Clinical lung and heart/lung transplantationHeart–lung or lung transplantation for Eisenmenger syndrome
Section snippets
Methods
The ISHLT/UNOS Joint Thoracic Registry prospectively collects demographic and outcome data on heart, heart–lung and lung transplantation performed around the world. The Registry contains data on 605 patients with ES transplanted between January 1988 and December 1998. Three procedures were performed as living-related transplants and were excluded from further analysis. Follow-up data were available for 95% of patients (576). Survival analysis was performed on only those patients with available
Results
The causes of ES are shown in Figure 1A. Atrial septal defect was the most common cause. The cause was not indicated to the Registry in 28% of the cases. Heart–lung transplantation was the most commonly employed procedure, constituting 71%, as shown in Figure 1B. Bilateral lung transplantation was used more commonly than SLT.
As expected, lung transplantation was applied more commonly in cases with simple cardiac problems. Recipients with patent ductus arteriosus (PDA) received lung
Discussion
There are three important findings of this study. First, patients with ES are not functionally equivalent to patients with PPH. Second, patients with ES comprise a heterogeneous group, with significant differences in survival after transplantation depending on the cause of ES. Third, HLT appears to be the operation of choice, especially for patients with VSD.
The strengths of this study include the large number of patients, the fact that the data were collected prospectively by data managers
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