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To Cath or Not to Cath: Pediatric Lung Transplant Candidates without a Diagnosis of Pulmonary Hypertension

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Purpose The purpose of this study is to investigate whether performing cardiac catheterization (cath) in pediatric lung transplantation (LTx) candidates without a diagnosis of pulmonary hypertension (PHTN) impacts listing outcomes.… Click to show full abstract

Purpose The purpose of this study is to investigate whether performing cardiac catheterization (cath) in pediatric lung transplantation (LTx) candidates without a diagnosis of pulmonary hypertension (PHTN) impacts listing outcomes. Methods The UNOS Registry was queried to identify patients (0-18yo) without a diagnosis of PHTN who were listed for LTx from 2000-2019. Patients were divided into those who underwent cath during waitlist (Cath) and those who did not (No Cath). Negative listing outcome was defined as death on waitlist or removal from waitlist due to deterioration of condition. All other outcomes were considered positive. Results 1,732 pediatric LTx candidates without a diagnosis of PHTN were identified. These patients were divided into Cath (n=431) and No Cath (n=1,301). Cath patients most common diagnosis was cystic fibrosis (n=163; 38%), were younger (p 6 (p=0.05) and the No Cath groups (p=0.04). PVR>6 patients had similar listing outcomes to No Cath patients (p=0.36). In CF patients who reached a waitlist outcome within one year, positive listing outcomes at one year was 88% for the PVR≤6 group compared to 67% in the PVR>6 (p=0.05). Conclusion Pediatric LTx candidates without a diagnosis of PHTN who either did not undergo cath or had a PVR >6 had inferior waitlist outcomes compared to those with a PVR≤6. However, 75% of candidates were not catheterized, so right heart catheterization should strongly be considered for pediatric lung transplant recipients in order to better manage waitlist prioritization and improve overall listing outcomes.

Keywords: diagnosis; cath; without diagnosis; pediatric lung; candidates without

Journal Title: Journal of Heart and Lung Transplantation
Year Published: 2021

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