RT Journal Article SR Electronic T1 Cautious epoprostenol therapy is a safe bridge to lung transplantation in pulmonary veno-occlusive disease JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP 1348 OP 1356 DO 10.1183/09031936.00017809 VO 34 IS 6 A1 D. Montani A1 X. Jaïs A1 L. C. Price A1 L. Achouh A1 B. Degano A1 O. Mercier A1 S. Mussot A1 E. Fadel A1 P. Dartevelle A1 O. Sitbon A1 G. Simonneau A1 M. Humbert YR 2009 UL http://erj.ersjournals.com/content/34/6/1348.abstract AB Pulmonary veno-occlusive disease (PVOD) carries a poor prognosis and lung transplantation is the only curative treatment. In PVOD, epoprostenol therapy is controversial, as this condition may be refractory to specific therapy with an increased risk of pulmonary oedema. We retrospectively reviewed clinical, functional and haemodynamic data of 12 patients with PVOD (10 with histological confirmation) treated with continuous intravenous epoprostenol and priority listed for lung transplantation after January 1, 2003. All PVOD patients had severe clinical, functional and haemodynamic impairment at presentation. Epoprostenol was used at low dose ranges with slow dose increases and high dose diuretics. Only one patient developed mild reversible pulmonary oedema. After 3–4 months, improvements were seen in the New York Heart Association functional class (class IV to III in seven patients), cardiac index (1.99±0.68 to 2.94±0.89 L·min−1·m−2) and indexed pulmonary vascular resistance (28.4±8.4 to 17±5.2 Wood units·m−2; all p<0.01). A nonsignificant improvement in the 6-min walk distance was also observed (+41 m, p = 0.11). Two patients died, one patient was alive on the transplantation waiting list on December 1, 2008 and nine patients were transplanted. Cautious use of continuous intravenous epoprostenol improved clinical and haemodynamic parameters in PVOD patients at 3–4 months without commonly causing pulmonary oedema, and may be a useful bridge to urgent lung transplantation.