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  • Title: Lung Transplantation in Pulmonary Hypertension: A Multidisciplinary Unit's Management Experience.
    Author: Quezada-Loaiza CA, de Pablo Gafas A, Pérez V, Alonso R, Juarros L, Real MI, López E, Cortes M, Meneses JC, González IH, Díaz-Hellín Gude V, Subías PE, Gámez P.
    Journal: Transplant Proc; 2018 Jun; 50(5):1496-1503. PubMed ID: 29880377.
    Abstract:
    BACKGROUND: Prognosis assessment of pulmonary hypertension (PH) is multifactorial and placement of patients on the lung transplantation (LT) waiting list requires the weighing of a complex set of criteria. The aim of this retrospective cohort study was to analyze a series of patients treated in our unit at the moment of their inclusion on the LT waiting list and long-term survival after LT. MATERIAL AND METHODS: Baseline characteristics, LT outcomes, and survival were evaluated in all patients diagnosed with pulmonary arterial hypertension (PAH) and pulmonary veno-occlusive disease (PVOD) who were included on the LT waiting list in 2011-2016. RESULTS: Thirty-three patients were listed with a diagnosis of PAH or PVOD. Patients had an average age of 43 ± 12 years and 71% were female. The median time between PAH diagnosis and inclusion on the LT waiting list was 62.5 months (interquartile range [IQR], 6-93.3 months). Twenty-eight patients (84%) underwent double LT. The difference between the waiting time in urgent cases (1.5 months; IQR, 0.4-4.2 months) and in elective cases (7.4 months; IQR, 2.7-16.2 months) was significant (P < .049). The 28 patients with PAH/PVOD in our hospital had a 95% short-term survival after LT both at 1 and at 3 months, without variance between urgent and elective LT. Longer-term survival rate was 84% both at 12 and 36 months. CONCLUSIONS: There is great complexity in determining the appropriate time for transplantation referral and inclusion on the waiting list for patients with PAH/PVOD so that LT can be more realistically incorporated into the treatment algorithm for PAH. LT offers a good short- and long-term survival in patients with PAH/PVOD.
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