Effect of pulmonary hypertension in patients with end-stage lung disease on posttransplantation outcomes

M. K. Omari, S. A. Smith, G. Jacobsen, V. Kaza

Research output: Contribution to journalArticle

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Abstract

A subgroup of patients with end-stage lung disease develop secondary pulmonary hypertension (PH). PH results in worse prognosis in these patients. However, it is unclear if this effect prevails in the immediate- and long-term outcomes of these patients after lung transplantation (LT). The objective of this study was to evaluate the effect of pretransplantation PH on immediate- or long-term posttransplantation outcomes. A retrospective chart review of post-LT patients at Henry Ford Hospital from January 1995 through January 2008 was done. Patients were grouped by presence or absence of PH and were compared using chi-square or Fisher exact tests for categorical variables and t tests or Wilcoxon rank sum tests for continuous variables. Kaplan-Meier estimation was used to evaluate primary and secondary outcomes. Among the patients included in the study, 25 had PH. This group consisted mostly of females (68%). There was no difference in the indication or type of LT in the 2 groups. There was no statistically significant difference in freedom from bronchiolitis obliterans syndrome (BOS; P = .42), time to onset of BOS (P = .82), grade of BOS (P = .21), or cummulative acute rejection (CAR) score (P = .66). There was no difference in overall mortality at 3 and 5 years (P = .57) or time to death (P = .25). Number of A1 rejection episodes was the only significant predictor for BOS (P = .001). In conclusion, PH due to end-stage lung disease does not have any effect on early or late posttransplantation outcomes. There is predisposition for females with end-stage lung disease to develop secondary PH more so than males. The number of A1 rejections increases the likelihood of development of BOS. A larger multicenter study is needed to confirm the results of this pilot study.

Original languageEnglish (US)
Pages (from-to)1881-1886
Number of pages6
JournalTransplantation Proceedings
Volume43
Issue number5
DOIs
StatePublished - Jun 2011

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Pulmonary Hypertension
Lung Diseases
Lung Transplantation
Nonparametric Statistics
Bronchiolitis Obliterans
Multicenter Studies
Mortality

ASJC Scopus subject areas

  • Surgery
  • Transplantation

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Effect of pulmonary hypertension in patients with end-stage lung disease on posttransplantation outcomes. / Omari, M. K.; Smith, S. A.; Jacobsen, G.; Kaza, V.

In: Transplantation Proceedings, Vol. 43, No. 5, 06.2011, p. 1881-1886.

Research output: Contribution to journalArticle

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abstract = "A subgroup of patients with end-stage lung disease develop secondary pulmonary hypertension (PH). PH results in worse prognosis in these patients. However, it is unclear if this effect prevails in the immediate- and long-term outcomes of these patients after lung transplantation (LT). The objective of this study was to evaluate the effect of pretransplantation PH on immediate- or long-term posttransplantation outcomes. A retrospective chart review of post-LT patients at Henry Ford Hospital from January 1995 through January 2008 was done. Patients were grouped by presence or absence of PH and were compared using chi-square or Fisher exact tests for categorical variables and t tests or Wilcoxon rank sum tests for continuous variables. Kaplan-Meier estimation was used to evaluate primary and secondary outcomes. Among the patients included in the study, 25 had PH. This group consisted mostly of females (68{\%}). There was no difference in the indication or type of LT in the 2 groups. There was no statistically significant difference in freedom from bronchiolitis obliterans syndrome (BOS; P = .42), time to onset of BOS (P = .82), grade of BOS (P = .21), or cummulative acute rejection (CAR) score (P = .66). There was no difference in overall mortality at 3 and 5 years (P = .57) or time to death (P = .25). Number of A1 rejection episodes was the only significant predictor for BOS (P = .001). In conclusion, PH due to end-stage lung disease does not have any effect on early or late posttransplantation outcomes. There is predisposition for females with end-stage lung disease to develop secondary PH more so than males. The number of A1 rejections increases the likelihood of development of BOS. A larger multicenter study is needed to confirm the results of this pilot study.",
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