Current Situation and Prognostic Evolution of Combined Heart-lung Transplantation in a European Union Country

• Published in: International journal of organ transplantation medicine Vol. 13; no. 2; pp. 50 - 62
• Main Authors: López-Vilella, R, Bueno, M Gómez, Vílchez, F González, Jover, A Solé, Hernández, R Laporta, Guillén, R Vicente, Román, A I Gonzalez, Sánchez-Lázaro, I, Pérez, F Hernández, Badía, G Sales, Peláez, M D M Córdoba, Puerta, S Torregrosa, Gil, A teza, Dolz, L Martínez, Cubero, J Segovia, Bonet, L Almenar
• Format: Journal Article
• Language: English
• Published: Shiraz Shiraz University of Medical Sciences 01-01-2022
• Subjects: Cardiomyopathy; Cardiovascular disease; Chronic obstructive pulmonary disease; Congenital diseases; Cystic fibrosis; Emphysema; Ethics; Etiology; Heart; Lung diseases; Lung transplants; Mortality; Pulmonary hypertension; Variables; Spain
• ISSN: 2008-6482; 2008-6490

HLTx presents notable differences with other transplants, especially related to its high mortality, which forces us to re-evaluate its usefulness according to clinical and ethical criteria [6, 7]. [...]HLTx is much less common than the isolated heart (HTx) or lung (LTx) transplantation, not only due to the lower availability of suitable donors and the lower number of indications, but also due to the results; in the short and long term results are worse due to the high complexity of the intervention, especially in some subgroups [7]. [...]it consumes 3 organs that could be used for 3 different patients and its survival results are worse than those of HTx and LTx, perhaps concerning the low number of cases performed and the complexity of the intervention [7]. [...]the propensity score was used to calculate a weight of the inverse probability of belonging to the HLTx group, where the probability of HLTx= 1/Propensity score and the probability of isolated HTx= 1/(1 - Score of propensity). There were a large number of differences between the patients with a HLTx vs HTx. [...]HLTx recipients tend to be younger, have a more balanced relationship between the sexes, heart with a lower total ventricular mass, greater glomerular filtration, a lower proportion of diabetes, previous sternotomy, and mechanical ventilation at the time of transplantation.