초록접수 현황
| 19F-122 | 구연 발표 |
Postoperative outcome of lung transplantation for end stage lung disease with pulmonary hypertension : retrospective study of 175 patients
Jee Won Suh¹, Ha Eun Kim¹, Seong Yong Park¹, Chang Young Lee¹, Jin Gu Lee¹, Dae Joon Kim¹, Kyoung Young Chung¹, Su Jin Jeong², Moo Suk Park³, Song Yee Kim³, Hyo Chae Paik¹
¹Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea, ²Division of Infectious Disease, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea, ³Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
Purpose : Pulmonary hypertension (PH) is often associated with end stage lung disease patients who are waiting for lung transplantation. The severity of pulmonary HTN and the degree of combined right side heart dysfunction may affect patient outcome and may be a critical factor in deciding whether to perform lung or heart-lung transplantation. We investigated the outcomes of lung transplantation in patients with end stage lung disease combined with PH.
Methods : From January 2010 to December 2018, total of 250 patients underwent lung transplantation. Seventy-five patients were excluded due to unavailable data for assessment of pulmonary arterial pressure by right heart catheterization. Patients were divided into two groups – patients with and without PH. Baseline characteristics, preoperative mean PAPr, biventricular heart function estimated by echocardiography were collected and postoperative mean PAPr, postoperative heart function, perioperative outcomes and survival were analyzed.
Results : One hundred-eleven patients (65.7%) had preoperative PH. Mean PAPr (median [IQR]) was 20.0 [4] mmHg and 35.0 [16] mmHg in each group. Preoperative PCWP, PVR, peak TR velocity and NT-proBNP were significantly higher in Pulmonary HTN group. PAPr was recovered to normal range after transplantation. Greater than Grade 3 primary graft dysfunction, length of ICU stay, hospital stay, operative mortality and overall survival rate had no statistically significant difference between the two group.
Conclusion : Regardless of presence of right ventricular dysfunction, PH had no adverse effect on postoperative outcomes, and the right heart function improved after the transplantation. Therefore patients with PH had similar outcomes after lung transplantation compared with patients without PH.
Methods : From January 2010 to December 2018, total of 250 patients underwent lung transplantation. Seventy-five patients were excluded due to unavailable data for assessment of pulmonary arterial pressure by right heart catheterization. Patients were divided into two groups – patients with and without PH. Baseline characteristics, preoperative mean PAPr, biventricular heart function estimated by echocardiography were collected and postoperative mean PAPr, postoperative heart function, perioperative outcomes and survival were analyzed.
Results : One hundred-eleven patients (65.7%) had preoperative PH. Mean PAPr (median [IQR]) was 20.0 [4] mmHg and 35.0 [16] mmHg in each group. Preoperative PCWP, PVR, peak TR velocity and NT-proBNP were significantly higher in Pulmonary HTN group. PAPr was recovered to normal range after transplantation. Greater than Grade 3 primary graft dysfunction, length of ICU stay, hospital stay, operative mortality and overall survival rate had no statistically significant difference between the two group.
Conclusion : Regardless of presence of right ventricular dysfunction, PH had no adverse effect on postoperative outcomes, and the right heart function improved after the transplantation. Therefore patients with PH had similar outcomes after lung transplantation compared with patients without PH.
첨부파일 : pul HTN table and figure.pdf
책임저자: Hyo Chae Paik
Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
발표자: Jee Won Suh, E-mail : suh_1225@yuhs.ac