Outcomes of listing for lung and heart-lung transplantation in pulmonary hypertension: comparative experience in France and the UK.

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

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.

Informations de copyright

Copyright ©The authors 2024.

Déclaration de conflit d'intérêts

Conflict of interest: P. Pradère, J. Le Pavec, A. Pozza, G. Meachery, O. Mercier and E. Fadel have nothing to declare. Conflict of interest: S. Bos received lecture fees from Therakos (Mallinckrodt) and Jazz, and conference registration/travel support from GlaxoSmithKline and Takeda, outside of the submitted work. Conflict of interest: A. Nair received personal fees from Janssen, outside of the submitted work. Conflict of interest: J. Lordan reports travel support from Johnson and Johnson outside the submitted work and an honorarium from MSD for a PH advisory board meeting. Conflict of interest: M. Humbert reports grants from AOP Orphan, Janssen and Shou Ti; consulting fees from Aerovate, Altavant, AOP Orphan, Chiesi, Ferrer, Janssen, MorphogenIX, Shou Ti, Tiakis and United Therapuetics; lecture honoraria from Janssen; grants, consulting fees and personal fees for advisory board participation from Acceleron; grants and personal fees from Actelion; grants, consulting fees and personal fees from Bayer; personal fees from GSK; grants, consulting fees, lecture honoraria and personal fees for advisory board participation from Merck; personal fees from Novartis; personal fees from AstraZeneca; personal fees from Sanofi; and advisory board participation from Altavant, Janssen and United Therapeutics, outside the submitted work. Conflict of interest: L. Savale reports personal fees from Actelion, personal fees from MSD, grants and personal fees from GSK, outside the submitted work. Conflict of interest: A.J. Fisher reports grants from GlaxoSmithKline, grants, personal fees and nonfinancial support from Mallinckrodt Pharmaceuticals, personal fees from Altavant, and grants from Pfizer, outside the submitted work.