lung transplantation

LUNG TRANSPLANTATIONOverall 2011

NUMBER OF LUNG TRANSPLANTS REPORTED BY YEAR AND PROCEDURE TYPENOTE: This figure includes only the lung transplants that are reported to the ISHLT Transplant Registry. As such, this should not be construed as representing changes in the number of lung transplants performed worldwide. 2011

AVERAGE CENTER VOLUMELung Transplants: January 1, 2000 - June 30, 2010 2011

DISTRIBUTION OF TRANSPLANTS BY CENTER VOLUMELung Transplants: January 1, 2000 - June 30, 2010 2011

LUNG TRANSPLANTS: Transplant Recipient Age by Year of TransplantTransplants: January 1, 1987 June 30, 2010 2011

AGE DISTRIBUTION OF LUNG TRANSPLANT RECIPIENTS (1/1985-6/2010) 2011

AGE DISTRIBUTION OF LUNG TRANSPLANT RECIPIENTS BY ERA Transplants with unknown recipient age were excluded from this tabulation.2011

LUNG TRANSPLANTS: Donor Age by Year of Transplant Transplants: January 1, 1987 June 30, 2010 2011

DONOR AGE DISTRIBUTION FOR LUNG TRANSPLANTS (1/1985-6/2010) 2011

DONOR AGE DISTRIBUTION FOR LUNG TRANSPLANTS BY ERA Transplants with unknown donor age were excluded from this tabulation.2011

LUNG TRANSPLANTATIONAdult Recipients 2011

AGE DISTRIBUTION OF ADULT LUNG TRANSPLANT RECIPIENTS (1/1985-6/2010) 2011

AGE DISTRIBUTION OF ADULT LUNG TRANSPLANT RECIPIENTS BY ERA 2011

ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival (Transplants: January 1994 - June 2009) 2011

ADULT LUNG TRANSPLANTATION: Indications (1/1995-6/2010) 2011

DIAGNOSISSLT (N = 12,339)BLT (N = 18,334)TOTAL (N = 30,673)COPD/Emphysema5,769 ( 46.8% )4,839 ( 26.4% )10,608 ( 34.6% )Idiopathic Pulmonary Fibrosis3,995 ( 32.4% )2,938 ( 16.0% )6,933 ( 22.6% )Cystic Fibrosis214 ( 1.7% )4,941 ( 26.9% )5,155 ( 16.8% )Alpha-1728 ( 5.9% )1,225 ( 6.7% )1,953 ( 6.4% )Idiopathic Pulmonary Arterial Hypertension78 ( 0.6% )894 ( 4.9% )972 ( 3.2% )Pulmonary Fibrosis, Other424 ( 3.4% )537 ( 2.9% )961 ( 3.1% )Bronchiectasis50 ( 0.4% )815 ( 4.4% )865 ( 2.8% )Sarcoidosis236 ( 1.9% )547 ( 3.0% )783 ( 2.6% )Re-Transplant: Obliterative Bronchiolitis253 ( 2.1% )219 ( 1.2% )472 ( 1.5% )Connective Tissue Disease127 ( 1.0% )232 ( 1.3% )359 ( 1.2% )Obliterative Bronchiolitis (Not Re-Transplant)80 ( 0.6% )237 ( 1.3% )317 ( 1.0% )LAM101 ( 0.8% )207 ( 1.1% )308 ( 1.0% )Re-Transplant: Not Obliterative Bronchiolitis127 ( 1.0% )162 ( 0.9% )289 ( 0.9% )Congenital Heart Disease43 ( 0.3% )224 ( 1.2% )267 ( 0.9% )Cancer6 ( 0.0% )26 ( 0.1% )32 ( 0.1% )Other108 ( 0.9% )291 ( 1.6% )399 ( 1.3% )

ADULT LUNG TRANSPLANTATION: Distribution of Procedure Type for Major Indications (1994-2009) 2011

Year of TXAlpha-1COPDCystic FibrosisIPFIPAHDoubleSingleDoubleSingleDoubleSingleDoubleSingleDoubleSingle199444.855.218.881.286.913.113.686.464.036.0199545.554.522.078.090.29.828.271.889.310.7199647.352.727.772.186.813.228.171.981.718.3199746.453.627.572.592.67.421.578.590.39.7199848.251.830.269.893.26.819.180.987.013.0199946.653.427.971.991.38.723.376.486.413.6200057.942.129.370.794.25.830.769.393.07.0200159.940.130.269.893.96.131.468.690.010.0200256.443.639.061.096.23.835.065.089.610.4200365.234.843.256.895.64.441.358.795.74.3200473.625.745.854.296.33.744.155.994.55.5200578.022.049.350.697.32.745.954.192.67.4200672.627.458.141.898.51.546.653.4100.00.0200783.616.463.836.297.32.749.150.994.85.2200880.419.665.234.898.41.651.348.793.86.2200986.513.566.533.599.80.251.248.898.61.4

ADULT LUNG TRANSPLANTATIONProcedure Type within Indication, by Year 2011

ADULT LUNG TRANSPLANTATION: Indications for Single Lung Transplants (Transplants: January 1995 - June 2010)*Other includes:Pulmonary Fibrosis, Other:3.4%Sarcoidosis: 1.9%Bronchiectasis: 0.4%Congenital Heart Disease: 0.3%LAM: 0.8%Connective Tissue Disease:1.0%OB (non-ReTx): 0.6%Miscellaneous:0.9% 2011

ADULT LUNG TRANSPLANTATION: Indications for Bilateral/Double Lung Transplants (Transplants: January 1995 - June 2010) *Other includes:Pulmonary Fibrosis, Other:2.9%Sarcoidosis: 3.0%Bronchiectasis: 4.4%Congenital Heart Disease: 1.2%LAM: 1.1%Connective Tissue Disease:1.3%OB (non-ReTx): 1.3%Miscellaneous:1.7% 2011

ADULT LUNG TRANSPLANTATIONMajor Indications By Year (%) 2011

ADULT LUNG TRANSPLANTATIONMajor Indications By Year (Number) 2011

ADULT LUNG TRANSPLANTS:AGE DISTRIBUTION BY LOCATION Transplants between January 2000 and June 2010 2011

ADULT LUNG TRANSPLANTS:DIAGNOSIS DISTRIBUTION BY LOCATION Transplants between January 2000 and June 2010 2011

ADULT LUNG TRANSPLANTS:DONOR AGE DISTRIBUTION BY LOCATION Transplants between January 2000 and June 2010 2011

ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival by Era (Transplants: January 1988 June 2009) 2011

ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Age Group (Transplants: January 1990 June 2009) 2011

ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Gender (Transplants: January 1990 June 2009) 2011

ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival By Diagnosis (Transplants: January 1990 June 2009) 2011

ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival By Diagnosis Conditional on Survival to 3 Months (Transplants: January 1990 June 2009) 2011

ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival By Diagnosis Conditional on Survival to 1 Year (Transplants: January 1990 June 2009) 2011

ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival for Eisenmengers Syndrome (Transplants: January 1990 June 2009) 2011

ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival By Procedure Type(Transplants: January 1990 June 2009) Diagnosis: Alpha-1 Antitrypsin Deficiency 2011

ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival By Procedure Type and Age (Transplants: January 1990 June 2009) Diagnosis: Alpha-1 Antitrypsin Deficiency 2011

ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival by Procedure Type(Transplants: January 1990 June 2009) Diagnosis: Emphysema/COPD 2011

ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival by Procedure Type and Age (Transplants: January 1990 June 2009) Diagnosis: Emphysema/COPD 2011

ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival by Procedure Type (Transplants: January 1990 June 2009)Diagnosis: Idiopathic Pulmonary Fibrosis 2011

ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival by Procedure Type (Transplants: January 1990 June 2009)Diagnosis: Idiopathic Arterial Pulmonary Hypertension 2011

ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival by Procedure Type and Era (Transplants: January 1990 June 2009) Diagnosis: Emphysema/COPD, Single Lung 2011

ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival by Procedure Type and Era (Transplants: January 1990 June 2009) Diagnosis: Emphysema/COPD, Double Lung 2011

ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival by Procedure Type and Era (Transplants: January 1990 June 2009) Diagnosis: Cystic Fibrosis, Double Lung 2011

ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival by Procedure Type and Era (Transplants: January 1990 June 2009) Diagnosis: Idiopathic Pulmonary Fibrosis, Single Lung 2011

ADULT LUNG TRANSPLANTATIONKaplan-Meier Survival by Procedure Type and Era (Transplants: January 1990 June 2009) Diagnosis: Idiopathic Pulmonary Fibrosis, Double Lung 2011

ADULT LUNG TRANSPLANTATION Kaplan-Meier Survival by Donor CMV status/Recipient CMV status (Transplants: October 1999 June 2009) 2011

PERCENTAGE OF ADULT LUNG TRANSPLANT RECIPIENTS Experiencing Rejection between Transplant Discharge and 1-Year Follow-UpStratified by Donor/Recipient CMV status (Follow-ups: July 2004 - June 2010) D(-)/R(-): N = 1,110D(-)/R(+): N = 1,378D(+)/R(-): N = 1,533D(+)/R(+): N = 2,463No comparisons were statistically significant at 0.05Analysis is limited to patients who were alive at the time of the follow-upTreated rejection = Recipient was reported to (1) have at least one acute rejection episode that was treated with an anti-rejection agent; or (2) have been hospitalized for rejection.No rejection = Recipient had (i) no acute rejection episodes and (ii) was reported either as not hospitalized for rejection or did not receive anti-rejection agents.2011

PERCENTAGE OF ADULT LUNG TRANSPLANT RECIPIENTS Experiencing Rejection between Transplant Discharge and 1-Year Follow-Up Stratified by Donor/Recipient CMV status (Follow-ups: July 2004 - June 2010) 18-3435-4950-5960-65>65FemaleMaleNo comparisons were statistically significant at 0.05 except D(+)/R(-) vs. D(+)/R(+): 35-49 (p=0.0147) and 50-59: (p=0.0330)Analysis is limited to patients who were alive at the time of the follow-upTreated rejection = Recipient was reported to (1) have at least one acute rejection episode that was treated with an anti-rejection agent; or (2) have been hospitalized for rejection.No rejection = Recipient had (i) no acute rejection episodes and (ii) was reported either as not hospitalized for rejection or did not receive anti-rejection agents.2011

ADULT LUNG TRANSPLANTS (1997-6/2009) Risk Factors for 1 Year Mortality(N=13,937)*Other = All diagnoses other than COPD, IPAH, IPF, cystic fibrosis, pulmonary fibrosis, bronchiectasis, alpha-1 antitrypsin deficiency, retransplant and LAM. Reference group = COPD/Emphysema, Single lung2011

DIAGNOSISProcedure typeNRelative RiskP-value95% Conf. IntervalIPAHAll3792.06

ADULT LUNG TRANSPLANTS (1997-6/2009) Risk Factors for 1 Year Mortality (N=13,937)2011

TRANSPLANT CHARACTERISTICSNRelative RiskP-value95% Conf. IntervalTransplant year = 1997/1998 vs. 2008/20091,6251.89


DONOR CHARACTERISTICSNRelative RiskP-value95% Conf. IntervalDonor history of diabetes5601.44

(N=13,937)*Other = All diagnoses other than COPD, IPAH, IPF, cystic fibrosis, pulmonary fibrosis, bronchiectasis, alpha-1 antitrypsin deficiency, retransplant and LAM. Reference group = COPD/Emphysema, Single lung2011ADULT LUNG TRANSPLANTS (1997-6/2009) Borderline Significant Risk Factors for 1 Year Mortality

RECIPIENT CHARACTERISTICSNRelative RiskP-value95% Conf. IntervalDiagnosis = Bronchiectasis2731.340.05820.99 -1.80Prior Sternotomy3191.220.08100.98 -1.52Diagnosis = COPD/Emphysema, double lung1,9401.160.05171.00 -1.34Recipient history of diabetes1,7481.110.09270.98 -1.25Chronic steroid use6,6061.090.05061.00 -1.18

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Risk Factors for 1 Year Mortality 2011

Continuous Factors (see figures)Recipient ageBilirubinTransplant center volume Recipient oxygen required at restCardiac outputHeight differenceRecipient FVC % predicted

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Risk Factors for 1 Year MortalityRecipient Age 2011

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Risk Factors for 1 Year MortalityCenter Volume 2011

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Risk Factors for 1 Year MortalityRecipient Pre-Transplant Bilirubin 2011

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Risk Factors for 1 Year MortalityRecipient Oxygen Required at Rest 2011

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Risk Factors for 1 Year MortalityRecipient Pre-Transplant Cardiac Output 2011

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Risk Factors for 1 Year Mortality Height Difference 2011

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Risk Factors for 1 Year Mortality Recipient FVC (% predicted) 2011

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Diagnosis = COPD/EmphysemaRisk Factors for 1 Year Mortality(N=5,057) 2011

RECIPIENT CHARACTERISTICSNRelative RiskP-value95% Confidence IntervalHospitalized (including ICU)2581.89

ADULT LUNG TRANSPLANTS (1/1997-6/2009)Diagnosis = COPD/EmphysemaRisk Factors for 1 Year Mortality 2011

Continuous Factors (see figures)Recipient ageTransplant center volumeRecipient oxygen required at restCardiac output

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Diagnosis = COPD/EmphysemaRisk Factors for 1 Year MortalityRecipient Age 2011

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Diagnosis = COPD/EmphysemaRisk Factors for 1 Year MortalityCenter Volume 2011

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Diagnosis = COPD/Emphysema Risk Factors for 1 Year MortalityRecipient Oxygen Required at Rest 2011

ADULT LUNG TRANSPLANTS (1/1997-6/2009)Diagnosis = COPD/EmphysemaRisk Factors for 1 Year Mortality Recipient Pre-Transplant Cardiac Output 2011

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Diagnosis = IPFRisk Factors for 1 Year Mortality(N=3,455) 2011

RECIPIENT CHARACTERISTICSNRelative RiskP-value95% Confidence IntervalHospitalized (including ICU)3911.93

ADULT LUNG TRANSPLANTS (1/1997-6/2009)Diagnosis = IPFRisk Factors for 1 Year Mortality 2011

Continuous Factors (see figures)Recipient ageCenter volumeDonor heightBilirubinCardiac outputCreatininePCO2Donor weight (borderline)FVC (% predicted) (borderline)Oxygen required at rest (borderline)

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Diagnosis = IPFRisk Factors for 1 Year MortalityRecipient Age 2011

ADULT LUNG TRANSPLANTS (1/1997-6/2009)Diagnosis = IPFRisk Factors for 1 Year MortalityCenter volume 2011

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Diagnosis = IPFRisk Factors for 1 Year MortalityDonor Height 2011

ADULT LUNG TRANSPLANTS (1/1997-6/2009)Diagnosis = IPFRisk Factors for 1 Year MortalityRecipient Bilirubin 2011

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Diagnosis = IPFRisk Factors for 1 Year Mortality Recipient Pre-Transplant Cardiac Output 2011

ADULT LUNG TRANSPLANTS (1/1997-6/2009)Diagnosis = IPFRisk Factors for 1 Year Mortality Recipient Creatinine at Transplant 2011

ADULT LUNG TRANSPLANTS (1/1997-6/2009)Diagnosis = IPFRisk Factors for 1 Year MortalityRecipient PCO2 2011

ADULT LUNG TRANSPLANTS (1/1997-6/2009) Diagnosis = IPFRisk Factors for 1 Year MortalityDonor Weight 2011

ADULT LUNG TRANSPLANTS (1/1997-6/2009)Diagnosis = IPFRisk Factors for 1 Year MortalityRecipient Oxygen Required at Rest 2011

ADULT LUNG TRANSPLANTS (1/1997-6/2009)Diagnosis = IPFRisk Factors for 1 Year MortalityRecipient FVC (% predicted) 2011

(N=8,163) Reference group = COPD/Emphysema, Single lung2011ADULT LUNG TRANSPLANTS (1997-6/2005) Risk Factors for 5 Year Mortality

DIAGNOSISProcedure typeNRelative RiskP-value95% Confidence IntervalRetransplantAll2041.250.03801.01 -1.55COPD/EmphysemaDouble9790.870.02380.78 -0.98Cystic FibrosisAll1,1630.770.00750.64 -0.93LAMAll710.510.00520.32 -0.82


TRANSPLANT CHARACTERISTICSNRelative RiskP-value95% Confidence IntervalTransplant year = 1997/1998 vs. 2003-20051,6251.34


RECIPIENT CHARACTERISTICSNRelative RiskP-value95% Confidence IntervalRecipient on dialysis212.180.00201.33 -3.59IV inotropes472.09

ADULT LUNG TRANSPLANTS (1997-6/2005) Borderline Significant Risk Factors for 5 Year Mortality (N=8,163)Reference diagnosis group = COPD/Emphysema, Single lung2011

TRANSPLANT AND RECIPIENT CHARACTERISTICSNRelative RiskP-value95% Confidence IntervalDiagnosis = Alpha-1 antitrypsin deficiency, single lung2831.190.06020.99 -1.42Transplant year = 2001/2002 vs. 2003-20052,0231.090.05391.00 -1.190-3 HLA mismatches vs. 4-6 mismatches1,0930.920.08400.83 -1.01Female recipient/female donor vs. male recipient/male donor2,3210.870.05210.75 -1.00


Continuous Factors (see figures)Recipient ageRecipient oxygen required at restTransplant center volumeBilirubinCardiac output Donor age (borderline)Recipient FEV1 % predicted (borderline)

ADULT LUNG TRANSPLANTS (1/1997-6/2005) Risk Factors for 5 Year MortalityCenter Volume 2011

ADULT LUNG TRANSPLANTS (1/1997-6/2005) Risk Factors for 5 Year MortalityRecipient Pre-Transplant Bilirubin 2011

ADULT LUNG TRANSPLANTS (1/1997-6/2005) Risk Factors for 5 Year MortalityRecipient Pre-Transplant Cardiac Output 2011

ADULT LUNG TRANSPLANTS (1/1997-6/2005) Risk Factors for 5 Year MortalityDonor Age 2011

ADULT LUNG TRANSPLANTS (1/1997-6/2005) Risk Factors for 5 Year Mortality Recipient FEV1 (% predicted) 2011

ADULT LUNG TRANSPLANTS (1997-6/2005) Risk Factors for 5 Year MortalityConditional on Survival to 1 Year(N=6,305) Reference group = COPD/Emphysema, Single lung2011*Other = All diagnoses other than COPD, IPAH, IPF, cystic fibrosis, pulmonary fibrosis, bronchiectasis, alpha-1 antitrypsin deficiency, retransplant and LAM.

DIAGNOSISProcedure typeNRelative RiskP-value95% Conf. IntervalCOPD/EmphysemaDouble7960.820.01580.71 -0.96IPFDouble3620.670.00230.52 -0.87Alpha-1 antitrypsin deficiencyDouble2540.650.00210.50 -0.86Cystic FibrosisAll9590.59

ADULT LUNG TRANSPLANTS (1997-6/2005) Risk Factors for 5 Year MortalityConditional on Survival to 1 Year (N=6,305)2011

DONOR CHARACTERISTICSNRelative RiskP-value95% Confidence IntervalDonor cause of death = anoxia3730.730.00300.59 -0.90RECIPIENT CHARACTERISTICSPrior sternotomy2271.330.00761.08 -1.64Hospitalized (including ICU)3971.290.00821.07 -1.55Recipient history of diabetes5401.270.00251.09 -1.48Chronic steroid use2,9441.100.04201.00 -1.20Ventilator950.570.01060.37 -0.88

ADULT LUNG TRANSPLANTS (1997-6/2005) Risk Factors for 5 Year MortalityConditional on Survival to 1 Year (N=6,305)2011

TRANSPLANT CHARACTERISTICSNRelative RiskP-value95% Confidence IntervalMismatches at HLA A locus, per mismatch0 A MM (N=393)1 A MM (N=3,216)2 A MM (N=2,696)1.160.03891.01 -1.34Donor CMV +/ Recipient CMV -1,1751.150.00901.04 -1.28Male donor/female recipient vs. male donor/male recipient1,2831.150.03111.01 -1.30POST- TRANSPLANT CHARACTERISTICSOB within 1 year post-transplant4152.18

ADULT LUNG TRANSPLANTS (1997-6/2005) Borderline Significant Risk Factors for 5 Year MortalityConditional on Survival to 1 Year (N=6,305)*Other = All diagnoses other than COPD, IPAH, IPF, cystic fibrosis, pulmonary fibrosis, bronchiectasis, alpha-1 antitrypsin deficiency, retransplant and LAM.Reference group = COPD/Emphysema, Single lung2011

CHARACTERISTICSNRelative RiskP-value95% Confidence IntervalTransplant year = 1997/1998 vs. 2003-20051,2241.120.07670.99 -1.27Induction with IL2R-antagonist1,5460.900.05820.80 -1.00Diagnosis = Other*, double lung1730.750.07050.55 -1.02Diagnosis = Sarcoidosis1620.740.06040.54 -1.01

ADULT LUNG TRANSPLANTS (1/1997-6/2005) Risk Factors for 5 Year MortalityConditional on Survival to 1 Year 2011

Continuous Factors (see figures)Recipient ageTransplant center volumeCardiac output (borderline)Height difference (borderline)Recipient FEV1 % predicted (borderline)

ADULT LUNG TRANSPLANTS (1/1997-6/2005) Risk Factors for 5 Year Mortality Conditional on 1 Year SurvivalRecipient Age 2011

ADULT LUNG TRANSPLANTS (1/1997-6/2005)Risk Factors for 5 Year Mortality Conditional on 1 Year SurvivalCenter Volume 2011

ADULT LUNG TRANSPLANTS (1/1997-6/2005)Risk Factors for 5 Year Mortality Conditional on 1 Year Survival Recipient Pre-Transplant Cardiac Output 2011

ADULT LUNG TRANSPLANTS (1/1997-6/2005)Risk Factors for 5 Year Mortality Conditional on 1 Year SurvivalHeight Difference 2011

ADULT LUNG TRANSPLANTS (1/1997-6/2005)Risk Factors for 5 Year Mortality Conditional on 1 Year Survival Recipient FEV1 (% predicted) 2011

ADULT LUNG TRANSPLANTS (7/1994-6/2000) Risk Factors for 10 Year Mortality(N=4,663) Reference group = COPD/Emphysema, Single lung2011

DIAGNOSISProcedure typeNRelative RiskP-value95% Conf. IntervalRetransplantAll1101.360.01031.07 -1.71Alpha-1 antitrypsin deficiencySingle2621.350.00021.15 -1.57Cystic FibrosisAll6600.820.03570.68 -0.99LAMAll410.600.02860.38 -0.95

ADULT LUNG TRANSPLANTS (7/1994-6/2000) Risk Factors for 10 Year Mortality

(N=4,663)2011

DONOR CHARACTERISTICSNRelative RiskP-value95% Confidence IntervalDonor history of diabetes1001.360.00771.08 -1.70RECIPIENT CHARACTERISTICSIV inotropes531.410.03631.02 -1.96Prior sternotomy1661.380.00041.15 -1.64Ventilator1181.300.04461.01 -1.67PRA 10%901.280.03921.01 -1.63Recipient history of diabetes2541.240.00641.06 -1.45Hospitalized (including ICU)3921.230.00831.05 -1.43

ADULT LUNG TRANSPLANTS (7/1994-6/2000) Risk Factors for 10 Year Mortality (N=4,663)2011

TRANSPLANT CHARACTERISTICSNRelative RiskP-value95% Confidence IntervalDonor CMV +/ Recipient CMV -8261.22

ADULT LUNG TRANSPLANTS (7/1994-6/2000) Borderline Significant Risk Factors for 10 Year Mortality (N=4,663)2011

CHARACTERISTICSNRelative RiskP-value95% Confidence IntervalRecipient on dialysis111.940.06470.96 -3.91Donor cause of death = anoxia1970.860.08160.72 -1.02


Continuous Factors (see figures)Recipient ageTransplant center volumeDonor ageRecipient weightDonor HeightRecipient oxygen required at rest (borderline)

ADULT LUNG TRANSPLANTS (7/1994-6/2000)Risk Factors for 10 Year MortalityCenter Volume 2011

ADULT LUNG TRANSPLANTS (7/1994-6/2000) Risk Factors for 10 Year MortalityDonor Age 2011

ADULT LUNG TRANSPLANTS (7/1994-6/2000) Risk Factors for 10 Year MortalityRecipient Weight 2011

ADULT LUNG TRANSPLANTS (7/1994-6/2000) Risk Factors for 10 Year MortalityDonor Height 2011

ADULT LUNG RECIPIENTSCross-Sectional AnalysisFunctional Status of Surviving Recipients(Follow-ups: April 1994 June 2010) 2011

ADULT LUNG RECIPIENTSFunctional Status of Surviving Recipients (Follow-ups: March 2005 - June 2010)US Recipients Only 2011

ADULT LUNG RECIPIENTSEmployment Status of Surviving Recipients(Follow-ups: April 1994 June 2010) 2011

ADULT LUNG RECIPIENTS: Rehospitalization Post-transplant of Surviving Recipients (Follow-ups: April 1994 - June 2010) 2011

ADULT LUNG RECIPIENTSInduction Immunosuppression (Transplants: January 2002 - June 2010)Analysis limited to patients receiving prednisone

Analysis is limited to patients who were alive at the time of the discharge2011

ADULT LUNG RECIPIENTS Induction Immunosuppression (Transplants: 1997, 2002 and 1/2010-6/2010) Analysis limited to patients receiving prednisone Analysis is limited to patients who were alive at the time of the discharge2011

ADULT LUNG RECIPIENTSInduction Immunosuppression (Transplants: January 2000 - December 2009)Analysis limited to patients receiving prednisone Any Induction Polyclonal ALG/ATG IL-2R Antagonist Alemtuzumab Analysis is limited to patients who were alive at the time of the discharge2011

SURVIVAL BY INDUCTION USAGEFor Adult Lung Recipients (Transplants: April 1994-June 2009)Conditional on survival to 14 days 2011

SURVIVAL BY INDUCTION USAGEFor Adult Lung Recipients (Transplants: January 2000-June 2009)Conditional on survival to 14 days 2011

ADULT LUNG RECIPIENTSMaintenance Immunosuppression at Time of Follow-upFor follow-ups between January 2002 through June 2010Analysis limited to patients receiving prednisoneNOTE: Different patients are analyzed in Year 1 and Year 5 Analysis is limited to patients who were alive at the time of the follow-up2011

ADULT LUNG RECIPIENTSMaintenance Immunosuppression at Time of 1 Year Follow-up (Follow-ups: 2000, 2003, 7/2009 6/2010) Analysis limited to patients receiving prednisone

NOTE: Different patients are analyzed in each time frame. Analysis is limited to patients who were alive at the time of the follow-up2011

ADULT LUNG RECIPIENTS Maintenance Immunosuppression at Time of Follow-upFor follow-ups between January 2002 through June 2010Analysis limited to patients receiving prednisone

1 Year Follow-up (N = 8,457)5 Year Follow-up (N = 3,534)NOTE: Different patients are analyzed in Year 1 and Year 5 Analysis is limited to patients who were alive at the time of the follow-up2011

ADULT LUNG RECIPIENTS Maintenance Immunosuppression Drug Combinations at Time of Follow-upFor follow-ups between January 2002 through June 2010 Analysis limited to patients receiving prednisone Analysis is limited to patients who were alive at the time of the follow-up2011

ADULT LUNG RECIPIENTSKaplan-Meier Survival by Maintenance Immunosuppression Combinations Conditional on Survival to 1 Year (Transplants: January 2000-June 2009) Analysis limited to patients receiving prednisone 2011

ADULT LUNG RECIPIENTSKaplan-Meier Survival by Maintenance Immunosuppression Combinations Conditional on Survival to 1 Year (Transplants: January 2000-June 2009) Analysis limited to patients receiving prednisone Diagnosis: COPD/Emphysema 2011

ADULT LUNG RECIPIENTSKaplan-Meier Survival by Maintenance Immunosuppression Combinations Conditional on Survival to 1 Year (Transplants: January 2000-June 2009) Analysis limited to patients receiving prednisone Diagnosis: Idiopathic Pulmonary Fibrosis 2011

ADULT LUNG RECIPIENTSKaplan-Meier Survival by Maintenance Immunosuppression Combinations Conditional on Survival to 1 Year (Transplants: January 2000-June 2009) Analysis limited to patients receiving prednisone Diagnosis: Cystic Fibrosis 2011

PERCENTAGE OF ADULT LUNG TRANSPLANT RECIPIENTS Experiencing Rejection between Transplant Discharge and 1-Year Follow-Up(Follow-ups: July 1, 2004 - June 30, 2010) Analysis is limited to patients who were alive at the time of the follow-upOverall: N = 7,04918-34: N = 96135-49: N = 1,21550-59: N = 2,35260-65: N = 1,88066+: N = 641Female: N = 3,083 Male: N = 3,966Treated rejection = Recipient was reported to (1) have at least one acute rejection episode that was treated with an anti-rejection agent; or (2) have been hospitalized for rejection.No rejection = Recipient had (i) no acute rejection episodes and (ii) was reported either as not hospitalized for rejection or did not receive anti-rejection agents.2011

PERCENTAGE OF ADULT LUNG TRANSPLANT RECIPIENTS Experiencing Rejection between Transplant Discharge and 1-Year Follow-Up Stratified by Type of Induction (Follow-ups: July 1, 2004 - June 30, 2010) No induction: N = 3,157Polyclonal: N = 686IL-2R Antagonist: N = 2,682Alemtuzumab: N = 477Analysis is limited to patients who were alive at the time of the follow-upTreated rejection = Recipient was reported to (1) have at least one acute rejection episode that was treated with an anti-rejection agent; or (2) have been hospitalized for rejection.No rejection = Recipient had (i) no acute rejection episodes and (ii) was reported either as not hospitalized for rejection or did not receive anti-rejection agents.2011

PERCENTAGE OF ADULT LUNG TRANSPLANT RECIPIENTS Experiencing Rejection between Transplant Discharge and 1-Year Follow-Up Stratified by Type of Induction (Follow-ups: July 1, 2004 - June 30, 2010) 18-34: no induct vs. IL-2R (p=0.0478); poly vs. IL-2R (p=0.0030); IL-2R vs. Alemtuzumab (p=0.0080)35-49: no induct vs. Alemtuzumab (p=0.0069); IL-2R vs. Alemtuzumab (p=0.0027)50-59: no induct vs. IL-2R (p=0.0079)60-65: no induct vs. IL-2R (p=0.0327) 66+: no induct vs. poly (p=0.0007); poly vs. IL-2R (p=0.0004); poly vs. Alemtuzumab (p=0.0011)Analysis is limited to patients who were alive at the time of the follow-upTreated rejection = Recipient was reported to (1) have at least one acute rejection episode that was treated with an anti-rejection agent; or (2) have been hospitalized for rejection.No rejection = Recipient had (i) no acute rejection episodes and (ii) was reported either as not hospitalized for rejection or did not receive anti-rejection agents.2011

PERCENTAGE OF ADULT LUNG TRANSPLANT RECIPIENTS Experiencing Rejection between Transplant Discharge and 1-Year Follow-Up Stratified by Type of Induction (Follow-ups: July 1, 2004 - June 30, 2010) Female: no induct vs. IL2R (p=0.0324); IL-2R vs. Alemtuzumab (p=0.0065)Male: no induct vs.IL-2R (p=0.0016); poly vs. IL-2R (p = 0.0084)Analysis is limited to patients who were alive at the time of the follow-upTreated rejection = Recipient was reported to (1) have at least one acute rejection episode that was treated with an anti-rejection agent; or (2) have been hospitalized for rejection.No rejection = Recipient had (i) no acute rejection episodes and (ii) was reported either as not hospitalized for rejection or did not receive anti-rejection agents.2011

PERCENTAGE OF ADULT LUNG TRANSPLANT RECIPIENTSExperiencing Rejection between Transplant Discharge and 1-Year Follow-UpStratified by Maintenance Immunosuppression (Follow-ups: July 1, 2004 - June 30, 2010) Cyclosporine + MMF: N = 418 Cyclosporine + AZA: N = 610Tacrolimus + MMF: N = 3,474Tacrolimus + AZA: N = 1,755Analysis is limited to patients who were alive at the time of the follow-upTreated rejection = Recipient was reported to (1) have at least one acute rejection episode that was treated with an anti-rejection agent; or (2) have been hospitalized for rejection.No rejection = Recipient had (i) no acute rejection episodes and (ii) was reported either as not hospitalized for rejection or did not receive anti-rejection agents.2011

PERCENTAGE OF ADULT LUNG TRANSPLANT RECIPIENTS Experiencing Rejection between Transplant Discharge and 1-Year Follow-Up Stratified by Maintenance Immunosuppression (Follow-ups: July 1, 2004 - June 30, 2010) Analysis is limited to patients who were alive at the time of the follow-upTreated rejection = Recipient was reported to (1) have at least one acute rejection episode that was treated with an anti-rejection agent; or (2) have been hospitalized for rejection.No rejection = Recipient had (i) no acute rejection episodes and (ii) was reported either as not hospitalized for rejection or did not receive anti-rejection agents.2011All age groups: all comparisons with CyA + AZA are significant at 0.05 except 66+: CyA + AZA vs. CyA + MMF (p=0.0576)35-49: CyA + MMF vs. TAC + MMF( p=0.0399); CyA + MMF vs. TAC + AZA (p=0.0493) 50-59: CyA + MMF vs. TAC + MMF (p=0.0021); TAC + MMF vs. TAC + AZA (p=0.0273) 60-65: CyA + MMF vs. TAC + MMF (p=0.0046); TAC + MMF vs. TAC + AZA (p=0.0007)>65: TAC + MMF vs. TAC + AZA (p=0.0225)

PERCENTAGE OF ADULT LUNG TRANSPLANT RECIPIENTS Experiencing Rejection between Transplant Discharge and 1-Year Follow-Up Stratified by Maintenance Immunosuppression (Follow-ups: July 1, 2004 - June 30, 2010)Females: all comparisons are statistically significant at 0.001 except CyA + MMF vs. TAC + AZA (p=0.2541) Males: all comparisons were statistically significant at 0.02 except CyA + MMF vs. TAC + AZA (p=0.0927) Analysis is limited to patients who were alive at the time of the follow-upTreated rejection = Recipient was reported to (1) have at least one acute rejection episode that was treated with an anti-rejection agent; or (2) have been hospitalized for rejection.No rejection = Recipient had (i) no acute rejection episodes and (ii) was reported either as not hospitalized for rejection or did not receive anti-rejection agents.2011

PERCENTAGE OF ADULT LUNG TRANSPLANT RECIPIENTS Experiencing Rejection between Transplant Discharge and 3-Year Follow-Up Stratified by Maintenance Immunosuppression (Follow-ups: July 1, 2004 - June 30, 2010) Cyclosporine + MMF: N = 222 Cyclosporine + AZA: N = 349Tacrolimus + MMF: N = 1,391Tacrolimus + AZA: N = 889Analysis is limited to patients with rejection or no rejection reported on all three annual follow-ups through 3 yearsTreated rejection = Recipient was reported to (1) have at least one acute rejection episode that was treated with an anti-rejection agent; or (2) have been hospitalized for rejection.No rejection = Recipient had (i) no acute rejection episodes and (ii) was reported either as not hospitalized for rejection or did not receive anti-rejection agents.2011

PERCENTAGE OF ADULT LUNG TRANSPLANT RECIPIENTS Experiencing Rejection between Transplant Discharge and 3-Year Follow-Up Stratified by Maintenance Immunosuppression (Follow-ups: July 1, 2004 - June 30, 2010) Analysis is limited to patients with rejection or no rejection reported on all three annual follow-ups through 3 yearsTreated rejection = Recipient was reported to (1) have at least one acute rejection episode that was treated with an anti-rejection agent; or (2) have been hospitalized for rejection.No rejection = Recipient had (i) no acute rejection episodes and (ii) was reported either as not hospitalized for rejection or did not receive anti-rejection agents.2011All age groups and genders: all comparisons with CyA + AZA are significant at 0.01 except 35-49: CyA + AZA vs. CyA+ MMF (p=0.1019), 66+: CyA + AZA vs. CyA + MMF (p=0.0883) and 66+: CyA + AZA vs. TAC + AZA (p=0.0965)

POST-LUNG TRANSPLANT MORBIDITY FOR ADULTS Cumulative Prevalence in Survivors within 1 Year Post-Transplant (Follow-ups: April 1994 - June 2010) 2011

OutcomeFollow-ups: April 1994 June 2000 Follow-ups: July 2000 June 2010Within 1 YearTotal N with known responseWithin 1 YearTotal N with known responseHypertension49.3%(N = 3,739)53.5%(N = 9,119)Renal Dysfunction23.2%(N = 3,675)24.1%(N = 10,455) Abnormal Creatinine < 2.5 mg/dl12.8%17.9% Creatinine > 2.5 mg/dl8.6%4.5% Chronic Dialysis1.8%1.6% Renal Transplant0.0%0.1%Hyperlipidemia13.2%(N = 3,880)29.3%(N = 9,694)Diabetes16.9%(N = 3,700)29.5%(N = 10,374)Bronchiolitis Obliterans Syndrome 10.7%(N = 3,435)9.1%(N = 9,845)

POST-LUNG TRANSPLANT MORBIDITY FOR ADULTS Cumulative Prevalence in Survivors within 1 and 5 Years Post-Transplant (Follow-ups: April 1994 - June 2010) 2011

OutcomeWithin 1 YearTotal N with known responseWithin 5 YearsTotal N with known responseHypertension52.3%(N = 12,858)83.7%(N = 3,678)Renal Dysfunction23.9%(N = 14,130)33.3%(N = 4,439) Abnormal Creatinine < 2.5 mg/dl16.6%22.7% Creatinine > 2.5 mg/dl5.6%7.7% Chronic Dialysis1.6%2.5% Renal Transplant0.1%0.4%Hyperlipidemia24.7%(N = 13,574)57.5%(N = 4,012)Diabetes26.2%(N = 14,074)39.6%(N = 4,137)Bronchiolitis Obliterans Syndrome 9.5%(N = 13,280)37.9%(N = 3,487)

POST-LUNG TRANSPLANT MORBIDITY FOR ADULTS Cumulative Prevalence in Survivors within 10 Years Post-Transplant (Follow-ups: April 1994 - June 2010) 2011

OutcomeWithin 10 YearsTotal N with known responseRenal Dysfunction39.7%(N = 765) Abnormal Creatinine < 2.5 mg/dl26.3% Creatinine > 2.5 mg/dl4.8% Chronic Dialysis6.5% Renal Transplant2.1%Bronchiolitis Obliterans Syndrome 58.1%(N = 482)

FREEDOM FROM BRONCHIOLITIS OBLITERANS SYNDROME For Adult Lung Recipients (Follow-ups: April 1994-June 2010)Conditional on Survival to 14 days 2011

FREEDOM FROM BRONCHIOLITIS OBLITERANS SYNDROME STRATIFIED BY AGE GROUP For Adult Lung Recipients (Follow-ups: April 1994-June 2010)Conditional on Survival to 14 days 2011

FREEDOM FROM BRONCHIOLITIS OBLITERANS SYNDROME STRATIFIED BY DIAGNOSIS For Adult Lung Recipients (Follow-ups: April 1994-June 2010)Conditional on Survival to 14 days 2011

FREEDOM FROM BRONCHIOLITIS OBLITERANS SYNDROME STRATIFIED BY INDUCTION USEFor Adult Lung Recipients (Follow-ups: April 1994-June 2010)Conditional on Survival to 14 days 2011

FREEDOM FROM BRONCHIOLITIS OBLITERANS SYNDROME STRATIFIED BY INDUCTION USEFor Adult Lung Recipients (Follow-ups: April 1994-June 2010)Conditional on Survival to 1 Year 2011

FREEDOM FROM BRONCHIOLITIS OBLITERANS SYNDROME Stratified by Donor CMV Status/Recipient CMV StatusFor Adult Lung Recipients (Follow-ups: April 1994-June 2010)Conditional on Survival to 14 days 2011

FREEDOM FROM BRONCHIOLITIS OBLITERANS SYNDROME Stratified by Donor CMV Status/Recipient CMV StatusFor Adult Lung Recipients (Follow-ups: April 1994-June 2010)Conditional on Survival to 1 Year 2011

FREEDOM FROM SEVERE RENAL DYSFUNCTION*For Adult Lung Recipients (Follow-ups: April 1994-June 2010) 2011

FREEDOM FROM SEVERE RENAL DYSFUNCTION*For Adult Lung Recipients (Follow-ups: April 1994-June 2010) Conditional on Survival to 1 Year 2011

FREEDOM FROM SEVERE RENAL DYSFUNCTION* by Maintenance Immunosuppression Combinations at DischargeFor Adult Lung Recipients (Transplants : January 2000-June 2009) Analysis limited to patients receiving prednisoneConditional on Survival to 14 days 2011

MALIGNANCY POST-LUNG TRANSPLANTATION FOR ADULTSCumulative Prevalence in Survivors (Follow-ups: April 1994 - June 2010)* Recipients may have experienced more than one type of malignancy so sum of individual malignancy types may be greater than total number with malignancy.Other malignancies reported include: adenocarcinoma (2; 2; 1), bladder (2; 1; 0), lung (2; 4; 0), breast (1; 5; 2); prostate (0; 5; 1), cervical (1; 1; 0); liver (1; 1; 1); colon (1; 1; 0). Numbers in parentheses represent the number of reported cases within each time period. 2011

Malignancy/Type1-Year Survivors5-Year Survivors10-Year SurvivorsNo Malignancy14,023 (96.5%)3,925 (86.8%)571 (72.6%)Malignancy (all types combined)513 (3.5%)597 (13.2%)216 (27.4%)Malignancy Type*Skin149378143Lymph2127234Other13116965Type Not Reported2190

FREEDOM FROM MALIGNANCYFor Adult Lung Recipients (Follow-ups: April 1994-June 2010) 2011

FREEDOM FROM MALIGNANCYFor Adult Lung Recipients (Follow-ups: April 1994-June 2010) Conditional on Survival to 1 Year 2011

ADULT LUNG TRANSPLANT RECIPIENTS: Cause Of Death(Deaths: January 1992- June 2010) 2011

CAUSE OF DEATH0-30 Days (N = 2,204)31 Days 1 Year (N = 3,781) >1 Year 3 Years (N = 3,425)>3 Years 5 Years (N = 1,962 )>5 Years 10 Years (N = 2,336)>10 Years (N = 675) BRONCHIOLITIS7 (0.3%)180 (4.8%)870 (25.4%)566 (28.8%)572 (24.5%)128 (19.0%)ACUTE REJECTION81 (3.7%)70 (1.9%)55 (1.6%)12 (0.6%)18 (0.8%)5 (0.7%)LYMPHOMA1 (0.0%)92 (2.4%)67 (2.0%)36 (1.8%)58 (2.5%)27 (4.0%)MALIGNANCY, OTHER3 (0.1%)112 (3.0%)226 (6.6%)180 (9.2%)289 (12.4%)78 (11.6%)CMV098 (2.6%)32 (0.9%)6 (0.3%)4 (0.2%)1 (0.1%)INFECTION, NON-CMV442 (20.1%)1,334 (35.3%)786 (22.9%)374 (19.1%)417 (17.9%)120 (17.8%)GRAFT FAILURE597 (27.1%)655 (17.3%)660 (19.3%)364 (18.6%)428 (18.3%)111 (16.4%)CARDIOVASCULAR239 (10.8%)168 (4.4%)141 (4.1%)105 (5.4%)122 (5.2%)62 (9.2%)TECHNICAL207 (9.4%)94 (2.5%)22 (0.6%)11 (0.6%)16 (0.7%)9 (1.3%)OTHER627 (28.4%)978 (25.9%)566 (16.5%)308 (15.7%)412 (17.6%)134 (19.9%)

ADULT LUNG TRANSPLANT RECIPIENTS: Relative Incidence of Leading Causes of Death(Deaths: January 1992 - June 2010) 2011

ADULT LUNG TRANSPLANT RECIPIENTS: Cause Of Death Stratified by Donor CMV Status/Recipient CMV Status(Deaths: January 1992- June 2010) 2011

Donor CMV Status/ Recipient CMV StatusCause of Death0-30 Days31 Days 1 Year >1 Year 3 Years>3 Years 5 Years>5 Years 10 Years>10 YearsD(-)/R(-)(N=1,520)BRONCHIOLITIS1 (0.6%)22 (6.0%)96 (24.7%)74 (31.9%)65 (23.9%)17 (20.5%)INFECTION, NON-CMV31 (17.2%)132 (36.2%)93 (24.0%)44 (19.0%)37 (13.6%)14 (16.9%)GRAFT FAILURE55 (30.6%)68 (18.6%)83 (21.4%)49 (21.1%)54 (19.9%)18 (21.7%)D(-)/R(+)(N=2,281)BRONCHIOLITIS3 (1.1%)27 (5.4%)139 (25.7%)94 (24.8%)120 (26.1%)27 (20.9%)INFECTION, NON-CMV60 (21.7%)201 (40.5%)131 (24.2%)90 (23.7%)76 (16.6%)24 (18.6%)GRAFT FAILURE82 (29.6%)81 (16.3%)106 (19.6%)63 (16.6%)92 (20.0%)22 (17.1%)D(+)/R(-)(N=1,943)BRONCHIOLITIS019 (3.2%)118 (23.0%)67 (25.7%)67 (23.8%)4 (6.5%)INFECTION, NON-CMV42 (17.9%)220 (37.2%)118 (23.0%)45 (17.2%)51 (18.1%)20 (32.3%)GRAFT FAILURE68 (28.9%)116 (19.6%)115 (22.5%)58 (22.2%)69 (24.5%)9 (14.5%)D(+)/R(+)(N=3,466)BRONCHIOLITIS1 (0.2%)44 (5.3%)222 (24.7%)148 (27.3%)133 (22.1%)26 (16.7%)INFECTION, NON-CMV84 (19.3%)305 (36.7%)207 (23.1%)104 (19.2%)105 (17.4%)21 (13.5%)GRAFT FAILURE135 (31.0%)178 (21.4%)169 (18.8%)113 (20.8%)130 (21.6%)33 (21.2%)

This figure includes only the lung transplants that are reported to the ISHLT Transplant Registry. Therefore, these numbers should not be interpreted as the rate of change in lung procedures performed worldwide.

The age distribution of lung transplant recipients was compared between the two eras using a chi-square test. A significant p-value means that at least one of the groups is different than the others but it doesnt identify which group it is.The age distribution of donors for lung transplants was compared between the two eras using a chi-square test. A significant p-value means that at least one of the groups is different than the others but it doesnt identify which group it is.

The age distribution of lung transplant recipients was compared between the two eras using a chi-square test.

The age distribution of lung transplant recipients was compared between the eras using a chi-square test. A significant p-value means that at least one of the groups is different than the others but it doesnt identify which group it is.

Survival was calculated using the Kaplan-Meier method, which incorporates information from all transplants for whom any follow-up has been provided. Since many patients are still alive and some patients have been lost to follow-up, the survival rates are estimates rather than exact rates because the time of death is not known for all patients.

The half-life is the estimated time point at which 50% of all of the recipients have died. The conditional half-life is the estimated time point at which 50% of the recipients who survive to at least 1 year have died. Because the decline in survival is greatest during the first year following transplantation, the conditional survival provides a more realistic expectation of survival time for recipients who survive the early post-transplant period.

Survival rates were compared using the log-rank test statistic. A significant p-value means that at least one of the groups is different than the others but it doesnt identify which group it is. NOTE: Transplants with unknown diagnoses are excluded from this tabulation.

NOTE: Transplants with unknown donor age are excluded from this tabulation.Survival was calculated using the Kaplan-Meier method, which incorporates information from all transplants for whom any follow-up has been provided. Since many patients are still alive and some patients have been lost to follow-up, the survival rates are estimates rather than exact rates because the time of death is not known for all patients.

The half-life is the estimated time point at which 50% of all of the recipients have died. The conditional half-life is the estimated time point at which 50% of the recipients who survive to at least 1 year have died. Because the decline in survival is greatest during the first year following transplantation, the conditional survival provides a more realistic expectation of survival time for recipients who survive the early post-transplant period.

Survival rates were compared using the log-rank test statistic. No adjustments were made for multiple comparisons. Survival was calculated using the Kaplan-Meier method, which incorporates information from all transplants for whom any follow-up has been provided. Since many patients are still alive and some patients have been lost to follow-up, the survival rates are estimates rather than exact rates because the time of death is not known for all patients. The half-life is the estimated time point at which 50% of all of the recipients have died.

Survival rates were compared using the log-rank test statistic. No adjustments were made for multiple comparisons. Survival was calculated using the Kaplan-Meier method, which incorporates information from all transplants for whom any follow-up has been provided. Since many patients are still alive and some patients have been lost to follow-up, the survival rates are estimates rather than exact rates because the time of death is not known for all patients. The half-life is the estimated time point at which 50% of all of the recipients have died.

Survival rates were compared using the log-rank test statistic.

Survival was calculated using the Kaplan-Meier method, which incorporates information from all transplants for whom any follow-up has been provided. Since many patients are still alive and some patients have been lost to follow-up, the survival rates are estimates rather than exact rates because the time of death is not known for all patients. The half-life is the estimated time point at which 50% of all of the recipients have died.

Survival rates were compared using the log-rank test statistic. No adjustments were made for multiple comparisons. Only pair-wise comparisons statistically significant at p 0.05 are shown on the slide. Survival was calculated using the Kaplan-Meier method, which incorporates information from all transplants for whom any follow-up has been provided. Since many patients are still alive and some patients have been lost to follow-up, the survival rates are estimates rather than exact rates because the time of death is not known for all patients. The half-life is the estimated time point at which 50% of all of the recipients have died. This figure shows survival conditional on survival to 3 months. Therefore, only patients surviving to at least 3 months were included in the calculation. The conditional half-life is the estimated time point at which 50% of the recipients who survive to at least 3 months have died.

Survival rates were compared using the log-rank test statistic. No adjustments were made for multiple comparisons. Only pair-wise comparisons statistically significant at p 0.05 are shown on the slide.

Survival was calculated using the Kaplan-Meier method, which incorporates information from all transplants for whom any follow-up has been provided. Since many patients are still alive and some patients have been lost to follow-up, the survival rates are estimates rather than exact rates because the time of death is not known for all patients. The half-life is the estimated time point at which 50% of all of the recipients have died. This figure shows survival conditional on survival to 12 months. Therefore, only patients surviving to at least 12 months were included in the calculation. The conditional half-life is the estimated time point at which 50% of the recipients who survive to at least 12 months have died.

Survival rates were compared using the log-rank test statistic. No adjustments were made for multiple comparisons. Only pair-wise comparisons statistically significant at p 0.05 are shown on the slide. Survival was calculated using the Kaplan-Meier method, which incorporates information from all transplants for whom any follow-up has been provided. Since many patients are still alive and some patients have been lost to follow-up, the survival rates are estimates rather than exact rates because the time of death is not known for all patients. The half-life is the estimated time point at which 50% of all of the recipients have died.

Survival rates were compared using the log-rank test statistic.Survival was calculated using the Kaplan-Meier method, which incorporates information from all transplants for whom any follow-up has been provided. Since many patients are still alive and some patients have been lost to follow-up, the survival rates are estimates rather than exact rates because the time of death is not known for all patients. Survival rates were compared using the log-rank test statistic.


Survival rates were compared using the log-rank test statistic. A significant p-value means that at least one of the groups is different than the others but it doesnt identify which group it is.

Survival was calculated using the Kaplan-Meier method, which incorporates information from all transplants for whom any follow-up has been provided. Since many patients are still alive and some patients have been lost to follow-up, the survival rates are estimates rather than exact rates because the time of death is not known for all patients. Survival rates were compared using the log-rank test statistic.






Survival rates were compared using the log-rank test statistic. No adjustments were made for multiple comparisons. Survival was calculated using the Kaplan-Meier method, which incorporates information from all transplants for whom any follow-up has been provided. Since many patients are still alive and some patients have been lost to follow-up, the survival rates are estimates rather than exact rates because the time of death is not known for all patients.





Survival rates were compared using the log-rank test statistic. No adjustments were made for multiple comparisons. Only pair-wise comparisons statistically significant at p 0.05 are shown on the slide. Because of a modification in the data collection, the analysis is limited to follow-ups occurring on or after July 2004

Comparisons were made using the chi-square statistic. No adjustments were made for multiple comparisons.

Because of a modification in the data collection, the analysis is limited to follow-ups occurring on or after July 2004


Multivariable analysis was performed using a proportional hazards model censoring all patients at 1 year. Continuous factors were fit using a restricted cubic spline.

Analyses were limited to transplants having essentially complete information regarding risk factors.























NOTE: A separate model was fit for recipients with a diagnosis of COPD/emphysema.





Analyses were limited to transplants having essentially complete information regarding risk factors.NOTE: A separate model was fit for recipients with a diagnosis of COPD/emphysema.












NOTE: A separate model was fit for recipients with a diagnosis of IPF.



































Multivariable analysis was performed using a proportional hazards model censoring all patients at 5 years. Continuous factors were fit using a restricted cubic spline.


































































This figure shows the functional status reported on the 1-year, 3-year and 5-year annual follow-ups. Because all follow-ups between April 1994 and June 2010 were included, the bars do not include the same patients.

From March 2005 functional status in US is collected using Karnofsky score for adult recipients and Lansky score for pediatric recipients.

This figure shows the functional status reported on the 1-year, 2-year and 3-year annual follow-ups. Because all follow-ups between March 2005 and June 2010 were included, the bars do not include the same patientsThis figure shows the employment status reported on the 1-year, 3-year and 5-year annual follow-ups. Because all follow-ups between April 1994 and June 2010 were included, the bars do not include the same patients.

This figure shows the hospitalizations reported on the 1-year, 3-year, 5-year and 10-year annual follow-ups, representing the hospitalizations between discharge and 1 year, between the 2-year and 3-year follow-up, and between the 4-year and 5-year follow-up, respectively. Because all follow-ups between April 1994 and June 2010 were included, the bars do not include the same patients.


Survival rates were compared using the log-rank test statistic.


Survival rates were compared using the log-rank test statistic.This figure shows the maintenance immunosuppression reported as being provided at the time of the 1-year and 5-year annual follow-up forms. To provide a snapshot of current practice, only follow-ups occurring between January 2002 and June 2010 were included. Therefore, this figure does not represent changes in practice between the 1-year follow-up and 5-year follow-up on a cohort of patients. The patients in the 1-year tabulation are not the same patients as in the 5-year tabulation.

This figure shows the maintenance immunosuppression reported as being provided at the time of the 1-year and 5-year annual follow-up forms. To provide a snapshot of current practice, only follow-ups occurring between January 2002 and June 2010 were included. Therefore, this figure does not represent changes in practice between the 1-year follow-up and 5-year follow-up on a cohort of patients. The patients in the 1-year tabulation are not the same patients as in the 5-year tabulation.

This figure shows the maintenance immunosuppression reported as being provided at the time of the 1-year annual follow-up forms. As different patients were transplanted each year this figure does not represent changes in immunosuppression for individual patients but may represent changes in practice.This figure shows the maintenance immunosuppression reported as being provided at the time of the 1-year and 5-year annual follow-up forms. To provide a snapshot of current practice, only follow-ups occurring between January 2002 and June 2010 were included. Therefore, this figure does not represent changes in practice between the 1-year follow-up and 5-year follow-up on a cohort of patients. The patients in the 1-year tabulation are not the same patients as in the 5-year tabulation.

This figure shows the maintenance immunosuppression reported as being provided at the time of the 1-year and 5-year annual follow-up forms. To provide a snapshot of current practice, only follow-ups occurring between January 2002 and June 2010 were included. Therefore, this figure does not represent changes in practice between the 1-year follow-up and 5-year follow-up on a cohort of patients. The patients in the 1-year tabulation are not the same patients as in the 5-year tabulation.

Survival was calculated using the Kaplan-Meier method, which incorporates information from all transplants for whom any follow-up has been provided. Since many patients are still alive and some patients have been lost to follow-up, the survival rates are estimates rather than exact rates because the time of death is not known for all patients. The cohorts were conditioned on survival to 1 year, so that maintenance immunosuppression combinations use during the first year could be used as a stratification factor.

Survival rates were compared using the log-rank test statistic. A significant p-value means that at least one of the groups is different than the others but it doesnt identify which group it is. Survival was calculated using the Kaplan-Meier method, which incorporates information from all transplants for whom any follow-up has been provided. Since many patients are still alive and some patients have been lost to follow-up, the survival rates are estimates rather than exact rates because the time of death is not known for all patients. The cohorts were conditioned on survival to 1 year, so that maintenance immunosuppression combinations use during the first year could be used as a stratification factor.



Survival rates were compared using the log-rank test statistic. A significant p-value means that at least one of the groups is different than the others but it doesnt identify which group it is. Because of a modification in the data collection, the analysis is limited to follow-ups occurring on or after July 2004.

Comparisons were made using the chi-square statistic. No adjustments were made for multiple comparisons. Only pair-wise comparisons statistically significant at p 0.05 are shown on the slide.

Because of a modification in the data collection, the analysis is limited to follow-ups occurring on or after July 2004.
















This table shows the percentage of patients experiencing various morbidities as reported on the 1-year annual follow-up form. The percentages are based on patients with known responses. Because the outcomes are reported to be unknown at different rates the number with known responses for each outcome are also provided.This table shows the percentage of patients experiencing various morbidities as reported on the 1-year annual follow-up form and within 5 years following transplantation. The percentages are based on patients with known responses. To reduce bias, only patients with responses reported on every follow-up through the 5-year annual follow-up were included in the 5-year analysis. Because the outcomes are reported to be unknown at different rates the number with known responses for each outcome are also provided.This table shows the percentage of patients experiencing various morbidities as reported within 10 years following transplantation. The percentages are based on patients with known responses. To reduce bias, only patients with responses reported on every follow-up through the 10-year annual follow-up were included. Because the outcomes are reported to be unknown at different rates the number with known responses for each outcome are also provided.

Freedom from bronchiolitis obliterans rates were computed using the Kaplan-Meier method.

The development of bronchiolitis obliterans is reported on annual follow-ups; a date of diagnosis is not provided. For this figure the date of follow-up was used as the date of occurrence. Patients were included in the analysis until an unknown response for bronchiolitis obliterans was reported. Therefore, the rates seen here may differ from those reported in the cumulative prevalence slide which is based on only those patients with known responses for bronchiolitis obliterans at all follow-up time points.









Rates were compared using the log-rank test statistic.Freedom from bronchiolitis obliterans rates were computed using the Kaplan-Meier method.


Rates were compared using the log-rank test statistic.Freedom from bronchiolitis obliterans rates were computed using the Kaplan-Meier method.

The development of bronchiolitis obliterans is reported on annual follow-ups; a date of diagnosis is not provided. For this figure the date of follow-up was used as the date of occurrence. Patients were included in the analysis until an unknown response for bronchiolitis obliterans was reported. Therefore, the rates seen here may differ from those reported in the cumulat

lung transplantation

Documents

distribution of transplants

number of lung transplants

year of transplant transplants

era transplants

lung transplantationoverall

donor age distribution

transplant recipient

unknown donor age