Current situation and prognostic evolution of combined heart-lung transplantation in a European Union country

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 p...

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Detalles Bibliográficos
Autores: López-Vilella, R., Gómez Bueno, M., González Vílchez, Francisco Jesús, Sole Jover, A., Laporta Hernández, R., Vicente Guillén, R., González Román, A. I., Sánchez-Lázaro, I., Hernández Pérez, F., Sales Badfa, G., Córdoba Peláez, M. D. M., Torregrosa Puerta, S., Forteza Gil, A., Martínez Dolz, L., Segovia Cubero, J., Almenar Bonet, L.
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Universidad de Cantabria (UC)
Repositorio:UCrea Repositorio Abierto de la Universidad de Cantabria
Idioma:inglés
OAI Identifier:oai:repositorio.unican.es:10902/36189
Acceso en línea:https://hdl.handle.net/10902/36189
Access Level:acceso abierto
Palabra clave:Heart-lung transplantation
Heart transplantation
Survival
Etiology
Descripción
Sumario: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.

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