Pulmonary hypertension as a risk factor of mortality after lung transplantation
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Pulmonary hypertension as a risk factor of mortality after lung transplantation. / Andersen, Kasper H; Schultz, Hans Henrik L; Nyholm, Benjamin; Iversen, Martin P; Gustafsson, Finn; Carlsen, Jørn.
I: Clinical Transplantation, Bind 30, Nr. 4, 04.2016, s. 357-364.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - Pulmonary hypertension as a risk factor of mortality after lung transplantation
AU - Andersen, Kasper H
AU - Schultz, Hans Henrik L
AU - Nyholm, Benjamin
AU - Iversen, Martin P
AU - Gustafsson, Finn
AU - Carlsen, Jørn
N1 - © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
PY - 2016/4
Y1 - 2016/4
N2 - 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.
AB - 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.
KW - Cardiac Catheterization
KW - Female
KW - Follow-Up Studies
KW - Glomerular Filtration Rate
KW - Graft Rejection
KW - Graft Survival
KW - Hemodynamics
KW - Humans
KW - Hypertension, Pulmonary
KW - Lung Diseases
KW - Lung Transplantation
KW - Male
KW - Middle Aged
KW - Postoperative Complications
KW - Prognosis
KW - Respiratory Function Tests
KW - Retrospective Studies
KW - Risk Factors
KW - Survival Rate
KW - Journal Article
KW - Research Support, Non-U.S. Gov't
U2 - 10.1111/ctr.12692
DO - 10.1111/ctr.12692
M3 - Journal article
C2 - 26782019
VL - 30
SP - 357
EP - 364
JO - Clinical Transplantation
JF - Clinical Transplantation
SN - 0902-0063
IS - 4
ER -
ID: 181057765