| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2002;73:209-219
© 2002 The Society of Thoracic Surgeons
a Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
b Division of Pulmonary Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
c Division of Cardiology, Department of Pediatrics, St. Louis, Missouri, USA
d Division of Pulmonary Medicine, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
* Address reprint requests to Dr Mendeloff, St. Louis Children’s Hospital, One Children’s Place, Suite 5S50, St. Louis, MO 63110, USA
e-mail: mendeloffe{at}msnotes.wustl.edu
Presented at the Thirty-seventh Annual Meeting of The Society of Thoracic Surgeons, New Orleans, LA, Jan 29–31, 2001.
Background. Pulmonary hypertension (PHT) is a lethal condition resulting in markedly diminished life expectancy. Continuous prostaglandin I2 infusion has made an important contribution to symptom management, but it is not a panacea. Lung or heart-lung transplantation remains an important treatment option for end-stage PHT patients unresponsive to prostaglandin I2. This study reviews the outcomes after transplantation for PHT in our program.
Methods. A retrospective chart review was performed for 100 consecutive patients with either primary PHT (48%) or secondary PHT (52%) transplants since 1989. Living recipients were contacted to confirm health and functional status.
Results. Fifty-five adult and 45 pediatric patients underwent 51 bilateral lung transplants, 39 single lung transplants, and 10 heart-lung transplants. Mean age was 23.7 years (range, 1.2 months to 54.8 years) and mean pre-transplant New York Heart Association class was 3.2. Pre-transplant hemodynamics revealed a mean right atrial pressure of 9.6 ± 5.4 mm Hg and mean pulmonary artery pressure of 64 ± 14.4 mm Hg. Hospital mortality was 17% with early death predominantly because of graft failure and infection. With an average follow-up of 5.0 years, 1- and 5-year actuarial survival was 75% and 57%, respectively. Mean pulmonary artery pressure on follow-up catheterization was 22 ± 6.0 mm Hg, and mean follow-up New York Heart Association class was 1.3 (p < 0.001 for both compared with pre-transplant). Diagnosis and type of transplant did not confer a significant difference in survival between groups.
Conclusions. Whereas lung or heart-lung transplant for PHT is associated with higher early mortality than other pulmonary disease entities, it provides similar long-term outcomes with dramatic improvement in both quality of life and physiologic aspects.
This article has been cited by other articles:
|
|
 |
|
  K. Boutet, D. Montani, X. Jais, A. Yaici, O. Sitbon, G. Simonneau, and M. Humbert Review: Therapeutic advances in pulmonary arterial hypertension Therapeutic Advances in Respiratory Disease, August 1, 2008; 2(4): 249 - 265. [Abstract] [PDF]
|
|
|
|
 |
|
 F. Haddad, R. Doyle, D. J. Murphy, and S. A. Hunt Right Ventricular Function in Cardiovascular Disease, Part II: Pathophysiology, Clinical Importance, and Management of Right Ventricular Failure Circulation, April 1, 2008; 117(13): 1717 - 1731. [Full Text] [PDF]
|
|
|
|
 |
|
 G. Yung Lung Transplantation and Pulmonary Hypertension Seminars in Cardiothoracic and Vascular Anesthesia, June 1, 2007; 11(2): 149 - 156. [Abstract] [PDF]
|
|
|
|
|
|
V. V. McLaughlin and M. D. McGoon Pulmonary Arterial Hypertension Circulation, September 26, 2006; 114(13): 1417 - 1431. [Full Text] [PDF]
|
|
|
|
 |
|
 S. Deb, J. Yun, N. Burton, E. Omron, J. Thurber, and S. D. Nathan Reversal of idiopathic pulmonary arterial hypertension and allograft pneumonectomy after single lung transplantation. Chest, July 1, 2006; 130(1): 214 - 217. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S Mehta and G J Shoemaker Improving survival in idiopathic pulmonary arterial hypertension: revisiting the "kingdom of the near-dead" Thorax, December 1, 2005; 60(12): 981 - 983. [Full Text] [PDF]
|
|
|
|
 |
|
 L. J. Rubin and D. B. Badesch Evaluation and Management of the Patient with Pulmonary Arterial Hypertension Ann Intern Med, August 16, 2005; 143(4): 282 - 292. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. L. Doyle, D. McCrory, R. N. Channick, G. Simonneau, and J. Conte Surgical Treatments/Interventions for Pulmonary Arterial Hypertension: ACCP Evidence-Based Clinical Practice Guidelines Chest, July 1, 2004; 126(1_suppl): 63S - 71S. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Klepetko, E. Mayer, J. Sandoval, E. P. Trulock, J.-L. Vachiery, P. Dartevelle, J. Pepke-Zaba, S. W. Jamieson, I. Lang, and P. Corris Interventional and surgical modalities of treatment for pulmonary arterial hypertension J. Am. Coll. Cardiol., June 16, 2004; 43(12_Suppl_S): 73S - 80S. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Humbert, O. Sitbon, and G. Simonneau Novel therapeutic perspectives in pulmonary arterial hypertension Eur. Respir. J., August 1, 2003; 22(2): 193 - 194. [Full Text] [PDF]
|
|
|
|
|
|
H. A. Ghofrani, F. Rose, R. T. Schermuly, H. Olschewski, R. Wiedemann, A. Kreckel, N. Weissmann, S. Ghofrani, B. Enke, W. Seeger, et al. Oral sildenafil as long-term adjunct therapy to inhaled iloprost in severe pulmonary arterial hypertension J. Am. Coll. Cardiol., July 2, 2003; 42(1): 158 - 164. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Zaas and S. M. Palmer Respiratory Failure Early After Lung Transplantation: Now That We Know the Extent of the Problem, What Are the Solutions? Chest, January 1, 2003; 123(1): 14 - 16. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
