the australia and new zealand cardiothoracic organ transplant registry eighteenth annual report 1984...
TRANSCRIPT
THE AUSTRALIA AND NEW ZEALAND CARDIOTHORACIC ORGAN TRANSPLANT REGISTRY
EIGHTEENTH ANNUAL REPORT
1984 – 2013
ANZCOTR 2013
NUMBER OF ALL TRANSPLANT TYPES BY YEAR 1984 - 2013
0
50
100
150
200
84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 0 1 2 3 4 5 6 7 8 9 10 11 12 13
HEARTS HEART-LUNG SINGLE LUNG B-L LUNG
ANZCOTR 2013
NUMBER OF ALL TRANSPLANTS* 1984 - 2013YEAR HEART HEART-LUNG SINGLE LUNG BILATERAL LUNG1984 14 0 0 01985 22 0 0 01986 34 1 0 01987 30 1 0 01988 56 2 0 01989 93 14 0 01990 103 12 5 01991 103 19 18 01992 115 18 27 31993 114 13 24 331994 104 13 26 441995 108 13 28 431996 103 7 32 421997 105 4 43 431998 82 4 38 501999 76 2 27 472000 70 2 28 732001 82 1 29 552002 82 9 29 702003 89 5 20 68 Grand Total all Transplants
2004 78 6 13 912005 89 6 10 792006 80 6 17 882007 68 6 8 782008 90 5 12 1122009 71 2 13 1152010 76 3 10 1232011 76 2 12 1582012 85 4 4 1532013 86 2 5 181
2384 182 478 1749 4793
ANZCOTR 2013*Includes domino, heterotopic and retransplants
ALL HEART TRANSPLANTS BY HOSPITAL 1984 - 2013
St Vincents The Alfred Royal Perth Auckland Prince Charles Royal Childrens Year Totals1984 14 141985 22 221986 34 341987 28 2 301988 49 5 2 561989 50 30 8 5 931990 47 38 6 8 4 1031991 41 33 5 20 4 1031992 36 37 11 22 9 1151993 39 35 8 28 4 1141994 44 25 10 21 4 1041995 41 25 7 7 20 8 1081996 35 24 4 13 24 3 1031997 35 28 5 14 21 2 1051998 26 23 9 10 10 4 821999 19 25 8 10 11 3 762000 20 22 6 13 9 0 702001 17 30 7 15 8 5 822002 19 24 6 8 17 8 822003 14 24 11 22 16 2 892004 28 23 7 4 14 2 782005 26 22 12 13 13 3 892006 19 22 7 8 16 8 802007 18 21 5 9 13 2 682008 27 28 13 8 8 6 902009 19 18 7 11 10 6 712010 27 23 6 11 3 6 762011 24 17 9 11 10 5 762012 25 15 13 12 13 7 852013 25 23 7 9 13 9 86
Totals 868 635 149 263 348 121 2384
HEART LUNG TRANSPLANTS BY HOSPITAL 1986 - 2013
St Vincents The Alfred Royal Perth Auckland Prince Charles Royal Childrens Year Totals1986 1 0 0 0 0 0 11987 1 0 0 0 0 0 11988 1 0 0 0 0 1 21989 11 0 0 0 0 3 141990 6 6 0 0 0 0 121991 5 13 0 0 0 1 191992 8 10 0 0 0 0 181993 6 5 0 0 0 2 131994 6 6 0 0 0 1 131995 9 4 0 0 0 0 131996 4 3 0 0 0 0 71997 3 1 0 0 0 0 41998 4 0 0 0 0 0 41999 0 1 0 0 1 0 22000 2 0 0 0 0 0 22001 0 1 0 0 0 0 12002 2 4 0 0 3 0 92003 1 2 0 0 2 0 52004 3 0 0 0 3 0 62005 1 0 1 0 4 0 62006 1 3 0 0 2 0 62007 3 0 1 0 2 0 62008 1 3 1 0 0 0 52009 0 0 0 0 2 0 22010 0 1 2 0 0 0 32011 0 1 0 0 1 0 22012 3 0 0 0 1 0 42013 1 0 0 0 1 0 2Total 83 64 5 0 22 8 182
ANZCOTR 2013Prince Charles 2005 figure includes one retransplant
SINGLE LUNG TRANSPLANTS BY HOSPITAL 1990 - 2013
St Vincents The Alfred Royal Perth Auckland Prince Charles Royal Childrens Year Totals1990 3 2 0 0 0 0 51991 14 4 0 0 0 0 181992 19 8 0 0 0 0 271993 14 9 0 1 0 0 241994 10 14 0 2 0 0 261995 10 17 0 1 0 0 281996 9 18 0 2 3 0 321997 16 21 0 3 3 0 431998 10 25 0 3 0 0 381999 12 13 0 1 1 0 272000 7 16 0 3 2 0 282001 5 21 0 3 0 0 292002 3 20 0 3 3 0 292003 4 10 0 4 2 0 202004 0 10 1 0 2 0 132005 3 2 4 0 1 0 102006 2 9 3 1 2 0 172007 2 6 0 0 0 0 82008 3 4 4 0 1 0 122009 2 7 2 1 1 0 132010 1 7 0 0 2 0 102011 2 8 2 0 0 0 122012 0 2 2 0 0 0 42013 1 3 1 0 0 0 5
Totals 152 256 19 28 23 0 478
ANZCOTR 2013
BILATERAL LUNG TRANSPLANTS BY HOSPITAL 1992 - 2013
St Vincents The Alfred Royal Perth Auckland Prince Charles Royal Childrens Year Totals1992 2 1 0 0 0 0 31993 14 19 0 0 0 0 331994 21 22 0 1 0 0 441995 18 23 0 2 0 0 431996 23 12 0 6 0 1 421997 13 20 0 1 8 1 431998 17 16 0 2 13 2 501999 13 20 0 6 7 1 472000 29 25 0 9 10 0 732001 28 18 0 8 1 0 552002 28 25 0 5 12 0 702003 28 25 0 10 5 0 682004 31 32 0 9 19 0 912005 28 27 2 8 14 0 792006 32 35 4 9 8 0 882007 25 29 6 9 9 0 782008 40 40 6 12 14 0 1122009 38 49 4 7 17 0 1152010 40 54 7 9 13 0 1232011 43 70 12 10 23 0 1582012 47 57 12 12 25 0 1532013 45 68 11 19 38 0 181Total 603 687 64 154 236 5 1749
ANZCOTR 2013Includes retransplants
COMBINED WAITING LIST ACTIVITY 2013
ANZCOTR 2013*Contains complete calendar year activity from all Registry Participant Centres. nb lungs column includes heart/lung procedures
HEARTS TOTAL LUNGS TOTAL
Active as at 1 January 2013 78 107
New Additions during 2013 105 227
From on hold to Active Jan 2013
Removals from Waiting List (Permanent)
W1 - Transplant Performed 86 188
W2 - Patients condition Improved 5 2
W3 - Too ill, new dev of contraindications etc 12 10
W4 - Patient declined 1 1
W5 - Transferred to another interstate list 1 0
W6 - Died waiting 15 14
W7-Removed - unspecified 0 1
TOTAL at Year end - (Active) 31 December 2013 58 108
Total at month end inactive - (On HOLD) 9 10
PRE TRANSPLANT DIAGNOSISHEART 1984 - 2013
ISCHAEMIC HEART DISEASE 34%
IDIOPATHIC DILATED CARDIOMYOPATHY 40%
Viral CM / Myocarditis 3%
Congenital HD 6%
Other 13%
Retransplant 1%
Peripartum CM 1%
ANZCOTR 2013
Familial CM 2%
PRE TRANSPLANT DIAGNOSIS 1984 - 2013 n = 2384
Pre Transplant Diagnosis (Hearts) Number %Idiopathic Cardiomyopathy (IDCM) 962 40%Ischaemic Heart Disease (IHD) 801 34%Other (eg. Valve disease, adriamycin toxicity,trauma) 323 13%Congenital Heart Disease 133 6%Viral Cardiomyopathy/Myocarditis 63 3%Familial Cardiomyopathy 55 2%Peripartum Cardiomyopathy 24 1%Retransplantation 23 1%Total 2384 100%
ANZCOTR 2013
PRE-TRANSPLANT STATUS HEARTS 1996 -2013
ANZCOTR 2013
PRE-TRANSPLANT STATUS HEARTS 1993 - 2013
ANZCOTR 2013
STATUS - Year 96 97 98 99 0 1 2 3 4 5 6 7 8 9 10 11 12 13
n= 103 105 82 75 70 80 82 88 76 89 79 68 90 71 76 76 84 86
NYHA III % 70 55 57 60 61 64 50 67 50 43 34 44 59 38 60 28 49 35
NYHA IV % 17 24 26 20 29 20 32 16 27 27 28 21 8 21 7 8 13 7
Inotropic support % 9 13 12 15 6 10 12 11 5 3 11 10 8 9 4 9 2 17
Intra-aortic Balloon Pump % 1 1 1 1 0 0 2 1 5 1 0 0 0 0 0 1 0 1
Ventricular Assist Device % 3 7 4 4 4 6 4 5 13 26 27 25 25 32 28 29 35 40
Total Artificial Heart % 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0
DONOR / RECIPIENT STATE OF ORIGIN HEARTS 1984 - 2013
0
100
200
300
400
500
600
700
800
ACT NT NSW QLD VIC SA WA TAS NZ
Recipients 1984-2013 Donors 1984-2013
Number
ANZCOTR 2013
DONOR / RECIPIENT STATE OF ORIGIN HEARTS 1984 - 2013
Location Recipients 84-13 % Donors 84 - 13 % Recipients 2013 % Donors 2013 %
ACT 42 1.8 49 2.1 2 2 1 1.2NT 5 0.2 20 0.9 0 0 1 1.2
NSW 710 29.9 613 26.2 22 26 21 25.0QLD 387 16.3 453 19.3 16 19 15 17.9VIC 594 25.1 507 21.6 24 29 16 19.0SA 104 4.4 214 9.1 1 1 10 11.9WA 184 7.8 162 6.9 7 8 11 13.1TAS 58 2.4 36 1.5 3 4 0 0.0NZ 287 12.1 290 12.4 9 11 9 10.7
TOTALS 2371 100.0 2344 100.0 84 100 84 100.0
ANZCOTR 2013
Mean Waiting Time to TransplantHEARTS 1984 - 2013
0
50
100
150
200
250
84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 0 1 2 3 4 5 6 7 8 9 10 11 12 13
Mean Waiting Time in days
DAYS
YEAR
ANZCOTR 2013
WAITING DAYS TO HEART TRANSPLANT 1984-2013
ANZCOTR 2013
Year n= mean std dev + - median min-max1984 14 44 77 10 4-2951985 19 46 54 19 3-2091986 32 67 76 37 3-2951987 30 61 80 40 3-4241988 56 80 102 33 1-4001989 93 86 87 61 1-4451990 103 99 154 35 1-8421991 103 103 126 57 1-6331992 115 87 119 51 1-7901993 114 116 127 78 1-6261994 104 192 219 128 1-13921995 108 203 236 107 3-16841996 103 171 200 92 2-11441997 105 228 265 127 1-25771998 82 185 219 117 1-12601999 75 236 260 133 1-24112000 70 196 227 120 1-14312001 80 177 212 88 1-20482002 82 148 219 64 1-15022003 88 143 162 91 1-7822004 76 134 176 67 1-9082005 89 159 169 113 2-7922006 79 150 155 102 2-7642007 63 163 180 125 2-9742008 89 171 174 127 1-9762009 68 147 132 103 5-5652010 74 180 232 97 1-11892011 76 171 165 115 1-5862012 84 202 213 139 2-11812013 84 225 298 102 0-1668
Mean Recipient Age at TransplantHEARTS 1984 -2013
0
10
20
30
40
50
84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 0 1 2 3 4 5 6 7 8 9 10 11 12 13
Year
Age(yrs)
ANZCOTR 2013
RECIPIENT AGE AT HEART TRANSPLANT YEARS 1984 - 2013
ANZCOTR 2013
year n mean std dev + - median min-max1984 14 33 15 39 11-511985 19 39 13 38 10-541986 32 40 13 43 11-571987 30 41 12 46 13-561988 56 41 14 45 4-631989 93 42 14 46 1-651990 103 43 15 47 6-651991 103 47 14 52 1-641992 115 45 15 51 4-661993 114 46 14 51 6-651994 104 47 13 50 1-661995 108 46 16 50 2-681996 103 48 13 53 10-641997 105 46 14 50 9-661998 82 46 15 51 1-641999 75 47 15 53 2-672000 70 49 13 53 12-662001 80 45 15 49 2-642002 82 45 18 52 7-702003 88 45 15 47 1-672004 76 47 15 52 9-662005 89 48 14 52 5-652006 79 43 17 49 3-672007 66 46 16 49 5-712008 89 46 17 50 6-672009 68 45 17 48 1-692010 74 47 16 52 5-702011 76 45 17 48 5-722012 84 42 16 47 1-672013 84 42 18 48 1-70
Hearts Mean Donor Age 1984 - 2013
0
5
10
15
20
25
30
35
40
84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 0 1 2 3 4 5 6 7 8 9 10 11 12 13
Year
Age in years
ANZCOTR 2013
DONOR AGE HEARTS - YEARS 1984-2013
ANZCOTR 2013
year n mean std dev +- median min-max1984 14 24 8 23 13-411985 19 24 7 21 15-431986 32 26 7 25 16-391987 30 25 7 24 14-411988 56 25 8 23 12-441989 93 28 11 26 1-501990 103 30 11 28 9-521991 103 30 12 28 5-581992 115 30 12 28 1-561993 114 34 13 32 8-611994 104 34 14 31 1-661995 108 32 14 33 2-591996 103 33 12 33 1-571997 105 35 13 35 12-581998 82 31 13 30 1-621999 75 34 16 32 1-642000 70 33 13 33 5-572001 80 33 14 33 6-582002 82 30 15 25 2-602003 88 35 14 36 8-622004 76 33 14 31 7-592005 89 37 14 39 9-612006 79 31 14 29 5-592007 66 34 15 35 10-592008 89 37 13 40 2-612009 68 33 14 34 5-622010 74 38 12 39 6-602011 76 34 14 33 5-582012 84 34 14 34 4-582013 84 33 15 34 1-57
HEARTS - Mean Ischaemic Time 1984 - 2013
0
50
100
150
200
250
300
84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 0 1 2 3 4 5 6 7 8 9 10 11 12 13
Minutes
YearANZCOTR 2013
MEAN HEART ISCHAEMIC TIME - MINUTES 1984-2013
ANZCOTR 2013
ACTUARIAL SURVIVAL - HEART TRANSPLANT 1984 - 2013
YEAR n* %0 2364 100.01 2004 86.92 1870 84.53 1762 82.44 1653 80.25 1549 78.06 1423 75.07 1319 72.18 1206 69.39 1079 65.8
10 978 63.011 874 60.312 776 57.013 692 55.014 615 51.915 536 48.416 456 44.717 387 42.118 329 39.319 280 37.220 223 35.721 171 33.122 124 30.323 93 28.724 68 27.325 37 24.826 20 23.127 14 21.828 6 19.729 3 15.8
n* = Number alive at start of year
ANZCOTR 2013
ACTUARIAL SURVIVAL - HEART TRANSPLANT 1984 - 2013
0
10
20
30
40
50
60
70
80
90
100
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
Percent Survival
YEAR
ANZCOTR 2013Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ACTUARIAL SURVIVAL – ORTHOTOPIC v HETEROTOPIC v DOMINO TRANSPLANTS 1984 - 2013Orthotopic Heterotopic Domino
YEAR n % n % n %0 2364 100.0 31 100.0 36 100.01 2004 86.9 22 71.0 29 80.62 1870 84.5 19 61.3 28 80.63 1762 82.4 18 58.1 27 77.74 1653 80.2 18 58.1 22 63.35 1549 78.0 17 54.8 21 63.36 1423 75.0 15 54.8 19 57.37 1319 72.1 13 54.8 18 54.38 1206 69.3 11 46.4 18 54.39 1079 65.8 10 42.2 15 48.1
10 978 63.0 9 42.2 15 48.111 874 60.3 8 42.2 15 48.112 776 57.0 7 42.2 13 41.613 692 55.0 4 35.2 13 41.614 615 51.9 2 35.2 13 41.615 536 48.4 1 17.6 13 41.616 456 44.7 12 38.417 387 42.1 12 38.418 329 39.3 10 35.119 280 37.2 8 28.120 223 35.7 6 28.121 171 33.1 5 23.422 124 30.3 4 23.423 93 28.724 68 27.325 37 24.826 20 23.127 14 21.828 6 19.729 3 15.8
ANZCOTR 2013
Actuarial Survival Orthotopic v Heterotopic v Domino Hearts 1984 - 2013
0
20
40
60
80
100
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
Orthotopic Heterotopic Domino
Percent Survival
ANZCOTR 2013
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ACTUARIAL SURVIVAL ALL HEARTS PERIOD COMPARISON 1984 – 2013
0
20
40
60
80
100
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
1984-89 1990-99 2000-09 2010-13
ANZCOTR 2013
Percent Survival
p<0.001
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ACTUARIAL SURVIVAL HEARTS PERIOD COMPARISON 1984 - 2013
1984-1989 1990-1999 2000-2009 2010-2013Year n* % n* % n* % n* %
0 244 100.0 1012 100.0 790 100.0 318 100.01 213 87.3 871 86.1 695 88.0 227 87.02 202 82.8 847 83.7 678 85.8 144 85.13 198 81.1 819 80.9 665 84.2 84 84.44 196 80.3 789 78.0 652 82.5 16 81.15 192 78.7 762 75.3 597 80.86 185 75.8 725 71.6 514 78.77 176 72.1 688 68.0 456 77.48 168 68.9 654 64.6 384 75.99 158 64.8 621 61.4 301 72.710 145 59.4 595 58.8 239 70.811 139 57.0 566 55.9 171 69.112 132 54.1 532 52.9 115 66.313 127 52.0 514 50.8 51 63.914 117 48.0 487 48.1 12 61.915 107 43.9 429 45.116 97 39.8 359 41.917 94 38.5 297 39.218 87 35.7 242 36.619 84 34.4 196 34.420 81 33.2 144 33.021 76 31.1 95 30.322 70 28.7 54 27.623 66 27.0 27 26.324 63 25.8 5 24.725 38 23.426 21 21.927 14 20.628 6 18.729 3 14.930 1 14.9
ANZCOTR 2013*N = NUMBER ALIVE AT START OF YEAR
ACTUARIAL SURVIVAL PRE TRANSPLANT DIAGNOSIS 1984 - 2013
0
20
40
60
80
100
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
IHD IDCM Others
Percent
ANZCOTR 2013
IDCM v IHD p<0.005
IHD v Others p<0.005
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ACTUARIAL SURVIVAL PRE TRANSPLANT DIAGNOSIS HEARTS 1984 – 2013Year IHD IDCM Others
n % n % n %0 801 100.0 970 100.0 595 100.01 669 84.4 835 89.1 502 86.92 634 81.4 773 86.4 464 85.63 610 79.7 721 84.0 435 83.44 578 77.3 668 81.1 408 82.45 545 74.8 631 79.3 375 80.36 503 71.1 584 76.6 337 77.77 466 67.6 543 74.3 311 74.88 431 64.5 487 70.6 288 74.19 383 60.0 448 69.2 249 69.010 349 56.8 408 66.8 222 65.911 316 54.2 369 64.7 191 62.212 268 49.5 341 62.4 170 59.513 243 47.8 303 60.5 146 56.914 210 45.0 278 57.3 128 53.715 181 42.1 243 53.4 112 49.816 154 37.8 209 50.9 93 45.117 126 33.9 186 49.1 79 43.618 106 31.7 160 46.9 63 38.419 82 28.2 140 45.1 58 38.420 68 26.7 110 43.3 47 37.721 51 24.6 84 40.3 36 35.022 32 21.2 65 37.2 27 34.023 24 18.4 51 36.5 18 32.524 18 17.6 39 34.2 11 32.525 6 14.9 22 31.0 10 32.526 2 14.9 13 29.2 6 28.727 1 7.4 9 29.2 4 28.728 1 7.4 3 24.7 2 28.729 1 14.8 2 28.7
ANZCOTR 2013
ACTUARIAL SURVIVAL PRE-TRANSPLANT STATUS HEARTS 1984 - 2013
0
20
40
60
80
100
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
NYHA III NYHA IV INOTROPES IABP All VAD
ANZCOTR 2013
Percent
Survival
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
p=ns
ACTUARIAL SURVIVAL PRE-TRANSPLANT STATUS HEARTS 1984 - 2013
ANZCOTR 2013
NYHA III NYHA IV INOTROPES IABP All VADYear n= % n= % n= % n= % n= %
0 1157 100.0 578 100.0 264 100.0 51 100.0 274 100.01 1004 87.5 495 86.4 225 88.4 43 84.3 218 87.82 959 85.4 463 83.4 214 86.4 43 84.3 181 83.53 909 82.8 450 82.0 205 84.4 41 82.3 156 82.04 849 80.2 437 80.9 197 82.7 38 76.3 128 78.65 799 77.8 420 79.4 187 80.6 37 74.3 105 75.36 733 74.8 402 77.3 171 75.4 35 70.3 82 71.47 680 72.2 377 73.8 156 71.8 35 70.3 70 69.58 622 68.6 346 72.0 145 69.4 34 68.3 55 67.49 570 65.9 308 67.7 133 65.1 33 66.3 33 61.5
10 528 63.3 277 64.1 123 63.1 30 62.2 21 57.111 470 60.6 253 61.7 112 61.0 25 55.8 18 54.212 418 58.2 225 57.3 97 56.5 23 53.5 14 47.913 365 56.1 208 55.4 86 54.1 21 51.1 11 47.914 321 52.8 187 52.2 79 51.5 20 48.7 8 47.915 270 49.0 166 48.5 73 49.5 18 43.8 7 47.916 231 45.3 140 44.8 60 45.2 17 43.8 6 41.017 197 43.0 120 41.5 53 42.9 16 41.2 5 41.018 161 40.0 105 39.0 43 39.5 15 38.6 3 41.019 130 37.6 92 36.7 39 37.6 15 38.6 3 41.020 92 36.2 82 34.6 35 37.6 14 36.1 2 41.021 68 34.1 65 31.5 28 35.3 10 33.2 2 41.022 44 32.3 51 28.4 21 31.2 7 29.523 35 30.7 37 26.5 15 31.2 6 25.324 20 28.5 32 26.5 12 26.9 4 25.325 11 23.5 20 25.5 5 26.9 2 18.126 7 23.5 9 22.2 3 26.9 2 18.127 4 19.6 6 22.2 2 26.9 2 18.128 4 22.2 2 18.129 2 15.9 1 18.130
ACTUARIAL SURVIVAL RECIPIENT AGE BY GENDER HEARTS 1984 - 2013MALES 0-39 FEMALES 0 - 39 MALES >39 FEMALES > 39
Year n= % n= % n= % n= %0 451 100.0 232 100.0 1390 100.0 296 100.01 388 88.3 192 86.4 1178 86.6 249 86.62 356 86.0 185 85.0 1100 83.9 232 84.23 332 83.0 168 79.4 1050 82.3 217 83.84 316 82.0 156 77.0 983 79.4 199 83.45 298 79.9 145 76.0 924 76.9 185 81.76 278 78.0 130 72.7 855 73.5 166 78.57 261 76.6 118 69.3 793 70.4 150 75.18 234 73.2 107 69.3 725 67.0 140 74.09 207 69.3 95 66.0 659 63.7 120 70.710 188 67.3 89 63.2 600 60.9 104 66.411 171 65.4 77 58.7 538 58.2 93 63.812 154 62.7 71 57.2 475 54.7 79 59.513 141 62.2 61 53.0 423 52.5 68 57.914 131 60.4 56 51.2 370 49.1 60 53.515 121 59.5 51 48.4 312 44.5 52 51.616 105 55.9 46 47.4 261 40.5 44 47.517 91 54.2 40 46.4 223 37.3 39 46.418 77 50.5 34 43.9 184 34.5 34 45.119 72 49.1 33 43.9 150 31.9 26 42.220 63 48.4 27 43.9 114 29.8 22 42.221 47 45.0 24 42.2 89 27.3 14 39.922 37 44.0 17 40.2 58 23.8 12 37.023 30 42.7 16 40.2 42 22.9 6 26.424 22 41.1 10 40.2 31 21.6 5 22.025 14 36.7 6 40.2 15 19.8 3 17.126 11 36.7 4 32.9 5 19.8 1 10.327 7 36.7 3 32.9 4 15.928 3 36.7 1 32.9 2 11.329 2 24.5 1 32.930
ANZCOTR 2013*N= NUMBER ALIVE AT START OF YEAR
ACTUARIAL SURVIVAL BY RECIPIENT AGE AND GENDER HEARTS 1984 - 2013
0
20
40
60
80
100
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
MALES 0-39 FEMALES 0-39 MALES >39 FEMALES > 39
ANZCOTR 2013
Percent Survival
MALES 0-39 yrsv MALES>39yrs p<0.005
MALES>39yrs v FEMALES>39yrs p <0.05
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ACTUARIAL SURVIVAL DONOR AGE HEARTS 1984 - 2013
0 - 16 17 - 39 40 - 49 50 -59 >59Year n= % n= % n= % n= % n= %
0 215 100.0 1347 100.0 514 100.0 272 100.0 16 100.01 198 90.1 1176 89.0 422 84.3 211 81.2 9 56.32 174 88.6 1111 87.0 391 81.6 190 76.5 7 43.83 163 85.5 1058 84.9 366 79.3 173 75.3 7 43.84 157 84.0 996 83.0 334 75.5 161 73.9 6 37.55 149 82.3 936 80.7 315 73.4 148 72.5 4 30.76 142 79.5 867 77.7 283 69.8 134 70.0 3 23.07 134 76.7 814 75.2 250 65.3 121 67.8 3 23.08 121 73.2 753 73.1 225 62.3 105 62.1 2 15.39 112 68.9 683 69.6 197 58.6 88 60.8 1 15.3
10 105 67.0 618 66.1 183 57.4 74 56.5 1 15.311 96 65.7 550 62.4 164 56.1 68 56.5 1 15.312 84 64.3 493 58.8 142 52.2 59 53.8 1 15.313 75 62.7 441 56.3 125 51.0 51 52.9 1 15.314 69 60.1 394 53.0 110 48.1 43 49.6 1 15.315 64 58.3 345 49.7 94 44.0 32 43.4 1 15.316 53 54.5 295 45.5 80 40.6 28 43.417 47 51.3 258 43.3 64 36.8 24 41.818 43 50.2 222 40.7 48 33.1 16 35.919 38 47.8 195 39.1 36 28.7 12 33.520 35 47.8 158 37.6 24 25.9 9 33.521 31 47.8 118 34.0 18 24.7 7 33.522 24 44.4 85 30.8 13 24.7 2 26.823 20 42.4 64 28.8 8 24.7 2 26.824 13 39.9 49 27.3 5 24.7 1 26.825 8 39.9 29 24.6 1 24.726 6 39.9 15 22.527 3 39.9 11 20.828 2 39.9 4 18.229 2 39.9 1 12.230 1 39.9
ANZCOTR 2013
*
* 2 OF THE 16 CASES IN THE GREATER THAN 59 YEARS CATEGORY ARE HETEROTOPIC HEART TRANSPLANTS
ACTUARIAL SURVIVAL DONOR AGE HEARTS 1984 - 2013
0
20
40
60
80
100
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
0 - 16 17 - 39 40 - 49 50 -59 >59YEAR
Percent Survival
ANZCOTR 20132 OF THE 11 CASES IN THE GREATER THAN 59 YEARS CATEGORY ARE HETEROTOPIC HEART TRANSPLANTS
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
0-16yrs v 40-49yrs p<0.0010-16yrs v 50-59yrs p<0.00517-39yrs v 40-49yrs p<0.00117-39yrs v 50-59yrs p<0.009
ACTUARIAL SURVIVAL DONOR GENDER HEARTS 1984 - 2013
Female MaleYear n= % n= %
0 755 100.0 1608 100.01 610 83.2 1395 88.72 566 80.8 1306 86.23 528 78.7 1238 84.14 497 77.6 1156 81.35 468 75.8 1083 79.06 421 72.2 1005 76.27 392 70.3 928 72.98 347 67.3 859 70.29 294 62.0 787 67.510 271 60.1 709 64.211 246 58.5 631 61.212 221 56.8 558 57.213 203 55.7 490 54.814 177 52.3 440 51.815 152 48.6 384 48.416 131 45.6 325 44.517 113 43.8 279 41.618 90 40.1 239 39.219 76 36.8 205 37.420 61 35.8 165 35.821 45 33.8 129 33.022 30 30.4 94 30.523 23 29.2 71 28.724 13 27.7 55 27.325 7 27.7 31 24.326 3 22.6 18 23.427 2 22.6 12 21.928 1 22.6 5 19.429 3 19.4
ANZCOTR 2013
ACTUARIAL SURVIVAL DONOR GENDER HEARTS 1984 - 2013
0
20
40
60
80
100
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
Female MaleYear
Percent Survival
ANZCOTR 2013
p=ns
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ACTUARIAL SURVIVAL RECIPIENT GENDER HEARTS 1984 - 2013
Female MaleYear n= % n= %
0 528 100.0 1836 100.01 441 86.5 1565 87.12 416 84.5 1455 84.53 385 81.8 1381 82.54 355 80.5 1299 80.05 330 79.1 1221 77.76 295 75.9 1129 74.77 268 72.5 1052 71.98 247 71.9 959 68.69 215 68.6 865 65.110 193 65.0 787 62.411 169 61.5 707 60.012 150 58.5 629 56.613 128 55.6 564 54.814 116 52.5 500 51.715 103 50.1 433 47.916 90 47.6 366 44.017 79 46.5 312 41.118 68 44.6 261 38.119 58 43.2 222 35.820 49 43.2 176 34.021 38 41.3 135 31.322 29 38.9 95 28.523 22 34.6 71 27.424 15 32.8 53 26.225 9 30.1 29 23.726 5 22.6 16 23.727 3 22.6 11 22.028 1 22.6 5 19.429 1 22.6 2 14.6
ANZCOTR 2013
ACTUARIAL SURVIVAL RECIPIENT GENDER HEARTS 1984 - 2013
0
20
40
60
80
100
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
Female MaleYear
Percent Survival
ANZCOTR 2013
p=ns
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ACTUARIAL SURVIVAL ISCHAEMIC TIME HEARTS 1984 - 2013
<2hrs 2-4 hrs 4-6 hrs >6 hrsYear n= % n= % n= % n= %
0 346 100.0 1141 100.0 695 100.0 166 100.01 296 88.0 981 88.0 581 85.7 138 85.42 277 85.0 923 85.6 534 83.9 130 81.03 265 81.9 872 83.8 501 82.0 120 77.84 255 79.4 808 81.2 469 80.1 113 76.55 245 77.5 758 78.7 434 78.2 106 75.16 228 73.7 697 75.6 395 75.6 99 73.77 217 71.1 644 72.3 361 72.9 91 72.18 202 66.5 589 69.4 327 70.8 81 71.39 189 63.2 532 66.0 282 66.9 71 68.6
10 174 59.1 487 63.4 250 64.5 63 66.511 163 57.4 446 60.3 213 61.7 51 64.212 153 54.6 393 56.7 182 58.1 47 62.913 149 53.9 349 53.7 155 57.4 36 60.014 137 50.2 321 50.9 127 53.9 28 58.115 122 46.8 285 47.7 105 49.8 22 53.716 114 44.1 241 43.5 83 46.8 17 51.017 104 43.3 206 40.5 67 43.2 14 47.818 96 41.2 171 37.6 52 39.0 9 47.819 85 38.6 146 35.7 42 36.6 7 47.820 71 36.7 118 34.4 32 35.6 5 47.821 61 34.0 89 31.9 23 33.1 1 47.822 52 31.1 58 28.6 14 33.123 37 27.8 47 28.0 10 33.124 28 26.9 35 26.0 5 33.125 19 26.9 17 22.3 2 24.826 11 25.2 9 20.7 1 24.827 9 25.2 4 17.7 1 24.828 5 21.8 1 17.729 3 17.030 177 17.0
ANZCOTR 2013
ACTUARIAL SURVIVAL ISCHAEMIC TIME HEARTS 1984 - 2013
0
20
40
60
80
100
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
<2hrs 2-4 hrs 4-6 hrs >6 hrs
ANZCOTR 2013
p=ns
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ACTUARIAL SURVIVAL CROSSMATCH HEARTS 1984 - 2013Positive Negative
Year n= % n= %0 164 100.0 2017 100.01 129 79.8 1728 87.32 120 77.9 1619 84.83 109 74.5 1544 82.94 102 73.8 1469 80.75 95 72.3 1396 78.66 82 68.4 1293 75.67 75 64.1 1202 72.88 72 62.4 1100 69.99 65 58.0 995 66.610 60 54.4 909 63.811 54 52.6 818 61.112 46 47.5 731 58.013 44 47.5 647 55.814 41 47.5 575 52.515 38 44.1 497 49.016 32 40.4 424 45.317 25 36.4 367 42.818 25 36.4 304 39.819 21 30.6 260 38.020 17 30.6 209 36.421 11 26.5 163 33.922 8 26.5 116 30.923 7 26.5 87 29.124 6 26.5 62 27.625 3 21.2 35 25.426 1 21.2 20 23.627 1 21.2 13 22.228 6 20.029 3 16.030 1 16.0 ANZCOTR 2013
ACTUARIAL SURVIVAL CROSSMATCH HEARTS 1984 - 2013
0
20
40
60
80
100
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
Positive NegativeYear
Percent Survival
ANZCOTR 2013
p < 0.01
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ACTUARIAL SURVIVAL PEAK PANEL REACTIVE ANTIBODIES ALL HEARTS 1984 - 2013
Year PRA<15% PRA≥15n= % n= %
0 2136 100.0 221 100.01 1818 87.0 182 85.72 1706 84.5 166 84.23 1613 82.4 154 81.14 1517 80.4 137 76.85 1422 78.2 130 75.16 1305 75.2 121 72.27 1210 72.5 110 67.38 1099 69.5 107 66.79 989 66.2 95 61.610 890 63.2 90 60.311 796 60.8 81 54.912 705 57.4 74 52.213 624 55.3 69 51.414 557 52.4 60 46.915 486 49.0 50 42.816 416 45.4 40 38.317 359 42.8 33 36.218 301 39.7 28 36.219 257 37.3 24 36.220 208 35.8 18 36.221 159 33.1 15 34.122 113 30.1 11 34.123 84 28.3 10 34.124 59 27.2 9 30.725 30 24.3 8 30.726 18 23.3 3 25.627 11 21.7 3 25.628 5 19.2 1 25.629 2 14.4 1 25.630 1 25.6 ANZCOTR 2013
ACTUARIAL SURVIVAL PEAK PRA ALL HEARTS 1984 - 2013
0
20
40
60
80
100
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
PRA<15% PRA>=15%Year
Percent Survival
ANZCOTR 2013
p=ns
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ACTUARIAL SURVIVAL CMV STATUS HEARTS 1984 - 2013
Donor Neg Rec Neg
Donor Pos Rec Neg
Recipient Pos
Year n= % n= % n= %0 376 100.0 418 100.0 1528 100.01 317 87.8 350 85.7 1307 87.32 294 85.5 325 82.7 1225 84.93 280 84.1 306 80.9 1158 82.94 265 81.0 285 79.0 1082 80.85 252 80.1 273 76.8 1008 78.46 233 78.1 254 73.4 922 75.17 218 76.1 232 70.4 859 72.38 201 74.3 216 68.2 779 69.19 186 72.0 197 65.3 690 65.410 168 67.3 179 64.0 627 62.611 152 64.8 158 61.7 562 59.712 130 60.8 142 59.7 501 56.213 115 57.9 122 57.9 450 54.314 97 53.2 113 56.5 403 51.115 90 52.1 99 53.4 343 46.916 80 49.7 87 50.6 287 42.817 72 47.7 71 46.3 248 40.518 66 45.1 58 44.2 203 37.419 60 43.6 50 40.3 169 35.420 46 42.0 42 40.3 136 33.621 30 37.8 32 39.2 110 31.022 19 33.5 27 39.2 76 27.823 14 33.5 21 39.2 57 25.424 12 31.0 12 36.9 42 24.425 5 24.5 7 36.9 24 22.326 3 19.0 4 36.9 12 21.127 2 19.0 1 36.9 9 19.228 2 19.0 2 19.229 1 19.230
ANZCOTR 2013
ACTUARIAL SURVIVAL CMV STATUS HEARTS 1984 - 2013
0
20
40
60
80
100
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
R-ve/D-ve R-ve/D+ve R+veYear
Percent Survival
ANZCOTR 2013
p=ns
R+ve = R+veD+ve or R+veD-ve
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ACTUARIAL SURVIVAL HLA MISMATCH HEARTS 1984 - 2013
ANZCOTR 2013
Year MM0 MM1 MM2 MM3 MM4 MM5 MM6
n= % n= % n= % n= % n= % n= % n= %
0 2 100.0 5 100.0 33 100.0 115 100.0 351 100.0 812 100.0 1046 100.01 2 50.0 5 100.0 26 78.8 103 90.4 296 85.4 703 89.7 872 85.12 1 0.0 4 100.0 26 78.8 96 89.5 280 83.6 653 87.3 813 82.33 3 100.0 26 78.8 92 87.6 268 83.0 609 84.9 769 79.84 3 100.0 26 78.8 91 87.6 248 81.1 576 82.9 710 76.95 3 66.7 23 75.6 86 84.7 226 78.1 547 81.2 667 74.86 2 66.7 23 75.6 83 82.7 205 74.2 502 78.2 614 71.97 2 66.7 22 72.3 73 78.6 192 72.0 463 74.5 570 69.58 2 66.7 20 69.0 69 77.5 165 66.2 430 72.1 520 67.29 2 66.7 19 65.5 64 75.2 154 62.6 388 68.4 454 63.910 1 66.7 18 65.5 56 72.7 141 58.8 359 65.1 406 61.511 1 66.7 15 61.7 52 71.4 124 55.8 321 61.5 366 59.612 1 66.7 14 57.6 48 67.2 115 54.4 287 58.7 314 55.213 1 66.7 13 53.5 47 67.2 108 53.0 250 56.4 274 53.214 1 66.7 11 49.2 42 65.7 97 49.5 222 53.4 244 50.015 1 66.7 11 49.2 37 64.1 83 43.8 192 49.6 212 47.316 1 66.7 8 39.8 32 62.3 70 39.4 163 46.1 182 43.817 1 66.7 8 39.8 28 58.2 59 35.9 138 43.4 159 41.818 1 66.7 7 39.8 25 56.1 53 34.7 112 38.8 131 39.519 1 66.7 5 39.8 24 56.1 48 34.7 94 35.9 109 36.720 1 66.7 4 39.8 19 56.1 34 32.2 77 34.3 91 35.621 1 66.7 4 39.8 13 49.5 26 31.2 63 33.3 67 31.422 4 39.8 8 40.9 19 29.8 45 30.4 48 29.223 4 39.8 4 40.9 15 28.1 34 28.2 37 27.9
24 2 39.8 2 40.9 12 26.1 23 27.2 29 26.325 1 19.9 8 23.6 14 24.4 15 25.126 5 20.2 9 24.4 7 22.927 3 15.7 6 24.4 5 22.928 1 15.7 3 19.5 2 22.929 2 19.5 1 11.5
ACTUARIAL SURVIVAL HLA MISMATCH HEARTS 1984 - 2013
0
20
40
60
80
100
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
MM0 MM1 MM2 MM3 MM4 MM5 MM6Year
Percent Survival
ANZCOTR 2013
p<0.05
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ACTUARIAL SURVIVAL HLA DR LOCUS MISMATCH HEARTS 1984 - 2013
Year MM0 MM1 MM2n= % n= % n= %
0 72 100.0 484 100.0 1808 100.01 61 86.0 42 89.5 1526 86.32 55 83.1 389 87.5 1429 83.73 48 78.4 374 86.4 1345 81.54 47 78.4 356 85.2 1251 78.95 45 76.7 326 82.0 1181 76.96 40 69.8 304 79.7 1083 73.97 36 68.0 284 77.3 1002 70.88 34 68.0 257 73.4 915 68.29 31 63.9 235 69.6 815 64.9
10 30 63.9 213 66.0 738 62.111 26 61.7 191 62.8 662 59.612 23 56.9 171 59.1 585 56.413 22 54.4 157 57.7 514 54.314 20 51.9 139 53.9 458 51.415 20 51.9 122 51.1 394 47.616 16 46.4 102 46.3 338 44.317 15 46.4 91 43.5 287 41.718 13 43.2 77 40.0 239 39.119 12 43.2 68 39.0 201 36.520 11 43.2 49 37.0 166 35.121 9 43.2 39 34.6 126 32.422 5 32.4 32 33.6 87 29.523 5 32.4 24 31.3 65 27.924 3 32.4 15 29.7 50 26.525 1 19.4 9 27.3 28 24.626 4 23.4 17 23.527 4 23.4 10 21.828 3 17.6 3 21.829 1 17.6 2 14.530 1 14.5 ANZCOTR 2013
ACTUARIAL SURVIVAL HLA DR LOCUS MISMATCH HEARTS 1984 - 2013
0
20
40
60
80
100
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
MM0 MM1 MM2Year
Percent Survival
ANZCOTR 2013
p= ns
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ACTUARIAL SURVIVAL MALIGNANCIES HEART 1984 - 2013
Year PTLD
OTHER MALIGNANCIES
(invasive skin/other)n= % n= %
0 95 100.0 501 100.01 89 93.7 493 98.42 87 91.6 485 97.03 84 88.4 478 96.04 75 81.0 460 93.05 72 78.8 442 89.96 67 74.4 416 85.27 58 65.4 395 81.98 56 63.2 373 78.09 50 57.5 348 74.0
10 46 52.9 323 69.911 40 47.1 300 66.412 36 42.4 275 62.613 36 42.4 259 60.514 33 38.8 239 56.815 28 35.2 209 52.116 25 31.4 175 46.517 20 27.5 151 41.618 15 23.2 127 38.219 11 19.8 104 34.120 11 19.8 79 32.321 9 18.0 57 27.522 7 18.0 41 23.823 7 18.0 31 21.324 5 18.0 21 19.725 3 18.0 13 18.626 3 18.0 6 16.727 2 18.0 4 16.728 2 18.0 2 16.7
ANZCOTR 2013*Survival of the group who were defined by having developed a malignancy
ACTUARIAL SURVIVAL MALIGNANCIES HEARTS 1984 - 2013
0102030405060708090
100
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28
PTLD OTHER MALIGNANCIES Year
Percent Survival
ANZCOTR 2013
ptld v other mal p=<0.005
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
RECIPIENT CAUSE OF DEATH - HEARTS1984 - 2013 n = 1114
0
50
100
150
200
250
300
TxCAD Misc Infection Acute Rejection
Other Malignancies
PTLD CVA Hemorrhage
No of Deaths
ANZCOTR 2013
18%
27%
14%
10%15%
4%
4%1%
NSGF
7%
CAUSE OF DEATH HEARTS 1984 - 2013 Transplant Coronary Artery Disease (TxCAD) 201Other Malignancy (non PTLD) 171Infection 153Acute Rejection 106Non-specific Graft Failure (NSGF) 83PTLD 45CVA 42Hemorrage 15
OTHER TOTAL(incl unspecified) 298Renal Failure 60Sudden Death 30Multi-organ Failure 29Cardiac Arrest/MI 29Heart Failure 17TxCAD + Rejection 16Pulmonary/Resp Failure 12Non-compliance 9Suicide 7Pancreatitis 7Motor Vehicle Accident 6
Total all Deaths = 1114 Liver Failure 5Bowel Ischaemia 5Post Surgical Complication 5Right Ventricular Failure 4Pulmonary Hypertension 3Pulmonary Embolism 3Drug Overdose 2Aortic Dessection (Marfan's) 2
congenital bronchomalacia (1), pericarditis(1), peripheral vascular disease(3), anoxic brain/head inj(2)acute abdomen (2), myelodysplasia (1), esophogeal perforation (1)drug induced lung damage (1)esophageal diverticulum (1) COPD (3) Hepatic Encephalopathy (2) Gen. deterioration (4)amyloidosis (1), Parkinson's(1),mesenteric ischemia(1), died on table(2) aortic aneurism(2)Brain stem bleed (2), dissenting myopathy (1), stroke (2), Motor Neuron Disease (1)
Unspecified (data pending) 13
ANZCOTR 2013
CAUSE OF DEATH ALL HEARTS <5 YEARS AFTER TX 1984-2013
ANZCOTR 2013
No %
Infection 108 22
Misc (incl 4 no data 87 17
Rejection 86 17
Non Specific Graft Failure 67 14
Graft Atherosclerosis (TxCAD) 56 11
Non Lymphoid Malignancy 30 6
Lymphoproliferative Disease 13 3
CVA 20 4
Haemorrhage 12 2
Graft Atherosclerosis & Rejection 9 2
Pulmonary Failure 6 1
Pulmonary Hypertension 2 1
Totals 495 100.0
CAUSE OF DEATH ALL HEARTS ≥5 YEARS AFTER TX 1984-2013
No %
Misc (incl data pending) 178 29
Graft Atherosclerosis (TxCAD) 145 23
Non Lymphoid Malignancy 141 23
Infection 45 7
Lymphoproliferative Disease 32 5
Rejection 20 3
CVA 22 4
Non Specific Graft Failure 16 3
Pulmonary Failure 6 1
Haemorrhage 3 0.5
Graft Atherosclerosis & Rejection 7 1
Pulmonary Hypertension 1 0.5
Totals 619 100.0
ANZCOTR 2013
MALIGNANCIES* - HEART n = 596 1984 - 2013
PTLD 16 %
Other 84 %
ANZCOTR 2013
*the count of initial diagnosis only
MALIGNANCIES - HEART N=596 1984 - 2013PTLD 95 95/2364=4%Skin
Metastatic SCC 241 355/2364=15%Melanoma 35BCC 72Spindle Cell 2Merkle Cell 3Dermatofibrosarcoma 2
355
Other 146/2364=6.2%Lung 32Bowel 18Prostate 16Liver 11Renal 7Bladder 6Tonsil/throat/tongue 5Parotid 4Oesophagus 4Mesothelioma 4Pancreas 4Cervix 3Thyroid/Parathyroid 3Breast 3Larynx 2Caecum 2Testicle 2Carcinoid Tumour 1Ear/Face/Neck 1Brain 1Uterus 1Endometrium 1Leiomyosarcoma 1Leukaemia 1Liposarcoma 1Mediastinum 1Neuroblastoma 1Pituitary 1Seminoma 1Bone 1Unspecified 7 ANZCOTR 2013
Reason for Transplant Heart Lung 1986 - 2013
PPH 26%
Eisenmenger’s 21%
Other PH 3%
AAT deficiency 7%
Emphysema 3%
Congenital Heart Disease 14%
Cystic Fibrosis 14%
CFA 3%Bronchiectasis 2%
Misc 7%
ANZCOTR 2013
REASON FOR TRANSPLANT HEART LUNG n = 182 1986 - 2013
ANZCOTR 2013
Primary Pulmonary Hypertension 47 Eisenmenger's Syndrome 37 Congenital Heart Disease 26Cystic Fibrosis 25Alpha-1-Antitrypsin Deficiency 13Emphysema 6Cryptogenic Fibrosing Alveolitis 5Other Pulmonary Hypertension 6Bronchiectasis 4Miscellaneous 13
Total 182
Reason for Transplant Single Lung 1990 - 2013
AAT 16%
Emphysema 51%
IPF 25%
Misc 6%
Bronchiectasis 1%
Other PH / Eisenmengers / CF 1%
ANZCOTR 2013
REASON FOR TRANSPLANT SINGLE LUNG 1990 - 2013 n = 476
Emphysema 242Idiopathic Pulmonary Fibrosis 119Alpha-1-Antitrypsin Deficiency 74*Miscellaneous lung 31Bronchiectasis 5Other Pulmonary Hypertension 2Eisenmenger's Syndrome 1Cystic Fibrosis 1*Lymphangioleiomyomatosis(5), OB(4), PLAM(4), sarcoidosis(3),
pulmonary eosinophillic granulomatosis(2), allergic alveolitis(3), tuberous sclerosis(2),
severe air f low obstruction(1), Histiocytosis X(2), alveolar cell sarcoma(1), asthma(1),
Agammaglobulinaemia(1), hypersensitive pneuminitis(1) UIP(1), LIP(1)
ANZCOTR 2013
Reason for TransplantBilateral Lung 1992 – 2013 n =1704
Cystic Fibrosis 33%
Emphysema 27%
IPF 10%
Bronchiectasis 8%
Misc 9% AAT 7%Other PH 1%
PPH 4%
ANZCOTR 2013
Eisenmengers 1%
REASON FOR TRANSPLANT BILATERAL LUNG 1992 - 2013 n = 1704
Cystic Fibrosis 568Emphysema 452Idiopathic Pulmonary Fibrosis 173Bronchiectasis 137Alpha-1-Antitrypsin Deficiency 118Primary Pulmonary Hypertension 70Other Pulmonary Hypertension 18Eisenmengers Syndrome 10*Miscellaneous lung 158* ILD(50), OB(24), sarcoidosis(24), PLAM (21), histiocytosis X(8), asthma (7), alveolitis(6), 1704eosinophilic granulomatosis(3), ARDS(3), silicosis(1), diffuse alveolar damage(2),
cystic lung disease (2), x -linked hypogammaglobulinemia(2), graft v host(1),
viral pneumonia(1), Wegeners granulomatosis(1), surficant c deficiency(1),
alveolar proteinosis(1), microlithiasis(1), pulmonary veno occlusive disease(1),
pulmonary capillary hemangiomatosis (1) hypersensitive pneumonitis(1)
ANZCOTR 2013
Donor / Recipient State of Origin All Lungs 1986 - 2013
0100200300400500600700800
Recipients 86 - 13 Donors 86 - 13
ANZCOTR 2013
Number
*Retransplants and unknown state of origins are not included
DONOR / RECIPIENT STATE OF ORIGIN ALL LUNGS 1986 - 2013
Location Recipients 86-13 % Donors 86-13 % Recipients 13 % Donors 13 %
ACT 23 1.0 53 2.2 1 0.6 2 1.1NT 4 0.2 30 1.3 0 0.0 3 1.7
NSW 694 29.5 621 26.3 47 26.1 42 23.3QLD 324 13.8 371 15.7 34 18.9 35 19.4VIC 678 28.8 580 24.6 49 27.2 42 23.3SA 163 6.9 226 9.6 11 6.1 12 6.7WA 191 8.1 172 7.3 11 6.1 21 11.7TAS 88 3.7 57 2.4 8 4.4 4 2.2NZ 186 7.9 248 10.5 19 10.6 19 10.6
Norfolk Isl 1 0.0 0 0 0 0.0 0 0.0
Total 2352 100.0 2358 100.0 180 100.0 180 100.0
ANZCOTR 2013*Retransplants and unknown state of origins are not included
Mean Wait to Transplant All Lungs 1990 - 2013
0
50
100
150
200
250
300
90 92 94 96 98 0 2 4 6 8 10 12
mean wait in days
Days
Year
ANZCOTR 2013
MEAN WAITING TIME TO LUNG
TRANSPLANT – DAYS 1990 - 2013year n mean std dev median min-max1990 17 194 168 136 2-5001991 37 273 234 202 5-10341992 48 209 217 148 1-10751993 70 211 259 119 7-23251994 83 272 239 201 8-10481995 84 297 295 165 8-16791996 81 205 205 132 7-10091997 90 260 251 166 6-18391998 92 215 178 186 1-12211999 76 242 204 195 7-9392000 103 197 199 135 1-9002001 85 241 231 169 1-11992002 108 226 215 161 7-13332003 91 221 217 163 3-13362004 109 285 256 197 4-15452005 92 211 239 130 5-13502006 108 188 221 119 0-11462007 87 192 195 130 6-14942008 120 228 244 130 1-28642009 125 234 261 125 1-13222010 130 221 216 149 0-12972011 166 197 225 108 1-16012012 156 186 216 120 0-11952013 180 161 202 91 0-1302
ANZCOTR 2013
Mean Recipient Age at Transplant LUNGS 1989 - 2013
0
10
20
30
40
50
60
70
89 90 91 92 93 94 95 96 97 98 99 0 1 2 3 4 5 6 7 8 9 10 11 12 13
HLTx SLTx BSLTx
ANZCOTR 2013
Age in Years
MEAN RECIPIENT AGE AT LUNG TRANSPLANT 1989 - 2013
HLTx SLTx BSLTxyear n mean std dev min-max year n mean std dev min-max year n mean std dev min-max1989 32 12 11-46 1989 19891990 37 10 20-51 1990 48 5 42-55 19901991 34 11 19-46 1991 46 8 32-57 19911992 31 12 15-49 1992 46 7 26-57 1992 3 34 17 19-521993 31 13 12-48 1993 51 3 46-57 1993 33 34 13 19-561994 32 10 14-46 1994 49 6 30-57 1994 44 36 10 19-541995 38 11 24-52 1995 51 7 22-59 1995 43 35 13 16-601996 26 6 18-37 1996 54 6 30-60 1996 42 39 14 13-601997 36 9 23-42 1997 51 6 35-62 1997 43 37 14 14-611998 4 26 14 13-43 1998 38 51 9 30-65 1998 50 38 14 14-601999 2 38 na 22-53 1999 27 55 7 37-64 1999 47 36 13 15-622000 2 34 na 22-46 2000 28 55 6 39-65 2000 73 40 13 14-632001 1 40 na 40 2001 29 56 9 32-69 2001 55 38 14 13-602002 9 35 10 22-49 2002 29 57 5 43-66 2002 70 39 14 14-652003 5 36 18 13-55 2003 21 57 7 42-66 2003 65 41 15 17-642004 6 36 10 21-47 2004 13 56 6 48-64 2004 90 44 14 15-652005 5 37 8 25-46 2005 10 61 3 57-66 2005 77 44 14 16-642006 6 25 14 9-45 2006 17 54 7 34-60 2006 85 45 16 15-662007 6 38 12 15-48 2007 8 57 5 50-64 2007 73 45 15 9-632008 5 36 9 25-45 2008 11 60 4 54-68 2008 106 44 15 15-692009 2 30 na 29-31 2009 12 58 14 14-67 2009 111 46 15 11-642010 3 37 18 17-51 2010 10 58 6 42-64 2010 117 45 16 11-692011 2 54 na 50-57 2011 12 59 5 53-68 2011 152 47 16 7-692012 4 25 9 18-37 2012 3 57 9 47-63 2012 149 47 15 12-692013 2 38 na 27-49 2013 5 62 5 56-67 2013 173 49 14 14-67
ANZCOTR 2013
Mean Donor Age at Transplant ALL LUNGS 1989 - 2013
0
10
20
30
40
50
60
89 90 91 92 93 94 95 96 97 98 99 0 1 2 3 4 5 6 7 8 9 10 11 12 13
HLTx SLTx BSLTx
ANZCOTR 2013
Years of Age
MEAN DONOR AGE AT TRANSPLANT LUNGS 1989 - 2013
HLTx SLTx BSLTxyear n mean std dev min-max year n mean std dev min-max year n mean std dev min-max1989 14 23 11 11-43 1989 19891990 12 25 10 12-47 1990 5 32 12 18-49 19901991 19 29 7 17-43 1991 18 30 11 15-53 19911992 18 26 11 11-44 1992 27 34 9 18-50 1992 3 21 3 18-241993 13 27 14 10-55 1993 24 32 12 14-55 1993 33 31 13 15-551994 13 33 13 15-53 1994 26 29 9 17-50 1994 44 33 13 12-551995 13 33 13 10-50 1995 28 33 12 18-56 1995 43 33 12 9-581996 7 32 16 14-49 1996 32 38 12 14-54 1996 42 34 12 10-601997 4 31 13 17-45 1997 43 37 13 12-56 1997 43 33 14 12-551998 4 32 15 16-51 1998 38 35 13 16-58 1998 50 35 13 10-621999 2 53 na 51-55 1999 27 37 17 15-62 1999 47 40 14 14-592000 2 21 na 15-26 2000 28 41 17 17-66 2000 73 38 13 11-612001 1 50 na 50-50 2001 29 35 13 16-53 2001 55 33 15 10-592002 9 37 12 18-50 2002 29 35 13 12-62 2002 70 36 16 7-642003 5 35 16 8-49 2003 21 40 15 18-61 2003 65 35 14 8-622004 6 37 16 12-52 2004 13 33 13 19-56 2004 88 36 15 7-642005 5 33 18 11-58 2005 10 32 14 13-47 2005 77 40 13 9-642006 6 20 16 7-48 2006 17 41 18 13-64 2006 85 35 15 11-622007 6 28 16 13-50 2007 8 47 19 17-61 2007 73 37 15 10-622008 5 39 18 17-58 2008 11 40 12 19-56 2008 106 38 15 9-672009 2 33 na 15-50 2009 12 34 19 16-62 2009 111 39 16 15-652010 3 37 18 17-51 2010 10 58 6 42-64 2010 117 42 15 5-702011 2 53 na 46-60 2011 12 59 5 53-68 2011 149 43 17 8-722012 4 34 11 23-43 2012 3 21 3 18-23 2012 150 44 16 11-732013 2 39 na 30-47 2013 5 28 10 18-41 2013 173 43 17 9-74
ANZCOTR 2013
LUNGS MEAN ISCHAEMIC TIME 1989 - 2013
0
100
200
300
400
500
89 90 91 92 93 94 95 96 97 98 99 0 1 2 3 4 5 6 7 8 9 10 11 12 13
SLTx BSLTx HLTx
ANZCOTR 2013
Minutes
LUNGS - MEAN ISCHAEMIC TIME 1989 - 2013 MINUTES
HLTx SLTx BSLTxyear mean std dev min-max mean std dev min-max mean std dev min-max1989 144 40 99-2071990 230 103 103-408 238 47 180-3101991 264 144 98-705 226 108 18-4501992 274 100 107-419 282 107 103-455 425 52 390-4851993 258 89 167-413 315 124 155-543 420 85 221-5681994 257 99 137-500 280 109 110-465 382 127 195-6551995 211 61 130-310 304 94 144-485 362 117 180-6001996 279 116 188-496 276 123 105-515 342 127 157-6561997 270 146 144-472 290 117 110-525 361 135 100-6751998 205 50 144-251 332 141 97-740 379 123 160-6231999 366 na 350-381 306 111 138-560 346 108 121-5792000 355 na 199-510 346 153 93-612 357 123 144-6552001 455 na 455-455 351 133 117-623 383 122 198-8152002 337 108 186-456 335 128 99-564 367 125 156-8502003 293 146 118-460 344 123 122-510 377 112 185-6352004 315 115 168-448 331 193 155-735 324 109 150-7352005 281 174 112-509 304 111 141-452 327 84 131-5402006 278 105 161-402 304 146 120-532 327 104 95-6252007 231 49 176-308 292 146 140-570 342 121 127-6092008 257 104 140-402 286 91 185-423 335 115 129-8802009 137 na 109-164 311 116 145-535 326 114 119-6352010 289 115 207-420 280 111 150-450 325 91 160-5772011 208 na 177-238 247 85 144-385 338 97 128-6572012 234 76 125-289 213 77 134-287 320 108 124-6222013 292 na 283-300 304 151 119-486 311 107 125-639
ANZCOTR 2013
Recipient Gender % Lung Transplants 1986 - 2013
474945
55
5153
0
10
20
30
40
50
60
70
Bilateral Lung Single Lung Heart Lung
Male Female
%
ANZCOTR 2013
Recipient Gender Lung Transplants 1986 - 2013
Transplant Type Male no % Female no %
Bilateral Lung 871 51 833 49
Single Lung 264 55 212 45
Heart Lung 85 47 96 53
ANZCOTR 2013
ACTUARIAL SURVIVAL ALL LUNGS 1986 - 2013
Year HLTx SLTx BSLTxn= % n= % n= %
0 181 100.0 476 100.0 1704 100.01 142 79.4 388 82.3 1398 88.52 123 69.3 342 73.1 1139 79.83 109 62.0 282 61.9 915 72.64 97 55.7 240 53.5 747 67.15 88 51.1 206 47.4 614 61.86 82 49.3 172 40.6 506 57.77 77 47.5 157 37.3 440 55.08 65 43.0 129 32.0 364 51.29 59 42.3 110 28.2 303 47.6
10 57 41.6 92 24.3 250 44.411 51 39.4 74 21.3 187 41.712 46 37.8 56 18.8 139 37.813 42 36.1 43 16.0 110 36.914 39 33.5 32 14.0 83 33.915 35 30.9 24 12.6 63 32.616 32 30.0 19 10.0 45 30.817 29 29.0 15 8.8 26 28.318 26 28.0 10 8.2 20 24.919 23 26.9 6 8.2 12 24.920 20 25.6 5 8.2 4 21.921 14 21.5 4 8.222 7 19.5 2 8.223 6 19.5
ANZCOTR 2013
ACTUARIAL SURVIVAL ALL LUNG TRANSPLANTS 1986 - 2013
0
20
40
60
80
100
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
HLTx SLTx BSLTxYear
Percent Survival
ANZCOTR 2013
SL v HL p<0.005
SL v BL p<0.005
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ACTUARIAL SURVIVAL DCD DONORS V DBD DONORS 2006 - 2013
0
20
40
60
80
100
0 1 2 3 4 5 6 7 8
DCD Donors NON DCD DonorsYear
Percent Survival
ANZCOTR 2013
p=ns
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ACTUARIAL SURVIVAL DCD DONORS v DBD DONORS 2006 - 2013
Year DCD ONLY NON DCD
n= % n= %
0 133 100.0 905 100.01 106 91.2 696 89.02 76 81.7 534 81.93 51 74.3 378 75.04 28 70.7 265 69.4
5 12 70.7 177 64.0
6 8 70.7 94 59.07 3 70.7 52 58.2
ANZCOTR 2013
ACTUARIAL SURVIVAL DONOR AGE ALL LUNGS 1986 - 2013
0
20
40
60
80
100
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
0-16 17 - 39 40 - 49 > 49YEAR
Percent Survival
ANZCOTR 2013
0-16 yrs vs 40-49yrs p<0.05
17-39yrs vs 40-49yrs p<0.05
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ACTUARIAL SURVIVAL DONOR AGE ALL LUNGS 1986 – 2013 0-16 17 - 39 40 - 49 50+
Year n= % n= % n= % n= %0 179 100.0 1056 100.0 522 100.0 604 100.01 151 87.5 876 86.7 432 86.5 469 85.82 130 80.3 746 78.2 357 76.8 371 76.33 112 75.2 641 70.7 280 65.6 273 68.74 94 68.2 544 64.7 232 60.0 214 61.05 80 63.0 465 59.7 194 54.1 169 54.36 71 60.5 397 54.7 156 49.1 136 50.27 63 57.8 357 51.7 137 46.1 117 47.58 50 51.1 302 47.1 113 42.6 93 43.29 43 48.9 257 42.3 94 41.0 78 41.2
10 37 44.3 222 39.2 76 36.0 64 40.111 33 43.0 169 36.1 62 33.5 48 36.012 28 41.7 132 32.5 52 31.2 29 31.613 22 41.7 110 30.7 38 28.6 25 29.414 17 37.6 89 28.6 30 25.4 18 25.515 14 37.6 77 26.9 19 21.5 12 25.516 11 34.7 61 24.7 13 19.0 11 25.517 7 34.7 47 23.3 9 15.8 7 22.818 6 34.7 39 21.8 6 15.8 5 16.319 5 28.9 30 21.8 4 15.8 2 16.320 4 28.9 20 20.1 3 15.8 2 16.321 2 20.7 13 17.8 2 15.8 1 16.322 2 20.7 6 17.8 2 15.8 1 16.323 2 20.7 4 17.824 2 17.8
ANZCOTR 2013
ACTUARIAL SURVIVAL ISCHAEMIC TIME ALL LUNGS 1986 - 2013
<2hrs 2-4 hrs 4-6 hrs >6 hrsYear n= % n= % n= % n= %
0 33 100.0 510 100.0 948 100.0 766 100.01 27 84.6 416 87.4 787 88.4 619 84.12 25 78.3 346 80.0 642 78.3 524 75.33 21 65.8 279 69.7 525 71.4 423 66.94 19 59.5 233 64.4 428 64.8 349 59.75 15 47.0 199 59.6 343 57.8 307 56.56 12 43.7 172 56.4 281 53.6 260 51.37 9 32.7 155 53.4 250 51.0 228 48.58 9 32.7 122 47.2 203 46.5 197 44.79 9 32.7 107 43.7 164 42.6 170 41.5
10 8 29.1 87 39.8 146 41.0 144 37.011 7 25.5 75 37.9 114 38.2 108 33.112 6 21.8 55 34.5 88 33.9 84 30.713 5 18.2 49 33.2 65 31.0 69 29.614 4 14.6 38 28.9 54 29.0 53 27.715 4 14.6 30 25.7 40 28.4 44 25.516 4 14.6 25 24.8 30 25.3 35 23.017 3 14.6 23 24.8 20 22.4 22 20.718 3 14.6 21 23.7 15 20.0 15 18.619 2 14.6 17 22.5 11 20.0 11 16.820 2 14.6 14 21.1 6 17.8 7 18.621 2 14.6 9 17.7 5 17.8 2 14.922 1 14.6 5 17.7 3 17.823 1 14.6 3 17.7 2 17.824 1 14.6 2 17.7 1 17.8
ANZCOTR 2013
ACTUARIAL SURVIVAL ISCHAEMIC TIME ALL LUNGS 1986 - 2013
0
20
40
60
80
100
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
<2hrs 2-4 hrs 4-6 hrs >6 hrsYear
Percent Survival
ANZCOTR 2013
p=ns
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ACTUARIAL SURVIVAL CROSSMATCH ALL LUNGS 1986 - 2013
Positive NegativeYear n= % n= %
0 138 100.0 1910 100.01 117 86.1 1561 86.42 104 78.0 1307 77.53 79 65.4 1083 69.44 66 60.2 919 63.15 58 56.5 776 57.36 50 52.4 653 52.57 47 50.3 581 49.38 40 43.8 495 44.99 34 39.3 423 41.510 30 36.9 357 38.211 22 32.9 279 35.412 16 28.1 216 32.313 15 28.1 176 30.214 11 24.1 142 27.815 10 24.1 111 25.916 10 24.1 85 23.617 7 21.4 62 22.118 6 21.4 49 20.219 4 21.4 36 19.720 3 16.1 25 19.121 2 16.1 15 16.422 1 16.1 8 16.423 1 16.1 5 16.424 3 16.4
ANZCOTR 2013
ACTUARIAL SURVIVAL CROSSMATCH LUNGS 1986 - 2013
0
20
40
60
80
100
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
Positive NegativeYear
Percent Survival
ANZCOTR 2013
p=ns
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ACTUARIAL SURVIVAL CMV STATUS ALL LUNGS 1986 - 2013
YearDonor Neg Rec Neg
Donor Pos Rec Neg
Recipient Pos
n= % n= % n= %0 366 100.0 457 100.0 1490 100.01 298 86.0 380 90.0 1212 85.72 258 78.6 314 79.5 1004 77.13 221 71.7 263 73.2 799 68.24 189 65.3 215 65.6 659 62.05 161 61.4 188 61.2 543 55.96 129 54.9 160 56.5 458 51.77 109 51.4 144 53.6 408 48.98 88 46.9 119 47.8 340 44.99 74 44.6 99 44.0 288 41.210 64 39.7 83 40.7 241 38.211 53 37.1 63 38.0 187 35.012 42 34.1 52 36.7 139 31.113 34 32.4 41 33.7 113 29.714 29 32.4 31 30.2 88 26.615 21 31.1 28 29.2 69 24.916 15 27.8 21 24.8 56 23.817 11 27.8 12 23.3 44 21.918 10 25.3 9 23.3 34 19.819 8 25.3 7 23.3 24 19.820 5 21.7 6 23.3 16 18.821 4 21.7 1 17.5 11 16.222 2 21.7 1 17.5 4 14.223 2 21.7 2 14.224 2 21.7 1 14.2
ANZCOTR 2013
ACTUARIAL SURVIVAL CMV STATUS LUNGS 1986 - 2013
0
20
40
60
80
100
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
R-ve/D-ve R-ve/D+ve R+ve
ANZCOTR 2013
Percent Survival
Years
R-D+ vs R+ p<0.05
R+ve = R+ve/D+ve or R+ve/D-ve
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ACTUARIAL SURVIVAL HLA MISMATCH ALL LUNGS 1986 - 2013
ANZCOTR 2013
Year MM0-1 MM2 MM3 MM4 MM5 MM6n= % n= % n= % n= % n= % n= %
0 13 100.0 26 100.0 112 100.0 338 100.0 772 100.0 1100 100.01 11 84.6 21 80.8 96 90.0 280 87.6 617 85.1 905 86.92 9 69.2 18 69.2 86 84.2 238 79.5 512 77.4 741 76.83 8 69.2 16 69.2 73 77.1 186 70.0 413 69.2 610 68.64 5 50.8 12 60.0 63 73.8 148 61.0 334 61.7 522 63.75 4 50.8 10 60.0 57 71.4 123 55.8 287 56.7 427 57.26 4 50.8 8 48.0 50 66.2 105 52.9 237 51.7 356 52.47 4 50.8 8 48.0 44 62.1 93 50.3 206 48.4 319 49.98 2 50.8 7 42.0 34 57.5 77 44.7 166 44.4 272 45.49 2 50.8 7 42.0 28 53.9 62 38.7 148 41.6 226 42.2
10 2 50.8 7 42.0 26 52.0 56 36.8 131 37.7 177 38.811 1 50.8 6 42.0 22 45.9 48 33.4 104 34.9 131 36.112 1 50.8 6 42.0 19 39.6 41 32.0 78 32.3 96 31.913 1 50.8 6 42.0 15 35.2 37 31.2 64 31.4 72 29.014 1 50.8 5 35.0 13 32.8 29 27.6 51 28.8 55 26.815 1 50.8 3 35.0 11 32.8 22 25.5 44 28.2 41 23.716 1 50.8 2 35.0 9 32.8 15 22.9 35 25.5 34 21.817 1 50.8 1 17.5 7 32.8 11 21.2 23 22.2 27 21.818 1 50.8 5 32.8 9 21.2 21 22.2 20 17.619 1 50.8 3 32.8 6 21.2 15 22.2 16 16.720 1 50.8 3 32.8 4 21.2 10 18.9 11 16.721 1 50.8 1 19.7 2 21.2 5 14.4 9 16.722 1 50.8 1 21.2 2 10.8 5 16.723 1 50.8 1 21.2 1 10.8 3 16.724 1 50.8 1 10.8 3 16.7
ACTUARIAL SURVIVAL HLA MISMATCH ALL LUNGS 1986 – 2013
0
20
40
60
80
100
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
MM0-1 MM2 MM3 MM4 MM5 MM6
ANZCOTR 2013
Years
Percent Survival
MM0-1 v MM5 p<0.05MM0-1 v MM6 p<0.05
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ACTUARIAL SURVIVAL HLA DR LOCUS MISMATCH ALL LUNGS 1986 -2013
0
20
40
60
80
100
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
MM0 MM1 MM2
ANZCOTR 2013
Percent Survival
Years
p=ns
Survival by Cutler-Ederer life tables, comparisons by log rank Cox-Mantel
ACTUARIAL SURVIVAL HLA DR LOCUS MISMATCH LUNGS 1986 – 2013
MM0 MM1 MM2Year n= % n= % n= %
0 62 100.0 489 100.0 1810 100.01 52 86.9 394 85.7 1484 86.72 45 78.4 334 77.8 1225 77.53 41 76.6 271 70.7 995 68.84 35 68.9 210 62.2 839 63.15 30 66.8 180 57.5 698 57.26 27 62.3 153 54.2 580 52.27 24 55.4 128 50.5 523 49.78 18 48.0 99 45.0 441 45.69 15 42.5 85 41.7 373 42.2
10 15 42.5 75 38.2 309 38.911 14 42.5 64 37.7 235 35.212 13 39.5 54 35.2 174 31.813 13 39.5 45 33.1 137 29.814 11 33.4 33 27.0 110 28.415 8 33.4 27 25.2 88 26.516 6 28.9 20 24.2 70 24.217 5 24.1 17 22.9 48 22.618 4 24.1 13 22.9 39 20.219 3 24.1 10 22.9 28 19.620 3 24.1 5 17.5 21 19.621 2 24.1 2 13.1 14 17.522 1 24.1 8 15.923 1 24.1 5 15.924 4 15.9
ANZCOTR 2013
CAUSE OF DEATH - ALL LUNGS 1986 - 2012
ANZCOTR 2012
CAUSE OF DEATH - LUNGS 1986 - 2013 n = 1219Bronchiolitis Obliterans 403 33%
Infection 267 22%
Pulmonary Failure 94 8%
Other Malignancy 75 6%
NSGF 70 5%
Acute Rejection 32 3%
Renal Failure 39 3%
Hemorrage 34 3%
PTLD 26 2%
CVA 26 2%
TxCAD 6 1%
OTHER (incl unspec) 147 13%
Totals 1219 100%Multi-organ Failure 27Cardiac Arrest (16) Heart Failure(5) IHD(4) 25Sudden Death (cause unknown) 12Post Surgical Complications 11Suicide(4) Non compliance(4) Withdrawal of treatment(2) Inanition(1) 9Bowel Ischemia(4) Perforation(1) Rupture(1) 6Liver Failure(5) Cirrhosis(1) 6Necrotising Bronchiolitis(3) BronchO Pneumonia(2) 5Pulmonary Embolism (4) 4Aspergillosis (3) Aspiration (1) 4Pancreatitis 4Hypoxic brain (2) 2Pneumothorax(1) 1Aortic Dissection 1Esophageal rupture 1Systemic vasculitis 1Parkinson's disease 1Metabolic problem 1Reperfusion Injury 1Dissecting Abdominal Aortic Aneurysm 1Cyclosporin Neurotoxicity 1Metabolic problem 1Unspecified (no data) 23
ANZCOTR 2013
CAUSE OF DEATH ALL LUNGS < 5 YEARS POST TX
No %Bronchiolitis Obliterans 134 37.5
Infection 57 16.0Non Lymphoid Malignancy 45 12.6
Misc 42 11.8Pulmonary Failure 24 6.7
Renal Failure 22 6.2PTLD 8 2.2
NonSpecific Graft Failure 7 2.0No Data 6 1.7
Hemorrhage 5 1.4Rejection 4 1.1
CVA 2 0.6Graft Atherosclerosis (TxCAD) 1 0.3
Totals 357 100.0
CAUSE OF DEATH ALL LUNGS ≥ 5 YEARS POST TX
No %Bronchiolitis Obliterans 269 31.2
Infection 209 24.2Misc 93 10.8
Pulmonary Failure 70 8.1Non specific Graft Failure 63 7.3
Non Lymphoid Malignancy 30 3.5Hemorrhage 29 3.4
Rejection 28 3.2CVA 25 2.9
PTLD 18 2.1Renal Failure 17 2.0
No Data 6 0.7Graft Atherosclerosis (TxCAD) 5 0.6
Totals 862 100.0
ANZCOTR 2013