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1 2.5% 0.42% 5- - 65%, - 47% III-IV 30 -70% 4% 1%

*Rich M. J Am Geriatric Soc. 1997;45:968974.American Heart Association. 2003 Heart and Stroke Statistical Update. Dallas, Texas: AHA 2003.

J.Hardy (1964) C.Barnard (1967) (P.Caves 1973) - (1981) -

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ISHLTJ Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ISHLTJ Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132 This figure includes only the heart transplants that are reported to the ISHLT Transplant Registry. As such, the presented data may not mirror the changes in the number of heart transplants performed worldwide.

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24/9,27,1/4,715,9/10,446/34,328/15,941/25,3 27/16,724/13,23,8/31,8/0,8 / (1 . )

(N=11,861)

ISHLTJ Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

10- ( )

Multivariable analysis was performed using a proportional hazards model censoring all patients at 10 years. Continuous factors were fit using a restricted cubic spline.

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

5 O(I) (III) AB(IV) (n 61) - , , 45-55%, , = 2 . > 35 , - , - ( ), , . , ,

20% 1,8 ..2 < 45 Hg 15 Hg Wood 6 . VO2 max 12 // Na < 135 / > 600 / > 0,6 1- < 50% NYHA III IV

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(N=10,271)

ISHLTJ Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132 ( )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.

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ISHLTJ Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ISHLTJ Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132 ( )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.

ISHLTJ Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132 The age distribution of heart 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.

10- ( )

(N=11,861)J Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132

ISHLTMultivariable analysis was performed using a proportional hazards model censoring all patients at 10 years. Continuous factors were fit using a restricted cubic spline.

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

- 65 . (> 6 . Wood, >15 ..). ( a, ) ( ) - ,

10- ( )

(N=11,861)

ISHLTJ Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132 Multivariable analysis was performed using a proportional hazards model censoring all patients at 10 years. Continuous factors were fit using a restricted cubic spline.

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

( - n 18) (- n 17) ( - n 10)

2419,1% , + (n 4) , + (n 3) , + (n 1) , (n 2) 946 + 89,8 n 10

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HeartMate II - 17 NYHA III - 3 IV - 14 LVAD - 11 Thoratec - 3 HeartMate II - 4 Incor - 2 Duraheart - 2

BiVAD (Thoratec) - 6

() - 464 / - 15/2 - 13 - 4 - 8 - 5

() 19737

Thoratec

IncorDuraheart

( n 17)26%

* LVAD, RVAD, TAH

ISHLTJ Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132 LVADBIVAD

%

() IA (34%) :- LVAD/BiVAD < 30 > 30 , IB (37%) / : - LVAD/BiVAD > 30 II (26%) , IB IA

(UNOS Exetcutiv Order, 1999) (HLA) - T-. cross-math test - (PRA) > 10-15% - PRA ,

- ~ 3000

8-350

92-270 . (143,552)

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3-10% ,

ISHLTJ Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132 Freedom from severe renal dysfunction rates by era were computed using the Kaplan-Meier method.

The development of severe renal dysfunction is reported on annual follow-ups; a date of diagnosis is not provided. For this figure the midpoint between the date of previous follow-up (when event had not occurred) and the date of follow-up when the event was reported was used as the date of occurrence. Patients were included in the analysis until an unknown response for the outcome of interest 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 each of the outcomes at all follow-up time points. - 50-90% -

100 , T- Epstein-Barr virus B- () -

ISHLTJ Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132 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. ( )

ISHLTJ Heart Lung Transplant. 2011 Oct; 30 (10): 1071-1132 This figure shows the functional status reported on the 1-year, 3-year and 5-year annual follow-ups. Because all follow-ups between 1995 and June 2010 were included, the bars do not include the same patients. !!!

LVAD, BiVAD, TAH !!!

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This figure shows the functional status reported on the 1-year, 3-year and 5-year annual follow-ups. Because all follow-ups between 1995 and June 2010 were included, the bars do not include the same patients.

. , ( )

This figure shows the functional status reported on the 1-year, 3-year and 5-year annual follow-ups. Because all follow-ups between 1995 and June 2010 were included, the bars do not include the same patients.1110.7740.6120.4840.3870.194

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1 1100% 100%77.40%-61.20%48.40%38.70%19.40%