Pulmonary hypertension in patients with bronchiolitis obliterans syndrome listed for retransplantation.
Bronchiolitis Obliterans Syndrome (BOS) is a major cause of morbidity and mortality post-lung transplantation. Pulmonary hypertension (PH) may complicate the course of patients with advanced lung disease. We sought to characterize the prevalence of PH in patients with BOS. We performed a retrospective analysis of lung transplant recipients with BOS relisted for transplantation with the United Network for Organ Sharing (UNOS). Right heart catheterization (RHC) data were required for analysis. Eighty patients with BOS qualified for the analysis. PH was present in 32.5% of patients with an average mean pulmonary artery pressure (mPAP) of 32.3 mmHg (range: 26-63 mmHg). Of these, 42.3% had an elevated pulmonary capillary wedge pressure. There was no difference in PH prevalence between bilateral (26.5%) and single lung recipients (41.9%), nor did it differ by primary disease. There was no correlation between pulmonary function data and the presence or severity of PH. There was no difference in oxygen requirements or 6-min walk distance between patients with and without PH. This is the first report of PH in patients with BOS. Many of these cases occur in association with diastolic dysfunction. Although no impact on functional status or outcomes was discerned, further studies appear warranted.
Nathan
S D
SD
Inova Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Falls Church, Virginia, USA. steven.nathan@inova.org
Shlobin
O A
OA
Ahmad
S
S
Barnett
S D
SD
Burton
N A
NA
Gladwin
M T
MT
Machado
R F
RF
D000328:Adult; D001989:Bronchiolitis Obliterans / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000453:epidemiology*; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012086:Reoperation; D012189:Retrospective Studies