Anne I. Dipchand

The registry of the international society for heart and lung transplantation: 29th official adult heart transplant report-2012

This 29th adult transplant report is based on data submitted by 394 transplant centers worldwide. In excess of 104,000 heart transplants have been registered in the database. Summary data are provided for the entire cohort of patients, whereas a number of additional analyses focus on cohorts of patients transplanted more recently. Detailed data analyses can be viewed on the slide set of the registry of the International Society for Heart and Lung Transplantation (ISHLT), which is available online (www.ishlt.org/registries). The report is divided into several sections. Baseline donor, recipient and medical center demographics are reviewed first. The second part focuses on immunosuppressive therapies and acute allograft rejection. Survival after heart transplant is examined next, and data on post-transplant morbidities and quality of life after transplant conclude the report.

The Registry of the International Society for Heart and Lung Transplantation: Thirty-first Official Adult Heart Transplant Report—2014; Focus Theme: Retransplantation

Data are submitted to the International Society for Heart and Lung Transplantation (ISHLT) Registry by national and multinational organ and data exchange organizations or by participating individual centers. Since the Registry inception, 416 heart transplant centers, 241 lung transplant centers, and 168 heart-lung transplant centers have reported data to the registry. We estimate that data submission to the Registry represents approximately 66% of worldwide thoracic transplant activity. This report used standard statistical methodology for analyses and reporting. Where appropriate, a more detailed explanation about the analytic methodology accompanies the Web site slides (in the “Notes Page” view). To assess time-to-event rates (e.g., survival), this report used the

The Registry of the International Society for Heart and Lung Transplantation: 29th Adult Lung and Heart-Lung Transplant Report—2012

This section of the 29th official International Society for Heart and Lung Transplantation (ISHLT) Registry report summarizes the current status of adult lung and heart-lung transplantation by reporting data on this international group of patients. The Registry contains data on 3,631 adult heart-lung and 39,835 adult lung transplants performed through June 30, 2011 from centers around the world. More detailed information is presented in the full slide set, which is available on the ISHLT Web site at www.ishlt.org/registries/.

International Society for Heart and Lung Transplantation working formulation of a standardized nomenclature for cardiac allograft vasculopathy-2010.

The development of cardiac allograft vasculopathy remains the Achilles heel of cardiac transplantation. Unfortunately, the definitions of cardiac allograft vasculopathy are diverse, and there are no uniform international standards for the nomenclature of this entity. This consensus document, commissioned by the International Society of Heart and Lung Transplantation Board, is based on best evidence and clinical consensus derived from critical analysis of available information pertaining to angiography, intravascular ultrasound imaging, microvascular function, cardiac allograft histology, circulating immune markers, non-invasive imaging tests, and gene-based and protein-based biomarkers. This document represents a working formulation for an international nomenclature of cardiac allograft vasculopathy, similar to the development of the system for adjudication of cardiac allograft rejection by histology.

The Registry of the International Society for Heart and Lung Transplantation: Thirtieth Official Adult Heart Transplant Report—2013; Focus Theme: Age

This 30th adult heart transplant report is based on data submitted on 110,486 heart transplants in recipients of all ages (including 99,008 adults) by 407 centers worldwide since 1982 through June 30, 2012, with follow-up until June 30, 2012. Summary data are provided for the entire cohort of patients, whereas a number of additional analyses focus on cohorts who received transplants more recently. Detailed data analyses can be viewed in the International Society for Heart and Lung Transplantation (ISHLT) Registry slide sets available online (www.ishlt.org/registries). The report is divided into several sections:

The Registry of the International Society for Heart and Lung Transplantation: Thirtieth Adult Lung and Heart-Lung Transplant Report—2013; Focus Theme: Age

This section of the 30th official Registry report of 2013 summarizes data from 43,428 adult lung and 3,703 adult heart-lung transplant recipients and their donors for transplants that occurred through June 30, 2012. This report describes donor and recipient characteristics, transplant type, and recipient outcomes data. The full Registry slide set available online (www.ishlt.org/registries) provides more detail, additional analyses, and other information not included in this printed report. For the first time, the Registry report focuses on an overall theme of recipient and donor age and incorporates new age-related analyses into its annual update.

ABO-Incompatible heart transplantation in infants

BACKGROUND Transplantation of hearts from ABO-incompatible donors is contraindicated because of the risk of hyperacute rejection mediated by preformed antibodies in the recipient to blood-group antigens of the donor. This contraindication may not apply to newborn infants, who do not yet produce antibodies to T-cell-independent antigens, including the major blood-group antigens. METHODS We studied 10 infants 4 hours to 14 months old (median, 2 months) who had congenital heart disease or cardiomyopathy and who received heart transplants from donors of incompatible blood type between 1996 and 2000. Serum isohemagglutinin titers were measured before and after transplantation. Plasma exchange was performed during cardiopulmonary bypass; no other procedures for the removal of antibodies were used. Standard immunosuppressive therapy was given, and rejection was monitored by means of endomyocardial biopsy. The results were compared with those in 10 infants who received heart transplants from ABO-compatible donors. RESULTS The overall survival rate among the 10 recipients with ABO-incompatible donors was 80 percent, with 2 early deaths due to causes presumed to be unrelated to ABO incompatibility. The duration of follow-up ranged from 11 months to 4.6 years. Two infants had serum antibodies to antigens of the donors blood group before transplantation. No hyperacute rejection occurred; mild humoral rejection was noted at autopsy in one of the infants with antibodies. No morbidity attributable to ABO incompatibility has been observed. Despite the eventual development of antibodies to antigens of the donors blood group in two infants, no damage to the graft has occurred. Because of the use of ABO-incompatible donors, the mortality rate among infants on the waiting list declined from 58 percent to 7 percent. CONCLUSIONS ABO-incompatible heart transplantation can be performed safely during infancy before the onset of isohemagglutinin production; this technique thus contributes to a marked reduction in mortality among infants on the waiting list.

The Registry of the International Society for Heart and Lung Transplantation: Thirty-second Official Adult Lung and Heart-Lung Transplantation Report—2015; Focus Theme: Early Graft Failure

This section of the 32nd official International Society for Heart and Lung Transplantation (ISHLT) Registry Report of 2015 summarizes data from 51,440 adult lung and 3,820 adult heart-lung transplants that occurred through June 30, 2014. This publication reports data for donor and recipient characteristics, transplant events, and recipient treatments and outcomes. This Registry Report focuses on an overall theme of recipient early graft failure. The Registry’s online full slide set provides more detail, additional analyses, and other information not included in this publication.

The Registry of the International Society for Heart and Lung Transplantation: Thirty-first Adult Lung and Heart–Lung Transplant Report—2014; Focus Theme: Retransplantation

This section of the 31st official International Society for Heart and Lung Transplantation (ISHLT) Registry Report 2014 summarizes data from 47,647 adult lung and 3,772 adult heart–lung transplants that occurred through June 30, 2013. We report findings for donor and recipient characteristics, transplant types and recipient outcomes. This report focuses on the overall theme of recipient retransplantation and incorporates new retransplantation-related analyses into its annual update. The full Registry slide set available online (www.ishlt.org/registries) provides more detail, additional analyses and other information not included herein.

The Registry of the International Society for Heart and Lung Transplantation: Thirty-second Official Adult Heart Transplantation Report - 2015; Focus Theme: Early Graft Failure

Data are submitted to the ISHLT Registry by national and multinational organ/data exchange organizations and individual centers. Since the Registry’s inception, 418 heart transplant centers, 242 lung transplant centers and 174 heart–lung transplant centers have reported data. The Registry website (www.ishlt.org/registries) provides spread sheets that show data elements collected in the Registry. The online slide set (http://www.ishlt.org/registries/slides.asp? slides=heartLungRegistry) provides POWERPOINT slides of figures and tables that support this study. The site contains additional slides for this report and slide sets from the previous annual reports.