RT Journal Article
SR Electronic
T1 Five-years experience with high urgency allocation program for lung and heart-lung transplantation in pulmonary hypertension
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2372
VO 44
IS Suppl 58
A1 Laurent Savale
A1 Jérôme Le Pavec
A1 Olaf Mercier
A1 Sacha Mussot
A1 Dominique Fabre
A1 Xavier Jais
A1 David Montani
A1 Olivier Sitbon
A1 Marc Humbert
A1 Gerald Simonneau
A1 Philippe Dartevelle
A1 Elie Fadel
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P2372.abstract
AB Background. French patients with severe pulmonary hypertension (PH) and imminent risk of death can access to heart-lung transplantation (HLT) or lung transplantation (LT) according to a high urgency allocation program (HUAP) since September 2006 and July 2007 respectively.Objective and methods. To report results of HLT and LT in PH patients listed on HUAP from 2007 to 2012. Characteristics and outcome of these patients were retrospectively analyzed and compared to the cohort of PH patients receiving non-urgent (NU) HLT or LT.Results. During the study period, 28/42 (67%) HLT and 24/53 (45%) LT were performed according to the HUAP. Based on the clinical classification of PH 64% of patients were group 1 (pulmonary arterial hypertension), 18% group 1' (veno-occlusive disease), 2% group 3, 8% group 4 and 7% group 5. Total median time on waiting list was 0.3 months (IQR 25-75%, 0.1-2.7) and 3.6 months (IQR 25-75%, 2-12) in HUAP and NU groups respectively (p<0.01). Median numbers of death per year on waiting list decreased from 8 (IQR 25-75%, 7-9) during 2000-2006 to 2.5 (IQR 25-75%, 1.25-3.75) during the study period. There was no significant difference in survival rates after transplantation between HUAP and NU groups (71%, 69%, 63%, 58% and 84%, 76%, 67%, 67% after 1,2,3 and 5 years respectively). Both groups were also similar in terms of mechanical ventilation duration and acute cellular rejection after surgery.Conclusion. This study suggests that HUAP for HLT or LT may improve survival of PH patients on waiting list with respect to similar morbidity and mortality after transplantation.