Lung transplantation for pulmonary hypertension

S. P. Gaine, J. B. Orens

Research output: Contribution to journalReview article

Abstract

Although lung transplantation is a viable option for patients with end-stage pulmonary hypertension, it is associated with numerous problems including infection, rejection, and limited long-term survival. Because of these limitations, transplantation should only be considered for patients who are failing maximal medical therapy. Treatment options for patients with pulmonary hypertension that may serve to prolong or obviate the need for transplantation include anticoagulation with warfarin, diuretics, and vasodilators such as calcium channel blockers or continuous intravenous epoprostenol (prostacyclin). The response to medical therapy should be assessed at regular intervals by evaluating exercise tolerance and hemodynamic parameters. Because waiting periods for transplantation now exceed 1.5 to 2 years in the United States, and the response to medications is unpredictable, referral for transplantation should occur when patients become symptomatic. Those who are responding well to medical therapy should be removed from the active transplant waiting list, whereas those who fail therapy should go on to transplant. Utilizing medical therapy and transplantation as complementary treatments will achieve the best potential to improve quality of life and prolong survival.

Original languageEnglish (US)
Pages (from-to)533-540
Number of pages8
JournalSeminars in Respiratory and Critical Care Medicine
Volume22
Issue number5
DOIs
StatePublished - Jan 1 2001

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Keywords

  • Lung transplantation
  • Prostacyclin
  • Pulmonary hypertension

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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