Heart-lung transplantation: A viable option for connective tissue diseases.

Autor: Stern LK; Department of Medicine, University of California San Francisco, San Francisco, California., Selby VN; Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, California., Kolaitis NA; Division of Pulmonary and Critical Care, Department of Medicine, University of California San Francisco, San Francisco, California., Boin F; Division of Rheumatology, Department of Medicine, University of California San Francisco, San Francisco, California., Aras M; Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, California., Klein L; Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, California., De Marco T; Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, California.
Jazyk: angličtina
Zdroj: Clinical transplantation [Clin Transplant] 2020 Feb; Vol. 34 (2), pp. e13776. Date of Electronic Publication: 2020 Jan 09.
DOI: 10.1111/ctr.13776
Abstrakt: Background: While lung transplantation (LTx) has been effective for connective tissue disease (CTD) patients with pulmonary involvement, outcomes for heart-lung transplantation (HLTx) are less defined. The aim of this study is to evaluate HLTx in CTD patients utilizing the UNOS database.
Methods: HLTx patients with CTD (HLTx-CTD) were compared to both LTx patients with CTD (LTx-CTD) and HLTx patients with all other indications (HLTx-OI) from 1999 to 2018. Primary outcome was 1- and 5-year graft survival. Secondary outcomes included freedom from first-year rejection and outcomes prior to transplant discharge.
Results: 1143/29 323 adults received first-time HLTx or LTx for CTD. Seventeen were HLTx-CTD (3.3% of total HLTx) and 1126 were LTx-CTD (3.9% of total LTx). There were 492 HLTx-OI. Transplant hemodynamic values including cardiac output, pulmonary capillary wedge pressure, and calculated pulmonary vascular resistance were significantly worse for HLTx-CTD vs LTx-CTD (4.2 vs 5.4 L/min, P = .005; 14 vs 10 mm Hg, P = .009; 439 vs 267 dynes, P = .007, respectively). Cardiac status 1 was more common for HLTx-CTD vs HLTx-OI (94% vs 56%, P < .001). HLTx-CTD 1 and 5-year graft survival was similar compared to LTx-CTD and HLTx-OI.
Conclusion: HLTx-CTD is a valid option for carefully selected patients with CTD cardiac and pulmonary involvement with similar morbidity and mortality compared to LTx-CTD and HLTx-OI.
(© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje