Bosentan in heart transplantation candidates with severe pulmonary hypertension: efficacy, safety and outcome after transplantation. (2nd August 2012)

• Record Type: Journal Article
• Authors: Perez‐Villa, Felix; Farrero, Marta; Cardona, Montse; Castel, Maria Angeles; Tatjer, Irene; Penela, Diego; Vallejos, Isabel
• Is Part Of: Clinical transplantation. Volume 27:Number 1(2013:Jan./Feb.)
• Page Start: 25
• Page End: 31
• Publication Date: 2012-08-02
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/j.1399-0012.2012.01689.x
• Languages: English
• ISSNs: 0902-0063

Abstract

<abstract abstract-type="main" id="ctr1689-abs-0001"> <title>Abstract</title> <sec id="ctr1689-sec-0001" sec-type="section"> <title>Background</title> <p>Increased pulmonary vascular resistance (PVR) is associated with increased right ventricular failure and mortality after heart transplantation.</p> </sec> <sec id="ctr1689-sec-0002" sec-type="section"> <title>Methods</title> <p>In this prospective study, 22 patients considered high‐risk candidates for heart transplantation because of severe pulmonary hypertension (PVR = 6 ± 2 Wood units; transpulmonary gradient 22 ± 7 mmHg), received bosentan 125 mg bid. Right heart catheterization was repeated after four months (n = 22) and 12 months (n = 9). Eleven patients who declined participation in the study were considered as control group.</p> </sec> <sec id="ctr1689-sec-0003" sec-type="section"> <title>Results</title> <p>After four months, PVR decreased by 38% in patients receiving bosentan (n = 22), while it increased by 25% in the control group (p = 0.001). Those patients who received bosentan for 12 months (n = 9), experienced a 60% reduction in PVR compared to baseline (p = 0.003). Only three patients (14%) had no hemodynamic improvement with bosentan. After bosentan therapy, 14 patients (64%) underwent heart transplantation. Patients with high PVR who received bosentan showed a trend toward better one‐yr survival after transplantation than patients with PVR ≤ 2.5 Wood units transplanted in the same period of time (93% vs. 83%).</p> </sec> <sec id="ctr1689-sec-0004" sec-type="section"> <title>Conclusions</title> <p>In patients considered high‐risk candidates for heart transplantation because of high PVR, therapy with bosentan is associated with a significant reduction in PVR and a good outcome after transplantation.</p> </sec> </abstract>