Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Purpose: End-stage lung disease patients (pts) who undergo lung transplantation (LTx) with an elevated mean pulmonary artery pressure (mPAP) are known to have adverse outcomes. We performed a single-center, retrospective analysis of pts with and without elevated mPAP before LTx and looked at clinical outcomes and survival after LTx.
Methods: 65 pts underwent LTx (2012-2013). Preoperatively, 37 pts' mPAP was greater than 25 mm Hg (pulmonary hypertension [PH] group); 28 pts' mPAP was less than 25 mm Hg (control group). We compared baseline demographics, need for cardiopulmonary bypass, postoperative length of stay (LOS), days on ventilator support, readmissions after LTx, and up to 26 months follow-up. We also analyzed a subgroup of PH pts (n=21) with a higher mPAP (> 30 mm Hg) and a pulmonary vascular resistance > 3.4 Wood units, and analyzed outcomes compared to the control group using the same criteria as above. Using STATA statistical analysis software, we did group comparisons using chi-square and t-tests. A Cox regression model was used to calculate hazard rates for each group, and proportional survival was analyzed using Kaplan-Meier estimates. P-values ≤ 0.05 were considered statistically significant.
Results: mPAP and PVR were 32±10 mm Hg and 5.8±10, respectively, in the PH group and 18±3 mmHg and 2.0±1.0 in the control group. No significant differences in pt demographics were found between these groups. Outcomes are summarized in Table 1. There were no significant differences in need for bypass, LOS, ventilator support, or readmissions. No differences in the survival between the groups were noted up to 26 months' follow up. The subgroup with higher PH also showed no significant differences in survival or adverse outcomes.
Conclusion: Pts with PH who underwent LTx did not demonstrate adverse clinical outcomes after LTx. Larger pt sample and longer follow-up may shed further insight into this pt population.
Table 1. Outcomes among pts’ with and without PH undergoing LTx
|PH (mPAP > 25 mm Hg)
| Control (mPAP < 25 mm Hg)
|Cardiopulmonary bypass, n (%)||10 (27%)||6 (21%)||0.6|
|Ventilator after LTx (days)||1.7||1.9||0.5|
|LOS after LTx (days)||16.4||13.6||0.4|
|Readmission after LTx (n)||2.4||2.1||0.5|
|Deaths after LTx (up to 26 mo. follow-up)||9 (24.3%)||3(11%)||0.1|
CITATION INFORMATION: Kalya A, Boga M, Dasyam S, Walia R, Smith M, Bremner R, Omar A, Patel V, Kuo E, Huang J, Hashimi S. Comparison of Clinical Outcomes in Lung Transplant Patients with and without Preoperative Pulmonary Hypertension. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:Kalya A, Boga M, Dasyam S, Walia R, Smith M, Bremner R, Omar A, Patel V, Kuo E, Huang J, Hashimi S. Comparison of Clinical Outcomes in Lung Transplant Patients with and without Preoperative Pulmonary Hypertension. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/comparison-of-clinical-outcomes-in-lung-transplant-patients-with-and-without-preoperative-pulmonary-hypertension/. Accessed March 6, 2021.
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