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Prognostic value of pre-transplant mean pulmonary arterial pressure in lung transplant recipients: a single-institution experience

Authors
 Chi Young Kim  ;  Ji Eun Park  ;  Ah Young Leem  ;  Joo Han Song  ;  Song Yee Kim  ;  Kyung Soo Chung  ;  Eun Young Kim  ;  Ji Ye Jung  ;  Young Ae Kang  ;  Young Sam Kim  ;  Joon Chang  ;  Jin Gu Lee  ;  Hyo Chae Paik  ;  Moo Suk Park 
Citation
 Journal of Thoracic Disease, Vol.10(3) : 1578-1587, 2018 
Journal Title
 Journal of Thoracic Disease 
ISSN
 2072-1439 
Issue Date
2018
Keywords
Lung transplantation (LTX) ; hypertension ; prognosis ; pulmonary
Abstract
Background: Currently, lung transplantation (LTX) is considered to be a curative treatment option in patients with end-stage lung disease. Although pulmonary hypertension (PH), confirmed by cardiac catheterization, is a prognostic factor in patients undergoing LTX, the prognostic value of PH in Asian lung transplant recipients remains uncertain. In this study, we aimed to determine whether PH before LTX may serve as a prognostic factor for survival in Asian patients. Methods: The medical records of 50 patients [male, 27; female, 23; mean age, 51.0 (41.0-60.0) years], who received preoperative right heart catheterization (RHC) and echocardiography before single or double LTX at Severance Hospital between January 2010 and December 2014, were reviewed. The relationship between 1-year survival after LTX and PH [mean pulmonary arterial pressure (mPAP) >/=25 mmHg at rest] was evaluated. Results: The mean right ventricular systolic pressure and mPAP were 48.5 (22.8) and 30.0 (24.0-40.0) mmHg. Of the 50 patients, 17 (34.0%) died within a year after LTX. The 1-year survival rate among patients with mPAP >/=25 mmHg (58.8%) was lower than the survival rate among patients with mPAP <25 mmHg (87.5%). Pre-transplantation mPAP of >/=25 mmHg was associated with post-transplantation survival [hazard ratio (HR), 4.832; 95% confidence interval (CI), 1.080-21.608, P=0.039]. The presence of preoperative PH was also associated with an increased risk of postoperative complications. Conclusions: Confirmation of PH via preoperative cardiac catheterization was associated with the prognosis of the patient after LTX. Clinicians should consider the necessity for early transplantation surgery before the mPAP reaches >/=25 mmHg.
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DOI
10.21037/jtd.2018.03.46
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실)
Yonsei Authors
강영애(Kang, Young Ae) ORCID logo https://orcid.org/0000-0002-7783-5271
김송이(Kim, Song Yee) ORCID logo https://orcid.org/0000-0001-8627-486X
김영삼(Kim, Young Sam) ORCID logo https://orcid.org/0000-0001-9656-8482
김은영(Kim, Eun Young)
김치영(Kim, Chi Young)
박무석(Park, Moo Suk) ORCID logo https://orcid.org/0000-0003-0820-7615
박지은(Park, Ji Eun)
백효채(Paik, Hyo Chae) ORCID logo https://orcid.org/0000-0001-9309-8235
송주한(Song, Joo Han)
이진구(Lee, Jin Gu)
임아영(Leem, Ah Young) ORCID logo https://orcid.org/0000-0001-5165-3704
장준(Chang, Joon)
정경수(Jung, Kyung Soo) ORCID logo https://orcid.org/0000-0003-1604-8730
정지예(Jung, Ji Ye) ORCID logo https://orcid.org/0000-0003-1589-4142
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/162671
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