Clinical impact of pre-kidney transplant pulmonary hypertension on post-transplant outcomes

Sadat, Besher; Tirunagari, Deepthi; Karthikeyan, Vanji; Patel, Anita; Harn, Meredith Van; Saleem, Muhammad; Ananthasubramaniam, Karthikeyan

doi:10.1007/s10554-021-02182-7

Cited by 2 publications

(3 citation statements)

References 24 publications

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“…All included studies were observational and had a retrospective design [ 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ]. Most studies evaluated echocardiographic parameters as indirect markers of PH [ 18 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ], while only one study included right heart catheterization in PH diagnostic algorithm [ 19 ]. PH was defined by using pulmonary artery systolic pressure (PASP) estimated by TTE in six studies [ 20 , 22 , 23 , 24 , 25 , 27 ].…”

Section: Resultsmentioning

confidence: 99%

“…Most studies evaluated echocardiographic parameters as indirect markers of PH [ 18 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ], while only one study included right heart catheterization in PH diagnostic algorithm [ 19 ]. PH was defined by using pulmonary artery systolic pressure (PASP) estimated by TTE in six studies [ 20 , 22 , 23 , 24 , 25 , 27 ]. Right ventricular systolic pressure (RVSP), maximum tricuspid regurgitation jet velocity (TRJV), and right ventricular dilation and function were other TTE parameters used in clinical trials to estimate PH [ 18 , 21 , 26 , 28 , 29 ].…”

Section: Resultsmentioning

confidence: 99%

“…However, PASP cutoff values varied among included studies. Most authors used the 35 mmHg PASP cutoff to discriminate patients with or without PH [ 20 , 23 , 25 , 27 ], while the others adopted different values, 40 mmHg [ 22 ] and 37 mmHg [ 24 ], respectively. Hence, standardized cutoff values of TTE parameters and measurement methods are required to obtain generalizable and reproducible results in future clinical studies.…”

Section: Discussionmentioning

confidence: 99%

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Pulmonary Arterial Hypertension and Adverse Outcomes after Kidney Transplantation: A Systematic Review and Meta-Analysis

Brinza

Covic

Stefan

et al. 2022

JCM

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Pulmonary arterial hypertension (PH) has a high prevalence in chronic kidney disease (CKD) patients, especially those undergoing kidney transplantation (KT). We aimed to systematically review and calculate the pooled effect size of the literature evaluating the association between pre-existing PH documented by transthoracic echocardiography (TTE) or invasively and adverse outcomes following KT. The primary composite outcome extracted from the included studies was represented by the mortality from any cause following KT and delayed graft function (DGF), graft dysfunction, or graft failure. The secondary outcomes were represented by individual components of the primary composite outcome. Twelve studies meeting the inclusion criteria were selected. The main finding is that pre-existing PH was associated with increased mortality and a higher rate of DGF, kidney graft dysfunction, or failure in KT recipients. The effect remained significant for all outcomes irrespective of PH evaluation, invasively or using TTE. Consequently, patients with PH defined only by TTE were at higher risk of death, DGF, or graft failure. Our findings support the routine assessment of PH in patients on the KT waitlist. PH might represent an extensively available and valuable tool for risk stratification in KT patients. These data should be confirmed in large prospective clinical trials.

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