Abstract 17758: Heart-Lung Transplantation Outcomes in Adult Congenital Heart Disease
Introduction: Heart-lung transplantation (HLT) may be indicated in adult congenital heart disease patients (ACHD) with or without Eisenmenger syndrome (ES) with end-stage heart and lung disease. Previous studies show worse survival in pediatric HLT recipients with CHD compared to those undergoing HLT for idiopathic pulmonary arterial hypertension (IPH). Outcomes and predictors of survival post HLT in ACHD patients however have not been clearly established. We aimed to determine HLT outcomes in adult CHD patients with and without ES compared to patients who underwent HLT for IPH and to identify predictors of decreased survival.
Methods: UNOS database was queried for adult HLT recipients from 1992 to 2015. Kaplan- Meier survival analysis was performed to compare post HLT survival in patients with CHD/ES, CHD without ES and IPH. Univariate and Multivariate cox regression analyses were performed to determine donor and recipient predictors of poor survival post HLT.
Results: We identified 984 patients >18 yrs who underwent HLT; CHD/ES was the diagnosis in 218 recipients, CHD with no ES in 41 and IPH in 174 recipients; 551 recipients had other diagnoses. Kaplan-Meier analysis showed no difference in post HLT survival in ACHD patients with and without ES compared to those with IPH. On multivariate analysis, only recipient female gender (adjusted HR 2.27, 95% CI 1.35-3.73), donor age (1.02; 1.01-1.03) and treated rejection episode within one year of transplant (1.53; 1.00-2.35) were found to be predictors of decreased post HLT survival.
Conclusions: We find no difference in post HLT survival in ACHD patients with or without ES compared to patients with diagnosis of IPH. ACHD population continues to expand and diversify as outcomes of palliative CHD improve and more pediatric patients survive into adulthood. However, caution must be exercised when extrapolating pediatric data to ACHD patients.
Author Disclosures: A.M. Khan: None. I.D. Lytrivi: None. H. Rajagopal: None. L.M. Nicholson: None. E. Pahl: None.
- © 2016 by American Heart Association, Inc.