TY - JOUR
T1 - Lung Transplantation in Pulmonary Arterial Hypertension
T2 - The Portuguese Experience
AU - Matias, Margarida V.
AU - Cruz, Zenito
AU - Figueiredo, Catarina
AU - Moita, Catarina
AU - Roxo, Miguel
AU - Reis, João E.
AU - Costa, Ana Rita
AU - Silva, João Santos
AU - Barbosa, João Maciel
AU - Calvinho, Paulo
AU - Semedo, Luísa
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2024/6
Y1 - 2024/6
N2 - Background: In patients with pulmonary arterial hypertension (PAH), refractory to medical therapy, lung transplantation emerges as an option. This study describes the outcomes of 8 PAH patients who underwent lung transplantation. Methods: A retrospective, single-center study was conducted among patients with PAH who underwent lung transplantation in our center. Results: Patients had a median age of 46 years, with female sex predominance (75%). Causes of HAP were pulmonary veno-occlusive disease (n = 5, 62.5%), idiopathic PAH (n = 2, 25%), and heritable PAH (n = 1, 12.5%). Pre-transplant hemodynamics revealed a median mean pulmonary artery pressure of 58.5 mm Hg (48-86). All patients received bilateral lung transplants with extracorporeal membrane oxygenation support, displaying immediate post-transplant hemodynamic improvement. Primary graft dysfunction grade 3 (PGD 3) was observed in 75% of patients. Five patients (62.5%) died, with a 72.9% survival at 12 months and 29.2% at 24 months post-transplantation. Conclusion: Our study reveals the complexity and challenges of lung transplants in patients with PAH. Despite notable immediate hemodynamic improvements, high rates of PGD 3 and the survival rate remain a concern. Further research to define optimal peri and post-transplant management to improve survival is required.
AB - Background: In patients with pulmonary arterial hypertension (PAH), refractory to medical therapy, lung transplantation emerges as an option. This study describes the outcomes of 8 PAH patients who underwent lung transplantation. Methods: A retrospective, single-center study was conducted among patients with PAH who underwent lung transplantation in our center. Results: Patients had a median age of 46 years, with female sex predominance (75%). Causes of HAP were pulmonary veno-occlusive disease (n = 5, 62.5%), idiopathic PAH (n = 2, 25%), and heritable PAH (n = 1, 12.5%). Pre-transplant hemodynamics revealed a median mean pulmonary artery pressure of 58.5 mm Hg (48-86). All patients received bilateral lung transplants with extracorporeal membrane oxygenation support, displaying immediate post-transplant hemodynamic improvement. Primary graft dysfunction grade 3 (PGD 3) was observed in 75% of patients. Five patients (62.5%) died, with a 72.9% survival at 12 months and 29.2% at 24 months post-transplantation. Conclusion: Our study reveals the complexity and challenges of lung transplants in patients with PAH. Despite notable immediate hemodynamic improvements, high rates of PGD 3 and the survival rate remain a concern. Further research to define optimal peri and post-transplant management to improve survival is required.
UR - http://www.scopus.com/inward/record.url?scp=85188215146&partnerID=8YFLogxK
U2 - 10.1016/j.transproceed.2024.01.013
DO - 10.1016/j.transproceed.2024.01.013
M3 - Article
C2 - 38423833
AN - SCOPUS:85188215146
SN - 0041-1345
VL - 56
SP - 1115
EP - 1120
JO - Transplantation Proceedings
JF - Transplantation Proceedings
IS - 5
ER -