title: [Pulmonary hypertension and early mortality after orthotopic heart transplantation].
abstract: OBJECTIVE
  To study the relationship between hemodynamic parameters before heart transplantation and the mortality rate at the first week posttransplant.
  
  
  METHODS
  85 patients had an orthotopic heart transplant. Before the operation we measured: vascular pulmonary resistance, index of vascular pulmonary resistance, pulmonary arterial pressure systolic and median and transpulmonary gradient. Ten patients with values of vascular pulmonary resistance higher than four Wood units and/or pulmonary artery systolic pressure higher than 60 mmHg, had a test of pulmonary vascular reactivity, the result of that test did not contraindicate the transplant. We used the Student's t test and chi 2 with continuity correction and the Fisher's exact test for the analysis of the data.
  
  
  RESULTS
  During the study period eight patients were dead (9.4%). The causes of death were: acute disfunction of the graft, 5 patients; multiorgan failure, 2 patients and septic shock, 1 patient. We compared the parameters of both groups of patients live and dead and could find a significant difference between the data with higher values in the death group: pulmonary arterial systolic pressure (p < 0.01); pulmonary arterial median pressure (p < 0.03) and transpulmonary gradient (p < 0.02). We also saw that the relative risk of mortality was 10.4 when the pulmonary artery systolic pressure was > or = 50 mmHg and 5.7 when the pulmonary vascular resistance was > or = 5 Wood units.
  
  
  CONCLUSIONS
  It is important a good evaluation of the pulmonary hemodynamic before the heart transplantation for a better selection of the receptor. The severe pulmonary hypertension (pulmonary vascular resistance > or = 5 Wood units or pulmonary artery systolic pressure > or = 50 mmHg) was associated with a higher rate of early death.
authors.affiliation: Servicio de Medicina Intensiva, Hospital Juan Canalejo, La Coruña.
authors.forename: V J
authors.initials: VJ
authors.lastname: López-Ciudad
authors.forename: J M
authors.initials: JM
authors.lastname: López Pérez
authors.forename: S
authors.initials: S
authors.lastname: Fojón Polanco
authors.forename: F J
authors.initials: FJ
authors.lastname: Blanco Sierra
authors.forename: G
authors.initials: G
authors.lastname: Pradas Montilla
authors.forename: J J
authors.initials: JJ
authors.lastname: Cuenca Castillo
authors.forename: N
authors.initials: N
authors.lastname: Vázquez González
authors.forename: L F
authors.initials: LF
authors.lastname: Hermida Alvarez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002423:Cause of Death; D016009:Chi-Square Distribution; D005260:Female; D016027:Heart Transplantation / Q000401:mortality / Q000502:physiology* / Q000706:statistics & numerical data; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000401:mortality / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012306:Risk; D013997:Time Factors
vernacular_title: Hipertensión pulmonar y mortalidad precoz después del trasplante cardíaco ortotópico.