Adverse outcomes associated with pulmonary hypertension in chronic obstructive pulmonary disease after bilateral lung transplantation - 26/07/17

Doi : 10.1016/j.rmed.2017.04.010

Don Hayes, MD, MS ^a,^b,^d,^⁎ , Dmitry Tumin, PhD ^a,^e, Maria M. Budev, DO, MPH ^f, Joseph D. Tobias, MD ^c,^e, Roy C. St John, MD ^g, Jasleen Kukreja, MD, MPH ^h
^a Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
^b Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA
^c Department of Anesthesiology, The Ohio State University College of Medicine, Columbus, OH, USA
^d Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, OH, USA
^e Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA
^f Department of Pulmonary Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA
^g Mount Carmel Health, Columbus, OH, USA
^h Department of Surgery, University of California at San Francisco Medical Center, San Francisco, CA, USA

^∗Corresponding author. The Ohio State University, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA.The Ohio State UniversityNationwide Children's Hospital700 Children's DriveColumbusOH43205USA

Abstract

Background

The impact of pulmonary hypertension (PH) in chronic obstructive pulmonary disease (COPD) on survival after lung transplantation (LTx) is not known.

Material and methods

First-time adult LTx recipients with COPD transplanted between May 2005 and September 2013 were identified in the United Network for Organ Sharing Registry database, and tracked from transplant date until death or censoring. Right heart catheterization (RHC) measurements at time of wait listing were used to predict all-cause mortality after LTx, with multivariable analyses stratified by transplant type.

Results

Of 3362 COPD LTx recipients, 3105 were included in the analytic sample, with multiple imputation used to complete missing data on covariates. Multivariable analysis found the hazard of death to increase with a 10 mmHg increase in mean pulmonary artery pressure (mPAP) among recipients of bilateral LTx (HR = 1.12; 95% CI = 1.01, 1.24; p = 0.032), but not among recipients of single LTx (HR = 0.92; 95% CI = 0.80, 1.06; p = 0.234).

Conclusion

PH prior to bilateral LTx in patients with COPD is associated with higher mortality risk.

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Keywords : Bilateral, Chronic obstructive pulmonary disease, Lung transplantation, Pulmonary hypertension, Survival

Plan

Univariate survival analysis

Multivariable survival analysis

Discussion

Funding

Conflict of interest

☆	The manuscript represents original work that is not being considered or has been accepted for publication elsewhere.

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Vol 128

P. 102-108 - juillet 2017 Retour au numéro

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Adverse outcomes associated with pulmonary hypertension in chronic obstructive pulmonary disease after bilateral lung transplantation - 26/07/17

Abstract

Background

Material and methods

Results

Conclusion

Plan

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