ISHLT Registry Series
The Registry of the International Society for Heart and Lung Transplantation: Thirty-fourth Adult Heart Transplantation Report—2017; Focus Theme: Allograft ischemic time

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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, 472 heart transplant centers, 256 lung transplant centers, and 180 heart-lung transplant centers have reported data to the Registry. We estimate data submitted to the Registry currently represent approximately 75% of worldwide transplant activity.

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

Focus Theme Methods: Allograft ischemic time

The Registry Steering Committee selected allograft ischemic time as the theme topic for the 2017 report. Allograft ischemic time was defined as the time elapsed between aortic cross-clamp performed during organ procurement surgery and coronary artery reperfusion during heart transplant surgery.

The reporting of allograft ischemic time varied significantly by geographic region, with high rates of data completeness from North American transplant centers, low rates of completeness from European

Transplant volumes

After a decline between 1993 and 2004, heart transplant volumes reported to the ISHLT Transplant Registry have been steadily increasing, especially in the last 3 years, and reached an all-time high in 2015 at a total of 5,074 heart transplants (including 4,388 adult heart transplants but excluding combined heart-lung transplants) from 285 centers (Figure 1; overall adult and pediatric heart transplant volumes reported to the ISHLT over time). Increases are most pronounced in North America and

Focus Theme: Allograft ischemic time

In addition to recipient, donor, and recipient and donor interactions, post-transplant outcomes are also affected by factors surrounding the transplant procedure itself. Allograft ischemic time affects allograft viability10 and may also be affected by geographic and other considerations for organ allocation. Therefore, for this 2017 report, we analyzed in detail the factors associated with allograft ischemic time and the association between allograft ischemic time and outcomes.

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. In this 2017 Report we observed an encouraging sizable increase in the number of heart transplants reported to the Registry for the third consecutive year. Post-transplant survival is improving both in unadjusted analyses and after adjustment for

Disclosure statement

D.C. received travel support from Astellas Pharma, Inc., and serves as a consultant and speaker for Roche Ltd. L.H.L. received research grant support to his institution from Novartis Inc. and Abbott Inc. J.W.R. and J.S. serve as consultants for Medtronic, Inc. None of the other authors has a financial relationship with a commercial entity that has an interest in the subject of the presented manuscript or other conflicts of interest to disclose.

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