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Lookup NU author(s): Dr Pauline Pradere, Saskia BosORCiD, Dr Andre Pozza, Dr Gerard Meachery, Dr James Lordan, Professor Andrew FisherORCiD
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).
© The authors 2024.Background Lung or heart–lung transplantation (LT/HLT) for severe pulmonary hypertension (PH) as the primary disease indication carries a high risk of waiting list mortality and post-transplant complications. France and the UK both have coordinated PH patient services but with different referral pathways for accessing LT services. Methods We conducted a comparative analysis of adult PH patients listed for LT/HLT in the UK and France. Results We included 211 PH patients in France (2006–2018) and 170 in the UK (2010–2019). Cumulative incidence of transplant, delisting and waiting list death within 3 years were 81%, 4% and 11% in France versus 58%, 10% and 15% in the UK (p<0.001 for transplant and delisting; p=0.1 for death). Median nonpriority waiting time was 45 days in France versus 165 days in the UK (p<0.001). High-priority listing occurred in 54% and 51% of transplanted patients respectively in France and the UK (p=0.8). Factors associated with achieving transplantation related to recipients’ height, male sex, clinical severity and priority listing status. 1-year post-transplant survival was 78% in France and 72% in the UK (p= 0.04). Conclusion Access to transplantation for PH patients is better in France than in the UK where more patients were delisted due to clinical deterioration because of longer waiting time. High rates of priority listing occurred in both countries. Survival for those achieving transplantation was slightly better in France. Ensuring optimal outcomes after transplant listing for PH patients is challenging and may involve early listing of higher risk patients, increasing donor lung utilisation and improving allocation rules for these specific patients.
Author(s): Pradere P, Le Pavec J, Bos S, Pozza A, Nair A, Meachery G, Lordan J, Humbert M, Mercier O, Fadel E, Savale L, Fisher AJ
Publication type: Article
Publication status: Published
Journal: ERJ Open Research
Year: 2024
Volume: 10
Issue: 1
Online publication date: 22/01/2024
Acceptance date: 17/11/2023
Date deposited: 19/02/2024
ISSN (electronic): 2312-0541
Publisher: European Respiratory Society
URL: https://doi.org/10.1183/23120541.00521-2023
DOI: 10.1183/23120541.00521-2023
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