Pulmonary Hypertension Associated with Lung Transplantation Obliterative Bronchiolitis and Vascular Remodeling of the Allograft
| Autor: | R. Saggar, D.J. Ross, D.A. Zisman, A. Gregson, J.P. Lynch III, M.P. Keane, S. Samuel Weigt, A. Ardehali, B. Kubak, C. Lai, D. Elashoff, M.C. Fishbein, W.D. Wallace, J.A. Belperio |
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| Rok vydání: | 2008 |
| Předmět: |
Adult
Male Pathology medicine.medical_specialty Hypertension Pulmonary medicine.medical_treatment Transplants Bronchiolitis obliterans Article medicine.artery Internal medicine medicine Humans Transplantation Homologous Immunology and Allergy Lung transplantation Pharmacology (medical) Bronchiolitis Obliterans Retrospective Studies Transplantation Lung business.industry Respiratory disease Bronchial circulation Middle Aged medicine.disease Pulmonary hypertension humanities medicine.anatomical_structure Pulmonary artery Cardiology Blood Vessels Female business Lung Transplantation |
| Zdroj: | American Journal of Transplantation. 8:1921-1930 |
| ISSN: | 1600-6135 |
| DOI: | 10.1111/j.1600-6143.2008.02338.x |
| Popis: | Pathologic obliterative bronchiolitis (OB)/Bronchiolitis obliterans syndrome (pathologic OB/BOS) is the major obstacle to long-term survival post-lung transplantation (LT). Our group has demonstrated that pulmonary hypertension (PH) complicates the course of chronic inflammatory lung diseases that have similarities to pathologic OB/BOS and that vascular remodeling of the bronchial circulation occurs during BOS. Consequently, we hypothesized that PH is associated with pathologic OB/BOS and may result from a vasculopathy of the allograft pulmonary circulation. We conducted a single-center, retrospective study and examined the presence of PH and vasculopathy in patients with pathologic OB/BOS. Fifty-two pathologic specimens post-LT were recovered from January 10, 1997 to January 5, 2007 and divided into two groups, those with and without pathologic OB/BOS.PH was defined as a mean pulmonary artery pressure (mPAP) > 25 mmHg by right heart catheterization (RHC) or right ventricular systolic pressure (RVSP) > or = 45 mmHg by transthoracic echocardiogram (TTE). PH was more prevalent in those LT recipients with pathologic OB/BOS (72% vs. 0%, p = 0.003). Furthermore, pulmonary arteriopathy and venopathy were more prevalent in patients with pathologic OB/BOS (84% vs. 4%, p < 0.0001, and 77% vs. 35%, p = 0.004, respectively). PH is common in LT recipients with pathologic OB/BOS and is associated with a vasculopathy of the allograft pulmonary circulation. |
| Databáze: | OpenAIRE |
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