Outcomes after lung transplant similar in PH groups 2 and 3
Rates of long-term survival, complications not different from not having PH
The rates of long-term survival and perioperative complications after a lung transplant in people with group 2 or group 3 pulmonary hypertension (PH) aren’t significantly different from those in people who don’t have PH, a study reports.
“No significant differences [between group 2 PH, group 3 PH, or no PH] were found in any relevant variables during surgery and the immediate postoperative period of lung transplant,” researchers wrote in the study, “Lung Transplant Outcomes in Patients With Preoperative Catheterization Indicating Group 2 Pulmonary Hypertension,” which was published in Pulmonary Circulation.
PH refers to high pressure in the vessels that carry blood from the heart through the lungs. There are different types of PH with different underlying causes. The classification of the disease into groups and classes comes from the World Health Organization (WHO). Among the most common are group 2 PH, which is caused by disease in the left side of the heart that’s responsible for pumping oxygen-rich blood out to the body, and group 3 PH, which is caused by chronic low oxygen levels in the lungs.
A lung transplant may be a treatment for various types of PH. The response to a lung transplant may vary by PH type, however. For example, group 3 PH, which is caused by lung disease, can usually be resolved by a successful lung transplant, but PH usually persists after a transplant in group 2 patients, whose PH results from heart dysfunction. In theory, this difference might lead to worse outcomes for people with group 2 PH, but there’s not a robust dataset about how outcomes after a lung transplant compare in different forms of PH.
Comparing outcomes in PH types after transplant
Here, researchers in Spain reviewed data from nearly 400 lung transplants performed at their center. Among the patients analyzed, 40 had PH group 2, 230 had group 3, and the remaining 98 didn’t have PH.
Long-term survival rates after lung transplants were similar with group 2 PH, group 3 PH, or no PH. Other outcomes, including perioperative complications, the amount of time spent in the hospital, and the need for additional surgeries, also were comparable.
Group 2 PH can be divided into two subsets — isolated and combined, based on specific patterns of which blood vessels are affected. The analyses showed no notable differences in outcomes after a lung transplant among the two subtypes.
“No significant variations were observed in perioperative complications or post-transplant survival between [PH group 2 and PH group 3] patients. Additionally, within the [PH group 2] group, isolated and combined [PH group 2] did not show differences in postoperative outcomes,” the researchers wrote. “These findings suggest that while [PH group 2] is relatively common, it does not adversely impact immediate or long-term outcomes in [lung transplant].”
The study was limited to patients who’d already undergone a transplant at a single center, so more studies are needed to validate the findings, the researchers said.
“Future research should focus on larger, multicenter studies to further investigate the impact of subtle left [heart] dysfunction in better understanding the effects of [PH group 2] on transplant outcomes,” the researchers wrote.
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