1. Current Situation and Prognostic Evolution of Combined Heart-lung Transplantation in a European Union Country.
- Author
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López-Vilella, R., Gómez Bueno, M., González Vílchez, F., Solé Jover, A., Laporta Hernández, R., Vicente Guillén, R., Gonzalez Román, A. I., Sánchez-Lázaro, I., Hernández Pérez, F., Sales Badía, G., Córdoba Peláez, M. D. M., Torregrosa Puerta, S., Forteza Gil, A., Martínez Dolz, L., Segovia Cubero, J., and Bonet, L. Almenar
- Subjects
INTERSTITIAL lung diseases ,PULMONARY hypertension ,EISENMENGER syndrome ,PULMONARY arterial hypertension ,CYSTIC fibrosis - Abstract
Background: This study aims to evaluate the entire experience in heart-lung transplantation (HLTx) in a country of the European Union with 47 million inhabitants according to the etiologies that motivated the procedure. Methods: A retrospective study on 1,751 consecutive transplants (HLTx: 78) was performed from 1990 to 2020 in two centers. Overall survival, adjusted for clinical profile and etiological subgroups, was compared. 7 subgroups were considered: 1) Cardiomyopathy with pulmonary hypertension (CM + PH). 2) Eisenmenger syndrome. 3) Congenital heart disease (CHD). 4) Idiopathic pulmonary arterial hypertension (IPAH). 5) Cystic fibrosis. 6) Chronic obstructive pulmonary disease (COPD)/Emphysema. 7) Diffuse interstitial lung disease (ILD). Results: Early mortality was 44% and that of the rest of the follow-up was 31%. There were differences between HTLx and HTx in survival, also comparing groups with a similar clinical profile with propensity score (p= 0.04). Median survival was low in CM + PH (18 days), ILD (29 days) and CHD (114 days), intermediate in Eisenmenger syndrome (600 days), and longer in IPAH, COPD/Emphysema and cystic fibrosis. Conclusion: HLTx has a high mortality. The etiological analysis is of the utmost interest to make the most of the organs and improve survival. [ABSTRACT FROM AUTHOR]
- Published
- 2022