Reversible Pulmonary Hypertension in Heart Transplant Candidates: To Transplant or Not to Transplant

摘要: Background Pulmonary hypertension (PHT), defined as a pulmonary vascular resistance (PVR) greater than 2.5 Wood units [WU] and(or) transpulmonary gradient (TPG) 12 mm Hg, is risk factor for mortality in cardiac transplantation due to elevated postoperative right heart failure. Orthotopic possible if PVR could be reversed below WU and TPG Hg. We show the Muenster experience from last 10 years. Methods From April 1996 December 2005 all transplant recipients separated into patients with without PHT were included. All had successful reduction (PVR ≤ Hg) using prostaglandin I 2 or E 1 . Posttransplant early late incidence of failure studied. Results Two hundred seventeen included this study. Of these, 168 normal pressures (non-PHT group), 49 (22.6%) reversible (rev-PHT group). Mean was 1.6 ± 1.1 vs 2.1 ( p = not significant [NS]). Thirty-day survival after orthotopic 85% 78% 0.150) year 63% 61% NS). Right during first 30 days occurred 27% non-PHT group 64% rev-PHT 0.035). However, transplanted 2001 it did appear. Conclusions Cardiac candidates have still significantly compared PHT. Despite higher failure, long-term affected.