Survival and left ventricular dysfunction post lung transplantation for pulmonary arterial hypertension

Otto, Madeleine; McGiffin, David C.; Whitford, Helen; Kure, Christina; Snell, Gregory I; Diehl, Arne; Orosz, Judit; Burrell, Aidan

doi:10.1016/j.jcrc.2022.154120

Cited by 5 publications

(4 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Impaired intrinsic contractility of the right and/or left ventricle as the basis for hypotension is rare. RV function recovers rapidly once pulmonary hypertension is relieved, although transient, generally mild LV systolic dysfunction can be observed in severe PAH 50 . A slightly lower than normal cardiac index is desirable during the immediate postoperative period to avoid graft overperfusion and the potential for PGD 7 .…”

Section: Hemodynamic Managementmentioning

confidence: 99%

“…Chronic underfilling of the left ventricle (LV) leads to atrophy and impaired contractility 46,47 . After relief of RV afterload with lung transplantation, the LV may be unable to accommodate the sudden increase in pulmonary venous return, with frequent occurrence of transient LV dysfunction [48][49][50][51] . Even a small rise in left atrial pressure in the setting of increased capillary permeability would be expected to promote alveolar edema.…”

Section: Primary Graft Dysfunctionmentioning

confidence: 99%

“…AKI (Table 6) is exceedingly common after LTX and has a significant impact on both shortand long-term outcomes. In a large meta-analysis, the incidence of AKI was 53% (95% CI [46][47][48][49][50][51][52][53][54][55][56][57][58][59]%), and renal replacement therapy (RRT) use ranged from 4-15% 102 . The pooled odds ratios for 1-yr mortality were 2.99 for any AKI and 8.32 for RRT.…”

Section: Acute Kidney Injury (Aki)mentioning

confidence: 99%

See 2 more Smart Citations

Pulmonary, circulatory and renal considerations in the early postoperative management of the lung transplant recipient

Girgis

Hadley

Murphy

2023

gcsp

View full text Add to dashboard Cite

Lung transplantation volumes and survival rates continue to increase worldwide. Primary graft dysfunction (PGD) and acute kidney injury (AKI) are common early postoperative complications that significantly affect short-term mortality and long-term outcomes. These conditions share overlapping risk factors and are driven, in part, by circulatory derangements. The prevalence of severe PGD is up to 20% and is the leading cause of early death. Patients with pulmonary hypertension are at a higher risk. Prevention and management are based on principles learned from acute lung injury of other causes. Targeting the lowest effective cardiac filling pressure will reduce alveolar edema formation in the setting of increased pulmonary capillary permeability. AKI is reported in up to one-half of lung transplant recipients and is strongly associated with one-year mortality as well as long-term chronic kidney disease. Optimization of renal perfusion is critical to reduce the incidence and severity of AKI. In this review, we highlight key early post- transplant pulmonary, circulatory, and renal perturbations and our center’s management approach.

show abstract

Section: Hemodynamic Managementmentioning

confidence: 99%

Section: Primary Graft Dysfunctionmentioning

confidence: 99%

Section: Acute Kidney Injury (Aki)mentioning

confidence: 99%

See 1 more Smart Citation

Pulmonary, circulatory and renal considerations in the early postoperative management of the lung transplant recipient

Girgis

Hadley

Murphy

2023

gcsp

View full text Add to dashboard Cite

show abstract

“…Patients with PAH have historically had higher perioperative mortality but favorable long-term outcomes [25]. With the increasing use of perioperative extracorporeal membrane oxygenation (ECMO) for RV support in the last 2 decades, patients with PAH have been shown to have excellent 1-year outcomes at some centers [26].…”

Section: Cardiovascular Diseasementioning

confidence: 99%

Lung Transplantation: Selection of Candidates

Thomas,

Williams,

Shlobin

2023

OBM Transplant

View full text Add to dashboard Cite

Lung transplantation is a last-resort treatment option for patients with end stage lung disease. The procedure is being performed more frequently and scientific advances continue to be made, but the median post-transplant survival is far shorter than other solid organ transplant recipients. Candidate selection is a resource intensive process that attempts to balance risks of the procedure with the benefits of much higher quality of life. Transplant centers must weigh disease specific considerations, medical comorbidities, and psychosocial factors with the likelihood of a successful transplantation. While the candidate selection process is exceptionally challenging, it leads to many patients undergoing successful lung transplantation.

show abstract

Lung Transplantation for Pulmonary Arterial Hypertension

Kolaitis

2023

CHEST

View full text Add to dashboard Cite

Survival and left ventricular dysfunction post lung transplantation for pulmonary arterial hypertension

Cited by 5 publications

References 31 publications

Pulmonary, circulatory and renal considerations in the early postoperative management of the lung transplant recipient

Pulmonary, circulatory and renal considerations in the early postoperative management of the lung transplant recipient

Lung Transplantation: Selection of Candidates

Lung Transplantation for Pulmonary Arterial Hypertension

Contact Info

Product

Resources

About