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| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Artículo Open Access |
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Wiley
2026
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| Online Access: | https://onlinelibrary.wiley.com/doi/10.1111/ctr.70493 |
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- Impact of Pulmonary Veno‐Occlusive Disease on Posttransplant Survival in Pulmonary Hypertension Pedro Manso Tejerina Quezada Loaiza Carlos Andrés Juan Margallo Iribarnegaray Virginia Luz Pérez González Alejandro Cruz Utrilla María Pilar Escribano Subias Cristina Martín‐Arriscado Arroba Fátima Hermoso Alarza Antonio Pablo Gámez García Olga González González Eloisa López López Alicia De Pablo Gafas Rodrigo Alonso Moralejo Clinical Transplantation ABSTRACT Introduction Pulmonary veno‐occlusive disease (PVOD) is a rare but severe form of pulmonary arterial hypertension (PAH), characterized by poor response to medical therapy. Lung transplantation is often the only therapeutic alternative. Methods We analyzed a retrospective cohort of 58 patients with group 1 PAH who underwent lung transplantation between 2011 and 2024. Baseline characteristics, perioperative complications, and survival were compared between patients with and without PVOD. Statistical methods included descriptive analysis, Kaplan–Meier survival curves, log‐rank tests, and Cox regression. Results Among the 58 patients, 21 (36.2%) had a diagnosis of PVOD before transplantation. PVOD patients were younger (median age 39.8 vs. 43.1 years, p = 0.03), had lower DLCO (32% vs. 66%, p < 0.001), shorter six‐minute walk distance (300 vs. 430 m, p < 0.001), and a higher COMPERA 2.0 four‐strata risk score (median 3 vs. 2, p = 0.035) tan non‐PVOD patients. Hemodynamically, PVOD patients showed lower systolic pulmonary artery pressure (78 vs. 98 mmHg, p = 0.038), lower pulmonary vascular resistance (9.2 vs. 10.6 Wood units, p = 0.03), and lower right atrial pressure (6.5 vs. 11.5 mmHg, p = 0.003). Time from diagnosis to transplantation was significantly shorter (23.8 vs. 69.6 months, p < 0.001), and extracorporeal membrane oxygenation (ECMO) as bridge to transplantation was more frequent (23.8% vs. 2.7%, p = 0.011). Survival did not differ significantly between groups (log‐rank p = 0.657). Postoperative need for non‐invasive ventilation (NIV) was independently associated with mortality (HR 3.15; 95% CI 1.00–9.83; p = 0.042). Conclusions Lung transplantation in PVOD patients results in survival comparable to other group 1 PAH subtypes. Postoperative need for NIV identifies patients at higher risk of mortality. 10.1111/ctr.70493 http://onlinelibrary.wiley.com/termsAndConditions#vor