Advanced pulmonary arterial hypertension: mechanical support and lung transplantation

Eur Respir Rev. 2017 Dec 20;26(146):170089. doi: 10.1183/16000617.0089-2017. Print 2017 Dec 31.

Abstract

The development of targeted therapies has transformed the outlook for patients with pulmonary arterial hypertension (PAH); however, some patients fail to achieve an adequate clinical response despite receiving maximal treatment. For these patients, lung transplantation remains an important therapeutic option, and recommendations for transplantation are included in the current European Society of Cardiology/European Respiratory Society guidelines for the diagnosis and treatment of pulmonary hypertension. Although lung transplantation is not without risk, overall long-term survival rates are good and substantial improvements in quality of life have been reported for lung transplant recipients. In this review, we describe the important considerations prior to, during and after transplantation, including the role of mechanical support, in patients with advanced PAH.

Publication types

  • Review

MeSH terms

  • Arterial Pressure*
  • Cardiac Catheterization* / adverse effects
  • Cardiac Catheterization* / mortality
  • Clinical Decision-Making
  • Extracorporeal Membrane Oxygenation* / adverse effects
  • Extracorporeal Membrane Oxygenation* / mortality
  • Heart-Assist Devices*
  • Humans
  • Hypertension, Pulmonary / diagnosis
  • Hypertension, Pulmonary / mortality
  • Hypertension, Pulmonary / physiopathology
  • Hypertension, Pulmonary / surgery*
  • Lung Transplantation* / adverse effects
  • Lung Transplantation* / mortality
  • Patient Selection
  • Pulmonary Artery / physiopathology*
  • Risk Factors
  • Treatment Outcome
  • Ventricular Dysfunction, Right / diagnosis
  • Ventricular Dysfunction, Right / mortality
  • Ventricular Dysfunction, Right / physiopathology
  • Ventricular Dysfunction, Right / therapy*
  • Ventricular Function, Right
  • Waiting Lists