Impact of High-Priority Allocation on Lung and Heart-Lung Transplantation for Pulmonary Hypertension

The Annals of Thoracic Surgery
Laurent SavaleElie Fadel

Abstract

Since 2006 and 2007, patients in France with severe pulmonary hypertension (PH) who are at imminent risk of death, despite optimal treatment in the intensive care unit, are placed on a high-priority list (HPL) for heart-lung transplantation (HLT) or double-lung transplantation (DLT). We assessed the effect of this approach on the waiting list and outcomes after transplantation. We conducted a single-center, retrospective, before-and-after study of consecutive patients with severe group 1, 1', or 4 PH listed for DLT or HLT between 2000 and 2013 (ie, 6 years before and 6 years after HPL implementation). We included 234 patients. HPL implementation resulted in a significant decrease of the cumulative incidence of death on the waiting list at 1 and 2 years (p < 0.0001). The cumulative incidence of transplantation increased significantly from 48% to 76% after 2 years (p < 0.0001). Overall survival after transplantation was not significantly different between the pre-HPL and post-HPL era. In the HPL period, patients on the regular list who received a transplant had a nonsignificant trend toward improved overall survival compared with those on the HPL who received a transplant (at 1, 2, 3, and 5 years: 85%, 77%, 72%, and 72% vs 67%, 6...Continue Reading

Citations

Mar 13, 2018·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Matthieu GlorionElie Fadel
Nov 17, 2017·European Respiratory Review : an Official Journal of the European Respiratory Society·Laurent SavaleMarc Humbert
Dec 14, 2018·The European Respiratory Journal·Marius M HoeperWalter Klepetko
Oct 12, 2019·The European Respiratory Journal·Arnaud RousselUNKNOWN French Groups of Lung Transplantation
Dec 10, 2019·Cardiovascular Research·Alice HuertasChristophe Guignabert
Apr 15, 2021·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Jérôme Le PavecElie Fadel
Apr 13, 2021·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Sébastien HascoëtElie Fadel
Aug 23, 2021·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Lorriana E LeardKathleen J Ramos

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