Premium
Pulmonary hypertension as a risk factor of mortality after lung transplantation
Author(s) -
Andersen Kasper H.,
Schultz Hans Henrik L.,
Nyholm Benjamin,
Iversen Martin P.,
Gustafsson Finn,
Carlsen Jørn
Publication year - 2016
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12692
Subject(s) - medicine , pulmonary wedge pressure , lung transplantation , pulmonary hypertension , hemodynamics , transplantation , lung , cardiology
Abstract Purpose Pulmonary hypertension ( PH ) is recognized as a risk factor in lung transplantation as reflected in the lung allocation score ( LAS ). We examined the impact of PH on outcome after lung transplantation, with special emphasis on pre‐ and post‐capillary PH . Methods Consecutive lung transplant recipients were evaluated according to ISHLT criteria including right heart catheterization in the period from 1992 to October 2014. Post‐transplant survival was assessed according to hemodynamic characteristics: post‐capillary PH (mean pulmonary arterial pressure [ mPAP ] ≥ 25 mmHg and pulmonary arterial wedge pressure [ PAWP ] > 15 mmHg), pre‐capillary PH ( mPAP ≥ 25 mmHg, PAWP ≤ 15 mmHg) and non‐ PH ( mPAP < 25 mmHg). Results Of 518 transplant recipients, 58 (11%) had post‐capillary PH . Pre‐capillary PH was present in 211 (41%) and 249 (48%) non‐ PH . Post‐capillary PH and pre‐capillary PH were associated with worse 90‐d outcomes after transplantation compared to non‐ PH (p = 0.043 and 0.003, respectively). The negative effect persisted 1 yr post‐transplantation in pre‐capillary PH (p = 0.037), but not in post‐capillary PH (p = 0.447). Long‐term survival was unaffected by hemodynamic classification. Conclusion Post‐capillary PH was present in 11% and pre‐capillary PH in 41% of the transplant cohort. Post‐capillary PH and pre‐capillary PH were associated with inferior 90‐d survival, but long‐term survival was unaffected.