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. 51 - 62
• Main Authors: Lopez-Vilella, R, Gomez Bueno, M, Gonzalez Vflchez, F, Sole Jover, A, Laporta Hernandez, R, Vicente Guillen, R, Gonzalez Roman, A I, Sanchez-Lazaro, I, Hernandez Perez, F, Sales Badfa, G, Cordoba Pelaez, M D M, Torregrosa Puerta, S, teza Gil, A, Martinez Dolz, L, Segovia Cubero, J, Almenar Bonet, L
• Format: Journal Article
• Language: English
• Published: Shiraz, Iran Avicenna Organ Transplantation Institute 01-01-2022
• Subjects: Original
• ISSN: 2008-6482; 2008-6490

BackgroundThis 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. MethodsA 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). ResultsEarly 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. ConclusionHLTx has a high mortality. The etiological analysis is of the utmost interest to make the most of the organs and improve survival.