECTION EPISODES FOR PEDIATRIC HEART
TRANSPLANT RECIPIENTS TREATED FOR REJECTION IN
1ST YEAR Stratified by Maintenance
Immunosuppression and Induction (Transplants
January 2000 - June 2005)
Average number of rejection episodes
ISHLT
2007

J Heart Lung Transplant 200726 796-807
72
PERCENTAGE OF PEDIATRIC HEART TRANSPLANT
RECIPIENTS TREATED FOR REJECTION IN 1ST YEAR
Stratified by Maintenance Immunosuppression
(Transplants January 2000 - June 2005)
treated for rejection within 1 year
Overall CyA MMF vs. TAC AZA (p 0.0027) CyA
AZA vs. TAC AZA (p 0.013). lt1 CyA MMF
vs. TAC MMF ( p 0.024) CyA AZA vs. TAC
MMF (p 0.021). 1-10 CyA MMF vs. TAC AZA
(p 0.0014) TAC MMF vs. TAC AZA (p
0.011) CyA AZA vs. TAC AZA (p 0.016).
ISHLT
2007

J Heart Lung Transplant 200726 796-807
73
NUMBER OF REJECTION EPISODES FOR PEDIATRIC HEART
TRANSPLANT RECIPIENTS TREATED FOR REJECTION IN
1ST YEAR Stratified by Maintenance
Immunosuppression (Transplants January 2000 -
June 2005)
Average number of rejection episodes
lt1 years CyA AZA vs. TAC MMF (p0.0027) CyA
AZA vs. TAC AZA (p0.45). No other age group
comparisons were significant.
ISHLT
2007

J Heart Lung Transplant 200726 796-807
74
PERCENTAGE OF PEDIATRIC HEART TRANSPLANT
RECIPIENTS TREATED FOR REJECTION IN 1ST
YEARStratified by Calcineurin Inhibitor Use at
Discharge (Transplants January 2000 - June 2005)
treated for rejection within 1year
Overall CyA vs. TAC (p 0.0084)
1-10 CyA vs. TAC (p 0.0079)
ISHLT
2007

J Heart Lung Transplant 200726 796-807
75
NUMBER OF REJECTION EPISODES FOR PEDIATRIC HEART
TRANSPLANT RECIPIENTS TREATED FOR REJECTION IN
1ST YEAR Stratified by Calcineurin Inhibitor Use
at Discharge (Transplants January 2000 - June
2005)
Average number of rejection episodes
ISHLT
2007

J Heart Lung Transplant 200726 796-807
76
POST-HEART TRANSPLANT MORBIDITY FOR PEDIATRICS
Cumulative Prevalence in Survivors within 1 Year
Post-Transplant (Follow-ups April 1994 - June
2006)
ISHLT
2007

J Heart Lung Transplant 200726 796-807
77
POST-HEART TRANSPLANT MORBIDITY FOR PEDIATRICS
Cumulative Prevalence in Survivors within 5
Years Post-Transplant (Follow-ups April 1994 -
June 2006)
ISHLT
2007

J Heart Lung Transplant 200726 796-807
78
POST-HEART TRANSPLANT MORBIDITY FOR PEDIATRICS
Cumulative Prevalence in Survivors within 8
Years Post-Transplant (Follow-ups April 1994 -
June 2006)
ISHLT
2007

J Heart Lung Transplant 200726 796-807
79
POST-HEART TRANSPLANT MORBIDITY FOR PEDIATRICS
Cumulative Prevalence in Survivors within 10
Years Post-Transplant (Follow-ups April 1994 -
June 2006)
ISHLT
2007

J Heart Lung Transplant 200726 796-807
80
FREEDOM FROM CORONARY ARTERY VASCULOPATHY For
Pediatric Heart Recipients (Follow-ups April
1994 - June 2006)
Freedom from CAV
ISHLT
2007

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FREEDOM FROM CORONARY ARTERY VASCULOPATHY For
Pediatric Heart Recipients (Follow-ups April
1994 - June 2006)Stratified by Induction
Freedom from CAV
p 0.8381
ISHLT
2007

J Heart Lung Transplant 200726 796-807
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FREEDOM FROM CORONARY ARTERY VASCULOPATHYFor
Pediatric Heart Recipients (Follow-ups April
1994 - June 2006)Stratified by Age Group
Freedom from CAV
ISHLT
2007

J Heart Lung Transplant 200726 796-807
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FREEDOM FROM CORONARY ARTERY VASCULOPATHYFor
Pediatric Heart Recipients (Follow-ups January
1999-June 2006)Stratified by Age Group
Freedom from CAV
ISHLT
2007

J Heart Lung Transplant 200726 796-807
84
FREEDOM FROM CORONARY ARTERY VASCULOPATHYFor
Pediatric Heart Recipients (Follow-ups April
1994 - June 2006)Stratified by Ischemia Time
Freedom from CAV
ISHLT
2007

J Heart Lung Transplant 200726 796-807
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FREEDOM FROM CORONARY ARTERY VASCULOPATHYFor
Pediatric Heart Recipients (Follow-ups January
1999 - June 2006)Stratified by Ischemia Time for
Recent Era
Freedom from CAV
ISHLT
2007

J Heart Lung Transplant 200726 796-807
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FREEDOM FROM CORONARY ARTERY VASCULOPATHYFor
Pediatric Heart Recipients (Follow-ups April
1994 - June 2006)Stratified by Ischemia Time and
Recipient Age
Freedom from CAV
ISHLT
2007

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GRAFT SURVIVAL FOLLOWING REPORT OF CORONARY
ARTERY VASCULOPATHY For Pediatric Heart
Recipients (Follow-ups April 1994 - June
2006)Stratified by Age Group
Survival since Report of CAV ()
ISHLT
2007

J Heart Lung Transplant 200726 796-807
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FREEDOM FROM SEVERE RENAL DYSFUNCTIONFor
Pediatric Heart Recipients (Follow-ups April
1994 - June 2006)
Freedom from Severe Renal Dysfunction
Severe renal dysfunction Creatinine gt 2.5
mg/dl (221 µmol/L), dialysis or renal transplant
ISHLT
2007

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MALIGNANCY POST-HEART TRANSPLANTATION FOR
PEDIATRICSCumulative Prevalence in Survivors
(Follow-ups April 1994 - June 2006)
Malignancy/Type Malignancy/Type 1-Year Survivors 5-Year Survivors 10-Year Survivors
No Malignancy No Malignancy 2771 (98.1) 1010 (95) 186 (93)
Malignancy (all types combined) Malignancy (all types combined) 55 (1.9) 53 (5) 14 (7)
Malignancy Type Lymph 51 48 13
Malignancy Type Other 3 6
Malignancy Type Skin 1
Malignancy Type Type Not Reported 1 1
NOTE Multiple types may be reported sum of
types may be greater than total number with
malignancy.
ISHLT
2007

J Heart Lung Transplant 200726 796-807
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FREEDOM FROM MALIGNANCYFor Pediatric Heart
Recipients (Follow-ups April 1994 - June 2006)
Freedom from Malignancy
ISHLT
2007

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PEDIATRIC HEART RECIPIENTS Incidence of
Hypertension between 1 and 3 Years(Transplants
April 1993 - June 2003)
Maintenance Immunosuppression at discharge and 1 year HTN reported between 1 and 3 years HTN reported between 1 and 3 years P-value
Maintenance Immunosuppression at discharge and 1 year For Patients on drug For Patients not on drug P-value
Azathioprine 21.9 24.2 0.4675
Cyclosporine 20.7 25.0 0.2225
MMF 20.7 22.1 0.6763
Prednisone 29.3 8.0 lt.0001
Rapamycin 100.0 21.1 - 
Tacrolimus 29.1 19.1 0.0045
ISHLT
2007

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PEDIATRIC HEART RECIPIENTS Incidence of
Hypertension between 3 and 8 Years(Transplants
April 1993 - June 1998)
Maintenance Immunosuppression at discharge and 1 year HTN reported between 3 and 8 years HTN reported between 3 and 8 years P-value
Maintenance Immunosuppression at discharge and 1 year For Patients on drug For Patients not on drug P-value
Azathioprine 37.0 42.3 0.6119
Cyclosporine 34.7 41.7 0.5062
MMF 38.5 37.4 0.9407
Prednisone 47.8 19.1 0.0002
Rapamycin - 35.8 - 
Tacrolimus 38.9 33.1 0.6234
N204
ISHLT
2007

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PEDIATRIC HEART RECIPIENTSRelationship of
Rejection and Coronary Artery Vasculopathy(Follow
-ups April 1994 June 2006)
Rejection During 1st Year Reported CAV between 1st and 3rd years post-transplant Reported CAV between 1st and 3rd years post-transplant Reported CAV between 1st and 3rd years post-transplant Reported CAV between 3rd and 5th years post-transplant Reported CAV between 3rd and 5th years post-transplant Reported CAV between 3rd and 5th years post-transplant
Rejection During 1st Year Yes No All Yes No All
Yes 44 7.7 529 92.3 573 100 23 7.7 275 92.3 298 100
No 18 3.0 588 97.0 606 100 15 4.8 300 95.2 315 100
p 0.0003 p 0.1293
NOTE Only those recipients without CAV prior to
3 years were included in the last set of columns
ISHLT
2007

J Heart Lung Transplant 200726 796-807
94
PEDIATRIC HEART TRANSPLANT RECIPIENTS Cause of
Death (Deaths January 1992 - June 2006)
CAUSE OF DEATH 0-30 Days (N 387) 31 Days - 1 Year (N 332) gt1 Year - 3 Years (N 249) gt3 Years - 5 Years (N 169) gt5 Years - 10 Years (N 237) gt10 Years (N 103)
CORONARY ARTERY VASCULOPATHY 4 (1.0) 27 (8.1) 50 (20.1) 60 (35.5) 72 (30.4) 32 (31.1)
ACUTE REJECTION 40 (10.3) 83 (25.0) 65 (26.1) 23 (13.6) 36 (15.2) 7 (6.8)
LYMPHOMA 7 (2.1) 11 (4.4) 3 (1.8) 23 (9.7) 6 (5.8)
MALIGNANCY, OTHER 4 (1.2) 2 (0.8) 1 (0.6) 3 (1.3) 7 (6.8)
CMV 1 (0.3) 7 (2.1) 1 (0.4)
INFECTION, NON-CMV 53 (13.7) 55 (16.6) 17 (6.8) 7 (4.1) 14 (5.9) 10 (9.7)
PRIMARY FAILURE 73 (18.9) 17 (5.1) 8 (3.2) 10 (5.9) 11 (4.6) 2 (1.9)
GRAFT FAILURE 90 (23.3) 35 (10.5) 45 (18.1) 38 (22.5) 47 (19.8) 25 (24.3)
TECHNICAL 21 (5.4) 2 (0.6) 2 (0.8) 1 (0.6) 2 (0.8)
OTHER 19 (4.9) 15 (4.5) 19 (7.6) 14 (8.3) 17 (7.2) 2 (1.9)
MULTIPLE ORGAN FAILURE 38 (9.8) 45 (13.6) 7 (2.8) 3 (1.8) 4 (1.7) 6 (5.8)
RENAL FAILURE 1 (0.3) 5 (1.5) 1 (0.4) 1 (1.0)
PULMONARY 24 (6.2) 20 (6.0) 13 (5.2) 8 (4.7) 4 (1.7) 5 (4.9)
CEREBROVASCULAR 23 (5.9) 10 (3.0) 8 (3.2) 1 (0.6) 4 (1.7)
ISHLT
2007

J Heart Lung Transplant 200726 796-807
95
PEDIATRIC HEART TRANSPLANT RECIPIENTS Cause of
Death (Deaths January 1998 - June 2006)
CAUSE OF DEATH 0-30 Days (N 164) 31 Days - 1 Year (N 159) gt1 Year - 3 Years (N 144) gt3 Years - 5 Years (N 104) gt5 Years - 10 Years (N 184) gt10 Years (N 96)
CAV 1 (0.6) 11 (6.9) 25 (17.4) 36 (34.6) 56 (30.4) 30 (31.3)
ACUTE REJECTION 19 (11.6) 30 (18.9) 32 (22.2) 14 (13.5) 27 (14.7) 7 (7.3)
LYMPHOMA 3 (1.9) 6 (4.2) 2 (1.9) 19 (10.3) 6 (6.3)
MALIGNANCY, OTHER 1 (0.6) 1 (0.7) 2 (1.1) 6 (6.3)
CMV 3 (1.9) 1 (0.7)
INFECTION, NON-CMV 24 (14.6) 22 (13.8) 8 (5.6) 2 (1.9) 12 (6.5) 8 (8.3)
PRIMARY FAILURE 30 (18.3) 5 (3.1) 4 (2.8) 3 (2.9) 5 (2.7) 2 (2.1)
GRAFT FAILURE 29 (17.7) 15 (9.4) 30 (20.8) 30 (28.8) 38 (20.7) 23 (24.0)
TECHNICAL 8 (4.9) . (.) 2 (1.4) 2 (1.1)
OTHER 14 (8.5) 10 (6.3) 16 (11.1) 9 (8.7) 14 (7.6) 2 (2.1)
MULTIPLE ORGAN FAILURE 20 (12.2) 31 (19.5) 6 (4.2) 2 (1.9) 3 (1.6) 6 (6.3)
RENAL FAILURE 5 (3.1) 1 (0.7) 1 (1.0)
PULMONARY 8 (4.9) 17 (10.7) 8 (5.6) 6 (5.8) 3 (1.6) 5 (5.2)
CEREBROVASCULAR 11 (6.7) 6 (3.8) 4 (2.8) 3 (1.6)
ISHLT
2007

J Heart Lung Transplant 200726 796-807