Transplantation for Pulmonary Arterial Hypertension with Congenital Heart Disease: Impact of current therapeutic approach including a high-priority allocation programme on outcomes - 14/08/21
, Margaux Pontailler, MD, PhD a, ⁎, Jérôme Le Pavec, MD, PhD b, c, Laurent Savale, MD, PhD b, Olaf Mercier, MD, PhD d, Dominique Fabre, MD, PhD b, Sacha Mussot, MD b, Gérald Simonneau, MD, PhD b, Xavier Jais, MD, PhD d, Séverine Feuillet, MD d, Francois Stephan, MD, PhD b, Sarah Cohen, MD, PhD b, Damien Bonnet, MD, PhD a, Marc Humbert, MD, PhD c, Philippe Dartevelle, MD, PhD c, Elie Fadel, MD, PhD b
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Résumé |
Patients with end-stage pulmonary arterial hypertension due to congenital heart disease had limited access to heart-lung transplantation or double-lung transplantation.
Methods and results |
We aimed to assess the effects of a high-priority allocation programme established in France in 2007. We conducted a retrospective study to compare waiting-list and post-transplantation outcomes before versus after implementation of the high-priority allocation programme. We included 67 consecutive patients (mean age at listing 33.2±10.5 years) with pulmonary arterial hypertension due to congenital heart disease listed for heart-lung transplantation or double-lung transplantation from 1997 to 2016. At one month, the incidences of transplantation and death before transplantation were 3.5% and 24.6% in 1997–2006, 4.8% and 4.9% for patients on the regular list in 2007–2016, and 41.2% and 7.4% for patients listed under the high-priority allocation programme (P<0.001 and P=0.0001 respectively). Overall survival was higher in patients listed in 2007–2016 (84.2% and 61.2% at 1 and 10 years versus 36.8% and 22.1%, P=0.0001).
Conclusion |
Increased incidence of transplantation, decreased waiting list mortality, and improved early and long-term outcomes were observed in patients with pulmonary arterial hypertension due to congenital heart disease listed for transplantation in the recent era, characterized by implementation of a high-priority allocation programme.
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| ☆ | Due to the pandemic, this abstract was already published in American Journal of Transplantation, https://doi.org/10.1111/ajt.16600. |
Vol 13 - N° 4
P. 274 - septembre 2021 Retour au numéro
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