Abstract Introduction Pulmonary hypertension (PH) is known to complicate parenchymal lung disease. In the context of engineered stone workers with silicosis referred for lung transplantation (LT) to the University of California Los Angeles, we sought to report pulmonary hemodynamics based on the gold standard right heart catheterization (RHC). Description: 16 male patients (age 47+8 years) RS1 with silicosis (11 biopsy proven) were referred to UCLA for LT between 1/1/2022 and 10/15/2025 (Table). 10 patients underwent bilateral LT, 4 patients remain on the waiting list, and 2 patients died prior to active listing. The following pulmonary hemodynamics (median+SD) were noted: mRAP mean right atrial pressure 3+2.9mmHg; mPAP mean pulmonary artery pressure 28.2+11.8mmHg; mPAWP mean pulmonary artery wedge pressure 8+8.1mmHg; CO cardiac output 4.5+1.2(liters/minute); CI cardiac index 2.6+0.7(liters/min/m2); PVR pulmonary vascular resistance 4.1+3.3(Wood units); PA saturation 67+7%; systemic MAP mean arterial pressure 87+14mmHg; heart rate 83+13(beats/min). All patients except one (94%) met criteria for PH; all had precapillary PH; and 38% met criteria for severe Group 3 PH (PVR5Wood units). Discussion There is a paucity of data regarding PH in the setting of silicosis, as assessed by RHC. At the time of LT referral, precapillary PH based on RHC complicates silicosis in almost all cases (94%) and can be severe in nearly 40% of cases. This finding contrasts with idiopathic pulmonary fibrosis (IPF) where ∼50% of cases have precapillary PH, and 24% have severe PH. Importantly, PH in the setting of silicosis is likely to further complicate an inherently difficult surgical dissection and lung explantation, and the related increased bleeding risk in this population. While it remains unclear whether PH complicating silicosis is amenable to PH-specific therapy, it may be appropriate to consider RHC and a trial of PH-specific therapy earlier during the progression of parenchymal disease. However, this consideration should be tempered by the significant obstructive lung disease (FEV1/FVC in the 5th percentile) noted in 70% of this cohort. This abstract is funded by: None
Saggar et al. (Fri,) studied this question.