Secondary pulmonary hypertension does not adversely affect outcome after single lung transplantation

Huerd, Scott; Hodges, Tony; Grover, Frederick L.; Mault, James R.; Mitchell, Max B.; Campbell, David N.; Aziz, Salim; Chetham, Paul M.; Torres, Fernando; Zamora, Martin R.

doi:10.1016/s0022-5223(00)70124-3

Cited by 41 publications

(23 citation statements)

References 12 publications

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“…Furthermore, our results corroborate previous studies demonstrating no difference in survival after single or double LTx in patients with coexisting secondary PAH. [4][5][6] However, our findings provide a unique insight into SLTx performed in patients aged Z 65 years.…”

mentioning

confidence: 79%

Outcomes after single lung transplantation in older patients with secondary pulmonary arterial hypertension

Brown

Mason

Pettersson

et al. 2013

The Journal of Heart and Lung Transplantation

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mentioning

confidence: 79%

Outcomes after single lung transplantation in older patients with secondary pulmonary arterial hypertension

Brown

Mason

Pettersson

et al. 2013

The Journal of Heart and Lung Transplantation

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“…The new International Society for Heart and Lung Transplantation report asserts that in IPF long-term outcomes are better for double lung transplantation [145], which is, however, contrary to a previous evaluation of the registry data by MEYER et al [144]. In older patients with pulmonary fibrosis and mild-tomoderate PH, single lung transplantation seems to be particularly appropriate [140,144]. A decision in favour of bilateral lung transplantation in IPF patients has to take into account multiple factors, including severity of PH, infections or colonisations (e.g.…”

Section: Lung Transplantationmentioning

confidence: 92%

“…There is conflicting evidence regarding the type of transplantation which should be performed, i.e. single or double lung transplantation [139][140][141][142][143][144][145]. The new International Society for Heart and Lung Transplantation report asserts that in IPF long-term outcomes are better for double lung transplantation [145], which is, however, contrary to a previous evaluation of the registry data by MEYER et al [144].…”

Section: Lung Transplantationmentioning

confidence: 95%

Pulmonary hypertension in interstitial lung disease

Behr

Ryu

2008

European Respiratory Journal

238

173

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In the lungs, parenchymal and vascular remodelling share pathomechanisms that may explain the relatively high prevalence (30-40%) of pulmonary hypertension (PH) in interstitial lung disease (ILD) patients. Notably, PH significantly contributes to exercise limitation and dismal prognosis of ILD patients. The absence of specific clinical symptoms commonly leads to delayed diagnosis. Besides clinical judgment and out-of-proportion reduction in diffusing capacity, severe hypoxaemia or exercise oxygen desaturation, echocardiography and biomarkers such as B-type natriuretic peptide (BNP) and N-terminal pro-hormone BNP are potentially helpful tools in identifying PH. However, right heart catheterisation is still necessary to confirm the diagnosis. Management of PH in ILD comprises treatment of the underlying disease process and long-term oxygen therapy. Affected patients should be listed for lung transplantation without delay, when appropriate. However, due to age and comorbidities only a minority of ILD patients will be eligible for lung transplantation. In the absence of satisfactory therapies for many ILDs, and considering the clinical burden of PH in affected patients, specific vasomodulatory therapies presently approved for PAH may be promising options for ILD patients. Consequently, there is an urgent need for adequately designed clinical trials to assess the effectiveness of specific PH therapy in the context of ILDs.

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“…The impact of preoperative PH on the outcome of patients with advanced lung disease after lung transplantation is controversial [83,84,85,86,87]. However, in a cohort study of 830 IPF patients in the International Society for Heart and Lung Transplant Registry, elevated pulmonary artery pressure proved to be a risk factor for 90-day mortality after single-lung transplantation [87].…”

Section: Prognostic Significancementioning

confidence: 99%

Pulmonary Hypertension in Idiopathic Pulmonary Fibrosis: A Review

2011

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Idiopathic pulmonary fibrosis (IPF) is a progressive diffuse parenchymal disease with a poor prognosis. Pulmonary hypertension (PH) often complicates the course of IPF and may even be found in patients with preserved lung function. Possible pathogenetic mechanisms of PH in IPF include vascular destruction, pulmonary hypoxic vasoconstriction and vascular remodeling due to overexpression of cytokines and growth factors. PH in IPF patients is associated with decreased exercise capacity and a worse prognosis. Due to its prognostic significance, it seems important to investigate for PH in these patients. As the symptoms of PH in IPF are nonspecific, the development of PH in a patient with known IPF can be easily overlooked. Noninvasive methods provide clues for the diagnosis, but their sensitivity is limited. Doppler echocardiography is a useful tool for the detection of PH which also provides additional information regarding associated cardiac abnormalities. However, right heart catheterization remains the gold standard diagnostic test. Therapeutic options for PH in IPF are limited. Long-term oxygen administration for the correction of hypoxemia should be recommended. The availability of new pharmacological agents in the treatment of PH has raised the possibility of therapy in patients with IPF and associated PH. Whether these PH-targeted therapies may be of benefit in this patient group, in terms of improving functional outcomes and survival, remains uncertain.

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Secondary pulmonary hypertension does not adversely affect outcome after single lung transplantation

Cited by 41 publications

References 12 publications

Outcomes after single lung transplantation in older patients with secondary pulmonary arterial hypertension

Outcomes after single lung transplantation in older patients with secondary pulmonary arterial hypertension

Pulmonary hypertension in interstitial lung disease

Pulmonary Hypertension in Idiopathic Pulmonary Fibrosis: A Review

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