Mora-Cuesta Víctor M, Martínez-Meñaca Amaya, Iturbe-Fernández David, Tello-Mena Sandra, Izquierdo-Cuervo Sheila, García-Camarero Tamara, Gil-Ongay Aritz, Alonso-Lecue Pilar, Cifrián-Martínez José M, Rodríguez-Chiaradia Diego Agustín, Escribano-Subías Pilar, Barreiro Esther
Respiratory Department Marqués de Valdecilla University Hospital Santander Spain.
ERN-LUNG (European Reference Network on rare respiratory diseases) Frankfurt Germany.
Pulm Circ. 2025 Jun 2;15(2):e70107. doi: 10.1002/pul2.70107. eCollection 2025 Apr.
Lung transplantation (LT) is a well-established therapeutic option for patients with advanced chronic respiratory diseases. This study aims to assess the prevalence and clinical impact of Group 2 pulmonary hypertension (PHg2) in LT recipients, comparing it with Group 3 pulmonary hypertension (PHg3). This retrospective cohort study analyzed LT recipients from 2015 to 2024 at a single center. Patients were categorized into three groups based on hemodynamic measurements: no PH, PHg2, and PHg3. Hemodynamic data were acquired via right heart catheterization. Perioperative complications, including primary graft dysfunction (PGD), and long-term survival were compared across the groups. Of the 412 LT recipients, 40 (10.9%) were diagnosed with PHg2, while 62.5% had PHg3. Statistical analysis revealed no significant differences in perioperative outcomes, including the incidence of PGD, between patients with PHg2 and those with PHg3. Additionally, there were no differences in long-term survival between the groups. Within the PHg2 subgroup, patients with isolated PHg2 and those with combined PHg2 exhibited similar post-transplant outcomes. PHg2 is identified in a notable fraction of LT recipients, yet it does not appear to adversely affect perioperative complications or long-term survival when compared to PHg3 or patients without PH. These findings suggest that PHg2, despite its prevalence, does not significantly alter transplant outcomes. Future multicenter studies are needed to further explore the impact of subtle left ventricular dysfunction on LT results.
肺移植(LT)是晚期慢性呼吸道疾病患者公认的治疗选择。本研究旨在评估肺移植受者中2型肺动脉高压(PHg2)的患病率及其临床影响,并与3型肺动脉高压(PHg3)进行比较。这项回顾性队列研究分析了2015年至2024年在单一中心接受肺移植的患者。根据血流动力学测量结果,将患者分为三组:无肺动脉高压组、PHg2组和PHg3组。通过右心导管插入术获取血流动力学数据。比较了各组围手术期并发症,包括原发性移植功能障碍(PGD)和长期生存率。在412例肺移植受者中,40例(10.9%)被诊断为PHg2,而62.5%患有PHg3。统计分析显示,PHg2患者和PHg3患者在围手术期结果,包括PGD发生率方面无显著差异。此外,各组之间的长期生存率也无差异。在PHg2亚组中,孤立性PHg2患者和合并性PHg2患者的移植后结果相似。在相当一部分肺移植受者中发现了PHg2,但与PHg3或无肺动脉高压患者相比,它似乎并未对围手术期并发症或长期生存产生不利影响。这些发现表明,尽管PHg2很常见,但它并未显著改变移植结果。未来需要进行多中心研究,以进一步探讨轻微左心室功能障碍对肺移植结果的影响。