Abstract Background Single lung transplant has been proposed as a viable option for patients with severe WHO group 3 pulmonary arterial hypertension due to pulmonary fibrosis. Most studies have yielded variable results and were done prior to the new ERS/ESC definition of severe pulmonary hypertension (PH). Herein, we study the pre- and post-transplant echocardiographic features of such patients with attention to right ventricular (RV) size and function. Methods We conducted a retrospective cohort study of lung transplant patients at Temple University Hospital between January 2015 and January 2025. All patients had right heart catheterization (RHC) done before lung transplant. Severe PH was defined as Pulmonary Vascular Resistance (PVR) 5. All patients with evidence of WHO group 1 or 2 PH were excluded. Post-transplant echocardiograms were reviewed with a focus on the RV. All echocardiographic data were preferably obtained 6 months after lung transplant. Results A total of 41 patients were included in the final analysis. Most patients (56%, n = 23) had Idiopathic Pulmonary Fibrosis (IPF), followed by Combined Pulmonary Fibrosis and Emphysema (CPFE) with predominant fibrosis (24% n = 10). All patients had severe PH with a mean PVR of 6.90±1.8, with a mean systolic PAP of 57.9±13.6, a mean PAP of 39.5±8.7, and a mean PCWP of 8.5±4.0. Before lung transplant, all patients had evidence of either dilated RV or reduced RV function of variable degree, and most (90%) had evidence of both. Out of 41 patients, 25 (61%) had normalization of both RV size and function on post-transplant echo. Seven (17%) patients had evidence of persistent RV dilation and reduced function. Five patients had normalization of RV function despite persist dilation of RV. Four patients had a normalization in size but persistent reduced RV function. Conclusion Most patients with pulmonary fibrosis and associated severe WHO group 3 pulmonary arterial hypertension demonstrate complete recovery in their RV function with normalization of size despite having a single lung transplant. This abstract is funded by: None
Raza et al. (Fri,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: