Bilateral sequential single lung transplantation for pulmonary hypertension and Eisenmenger’s syndrome

Ueno, Tetsuya; Smith, Julian Anderson; Snell, Gregory I; Williams, Trevor; Kotsimbos, Tom; Rabinov, Marc; Esmore, Donald S.

doi:10.1016/s0003-4975(99)01082-6

Cited by 43 publications

(33 citation statements)

References 16 publications

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“…Interestingly, for patients with Eisenmenger9s syndrome associated with a ventricular septal defect, the ISHLT/United Network for Organ Sharing (UNOS) registry data [7] show better survival with HLT compared with BLT with closure of the defect. However, there are a number of papers supporting a role for BLT and defect closure to maximise the use of available donor organs [8][9][10].…”

Section: Influence Of the Type Of Surgical Proceduresmentioning

confidence: 99%

“…Complex congenital heart disease patients with multiple previous corrective procedures are at high risk of bleeding during the transplant procedure [8,11]. Patients with severe pulmonary hypertension treated with SLT are at an increased risk of severe ischaemia-reperfusion injury and may require prolonged post-operative mechanical ventilation [10]. Similarly, recipients of older donor lungs (w50 yrs) that incur longer ischaemic times are also at increased risk of early and late graft dysfunction [3,13].…”

Section: Survival Benefitmentioning

confidence: 99%

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Lung transplant outcomes: a review of survival, graft function, physiology, health-related quality of life and cost-effectiveness

Studer¹

2004

European Respiratory Journal

162

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The success of lung transplantation has improved over time as evidenced by better long-term survival and functional outcomes. Despite the success of this procedure, there are numerous problems and complications that may develop over the life of a lung transplant recipient. With proper monitoring and treatment, the frequency and severity of these problems can be decreased. However, significant improvement for the overall outcomes of lung transplantation will only occur when better methods exist to prevent or effectively treat chronic rejection. Eur Respir J 2004; 24: 674-685.

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Section: Influence Of the Type Of Surgical Proceduresmentioning

confidence: 99%

Section: Survival Benefitmentioning

confidence: 99%

Lung transplant outcomes: a review of survival, graft function, physiology, health-related quality of life and cost-effectiveness

Studer¹

2004

European Respiratory Journal

162

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“…In patients with established PAH, particularly those with Eisenmenger syndrome, attempts at surgical closure of systemic-topulmonary connections can, in fact, increase the risk of death. 5 Numerous drawbacks also exist with lung or heart/lung transplantation, 6,7 including scarcity of organs and high mortality rates. Advances in nonsurgical therapy for this disease, including treatment with the vasodilators epoprostenol and its analog treprostinil, are now being reported in the literature.…”

mentioning

confidence: 99%

Efficacy of Bosentan in a Small Cohort of Adult Patients With Pulmonary Arterial Hypertension Related to Congenital Heart Disease

Benza

Rayburn

Tallaj

et al. 2006

Chest

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“…PAH treatment options have been poorly studied in CHD patients with shuntassociated PAH because of the more gradual clinical and physiological decline, longer life expectancy and concern regarding potential adverse effects such as worsening oxygenation. As such, heart and lung transplantation has long been the only treatment option in severely limited CHD patients with shunt-associated PAH (9,10).…”

Section: Méthodes : Les Auteurs Ont Interrogé Les Bases De Données Mementioning

confidence: 99%

“…However, this treatment approach is complex, impractical for many patients and can be associated with life-threatening side effects. Heart-lung transplantation is an option in patients with advanced CHD with shunt-associated PAH, although the drawbacks are considerable (9,36), including the scarcity of organs, numerous complications and significant mortality.…”

Section: Can J Cardiol Vol 25 No 3 March 2009 E66mentioning

confidence: 99%

Endothelin receptor antagonist therapy in congenital heart disease with shunt-associated pulmonary arterial hypertension: A qualitative systematic review

Fine¹,

Dias²,

Shoemaker³

et al. 2009

Canadian Journal of Cardiology

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BACKGROUND: Congenital heart disease (CHD) with systemic-topulmonary shunting is associated with pulmonary arterial hypertension (PAH). There are similar clinical and pathophysiological features between CHD with shunt-associated PAH and idiopathic PAH. Endothelin-receptor antagonists (ERAs) are oral medications that improve pulmonary hemodynamics, symptoms and functional capacity in many PAH patients. However, the role of ERAs in CHD with shunt-associated PAH is unclear. METHODS: MEDLINE, EMBASE and the Cumulative Index of Nursing and Allied Health Literature (CINAHL) databases were searched for articles published from 1966 through September 2006, as well as bibliographies of all retrieved papers. All published English-language studies of adult CHD patients with shunt-associated PAH treated with ERAs were reviewed for clinical, functional and hemodynamic outcomes. RESULTS: Ten studies of 174 adult CHD subjects with shunt-associated PAH were identified. Other than one placebo-controlled, randomized clinical trial, all studies were open-label, uncontrolled observational trials. Subjects were treated with the ERA bosentan for a mean (± SD) of 9±7 months. Nine studies reported improved World Health Organization (WHO) modification of the New York Heart Association functional class, with 95 of 164 subjects (58%) improving by at least one functional class. The 6 min walk distance improved in all eight studies in which it was assessed. Bosentan was generally well tolerated; 2.3% of subjects withdrew because of elevated liver enzymes. Two patients with WHO functional class IV PAH died during bosentan therapy. CONCLUSION: Treatment of CHD patients with shunt-associated PAH with the ERA bosentan is associated with an improvement in functional class and objectively measured exercise capacity. The consistency of the uncontrolled data and the positive results of a single randomized clinical trial suggest a role for ERA therapy in CHD patients with shunt-associated PAH. Caution is suggested when considering bosentan therapy for CHD patients with WHO functional class IV PAH.

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Bilateral sequential single lung transplantation for pulmonary hypertension and Eisenmenger’s syndrome

Cited by 43 publications

References 16 publications

Lung transplant outcomes: a review of survival, graft function, physiology, health-related quality of life and cost-effectiveness

Lung transplant outcomes: a review of survival, graft function, physiology, health-related quality of life and cost-effectiveness

Efficacy of Bosentan in a Small Cohort of Adult Patients With Pulmonary Arterial Hypertension Related to Congenital Heart Disease

Endothelin receptor antagonist therapy in congenital heart disease with shunt-associated pulmonary arterial hypertension: A qualitative systematic review

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