Navigating the Road to Transplantation for Pulmonary Arterial Hypertension

Transplantation is an important component of treatment for pulmonary arterial hypertension (PAH) patients with severe limitations despite optimal medical therapy. Although the risks of transplantation remain significant, appropriate candidates may achieve excellent functional outcomes and long-term survival. As PAH therapy and transplantation have advanced, the approaches to transplant referral and listing have changed. This article will review criteria and thresholds for transplant referral and listing, novel approaches to expanding the pool of donor organs, options for bridging to transplantation, and the ways in which the current system for organ allocation have evolved. Knowledge of these concepts will help to ensure timely referral and navigation of the course to successful transplantation for PAH patients.