Grant S C, Levy R D, Brooks N H
Department of Cardiology, Wythenshawe Hospital, Manchester.
Br Heart J. 1992 Oct;68(4):365-8. doi: 10.1136/hrt.68.10.365.
Raised pulmonary vascular resistance is associated with decreased survival after orthotopic heart transplantation and patients with this risk factor are usually denied transplantation. In a proportion of cases raised pulmonary vascular resistance may fall with time and medical treatment.
Seven patients with high pulmonary vascular resistance (range 3.9-6.6 Wood units) at initial assessment for cardiac transplantation were restudied by right heart catheterisation after a period of seven to 17 months.
In five of the seven patients the pulmonary vascular resistance had fallen, allowing orthotopic heart transplantation to be performed in four. In one patient the resistance was static and in one it had risen. The mean fall in pulmonary vascular resistance for the group was (mean (SD)) 2.6 (2.7) Wood units, p < 0.05.
Patients who have been denied transplantation on the basis of their raised pulmonary vascular resistance should be reassessed after four to six months if they remain otherwise clinically suitable.
肺血管阻力升高与原位心脏移植术后生存率降低相关，存在该危险因素的患者通常会被拒绝接受移植。在部分病例中，肺血管阻力可能会随着时间推移和药物治疗而下降。
对7例在心脏移植初始评估时肺血管阻力较高（范围为3.9 - 6.6伍德单位）的患者，在7至17个月后通过右心导管检查进行再次研究。
7例患者中有5例肺血管阻力下降，其中4例得以进行原位心脏移植。1例患者阻力无变化，1例患者阻力升高。该组肺血管阻力的平均下降值为（均值（标准差））2.6（2.7）伍德单位，p < 0.05。
因肺血管阻力升高而被拒绝移植的患者，如果在其他方面临床情况合适，4至6个月后应重新评估。
