The Registry of the International Society for Heart and Lung Transplantation: Thirty-third Adult Heart Transplantation Report—2016; Focus Theme: Primary Diagnostic Indications for Transplant

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Data collection, conventions, and statistical methods

National and multinational organ/data exchange organizations and individual centers submit data to the ISHLT Registry. Since the Registry’s inception, 457 heart transplant centers, 253 lung transplant centers, and 177 heart-lung transplant centers have reported data to the registry. In our estimation, data submission to the Registry represents approximately 66% of worldwide thoracic transplant activity.

An overview of donor and recipient characteristics and outcomes is presented throughout the

Analytic conventions

Unless otherwise specified, heart-lung transplants are not included in analyses of heart transplants or lung transplants.

Retransplant includes those with a previously reported transplant of the same organ type, same organ type in combination, or with a retransplant diagnosis. Because identification of all transplants for an individual may not be complete, the number of retransplant events may be slightly underestimated.

The Registry does not capture the exact occurrence date for most secondary

Focus theme methods: Primary diagnostic indications for transplant

The Registry Steering Committee selected underlying organ failure diagnosis as the theme topic for the 2016 report. All diagnoses were reviewed by the Steering Committee and categorized by organ and age (pediatric and adult) group. The listing of diagnoses in each category includes all diagnoses collected; there may be diagnoses listed for which no transplants have been reported. Categorization of the diagnoses for adult heart transplant recipients is reported in Table 1.

Transplant volumes

Figure 2 shows overall adult and pediatric heart transplant volumes reported to the ISHLT over time. A total of 4,746 heart transplants (including 4,157 adult heart transplants but excluding combined heart-lung transplants) from 268 centers were performed in 2014 and reported to the ISHLT. After a gradual decline between 1993 and 2004, heart transplant volumes reported to the ISHLT Transplant Registry are now increasing again, especially in the most recent years. A steady increase in transplant

Part 2. Focus theme: Primary diagnostic indications for transplant

Regardless of the underlying cause of cardiomyopathy, the heart failure syndrome is associated with compensatory but maladaptive neurohormonal activation. Therapy in heart failure with reduced ejection fraction is generally directed toward blocking this activation and is relatively universally applied. Similarly, heart transplantation is indicated with many different underlying cardiomyopathy diagnoses. However, donor organs are scarce, and better characterization of post-transplant outcomes in

Conclusions

Thanks to the data reporting efforts of participating heart transplant centers and collectives worldwide, this Report brings to the public comprehensive and current information regarding developments and challenges in adult heart transplantation. Trends that are notable in this report include a continued distinct increase in number of heart transplants reported to the ISHLT over more recent years. Post-transplant survival is improving in unadjusted analyses and also after adjustment for

Disclosure statement

All relevant disclosures for the Registry Director, Executive Committee Members, and authors are on file with the ISHLT and can be made available for review by contacting the Executive Director of the ISHLT.

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