Title:
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Lung and heart-lung transplantation in pulmonary arterial hypertension
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Author:
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López-Meseguer, Manuel; Quezada, Carlos A.; Ramon, Maria A.; Lázaro, María; Dos, Laura; Lara, Antonio; López, Raquel; Blanco, Isabel; Escribano, Pilar; Roman, Antonio; Universitat Autònoma de Barcelona
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Abstract:
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Real use of lung (LT) and heart-lung (HLT) transplantation in pulmonary arterial hypertension (PAH) is unknown. The objectives were to describe the indication of these procedures on PAH treatment in a national cohort of PAH patients, and to analyze the potential improvement of its indication in severe patients. Eligibility for LT/HLT was assessed for each deceased patient. Incident patients from REHAP diagnosed between January 2007 and March 2015 and considered eligible for LT/HLT were grouped as follows: those who finally underwent transplantation (LTP) and those who died (D-Non-LT). Of 1391 patients included in REHAP, 36 (3%) were LTP and 375 (27%) died. Among those who died, 36 (3%) were D-Non-LT. LTP and D-Non-LT were equal in terms of age, gender, and clinical status. Ten percent of those who died were functional class I-II. Patients functional class IV were less likely to undergo LT (8.3% LTP vs. 30.6% D-Non-LT, p = 0.017). Patients with idiopathic and drug/toxin-associated PAH were more likely to undergo LT (44.4% LTP vs. 16.7% D-Non-LT, p = 0.011). The present results show that the use of LT/HLT could double for this indication. Relevant mortality in early functional class reflects the difficulties in establishing the risk of death in PAH. |
Rights:
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open access
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Document type:
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Article |
Published by:
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Uri:
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https://ddd.uab.cat/record/254039
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