Journal Article Ahead of print
PubMed: 42492331 DOI: 10.1016/j.resmer.2026.101286
Pulmonary vascular complications following lung transplantation: characteristics, incidence, survival.
Respir Med Res 90:101286
Authors: Adam Dehili, Irene Hanot, Morgane Penhouet, Mehdi Lamkhioued, Dorian Hassoun, Eva Chatron, Isabelle Danner-Boucher, Emmanuel Eschapasse, Philippe Lacoste, Thierry Le Poivre, Claire Merveilleux du Vignaux, Jean-François Mornex, Arthur Petat, Adrien Tissot, Vincent Cottin, François Tronc, Ségolène Turquier
Affiliations
- National Referral Center for Rare Pulmonary Diseases and Constitutive Referral Center for Pulmonary Hypertension, Respiratory and Lung transplantation Department, Louis Pradel Hospital, Hospices Civils de Lyon, Louis Pradel Hospital, 28 avenue du doyen Lepine, 69500 Bron, Lyon, France.
- Respiratory and Lung Transplantation Department, Laennec Hospital, Nantes University Hospital Center, Nantes, France.
- Thoracic Surgery Department, Laennec Hospital, Nantes University Hospital Center, Nantes, France.
- Respiratory Intensive Care Unit, Laennec Hospital, Nantes University Hospital Center, Nantes, France.
- Thoracic Surgery Department, Louis Pradel Hospital, Hospices Civils de Lyon, Lyon, France.
- National Referral Center for Rare Pulmonary Diseases and Constitutive Referral Center for Pulmonary Hypertension, Respiratory and Lung transplantation Department, Louis Pradel Hospital, Hospices Civils de Lyon, Louis Pradel Hospital, 28 avenue du doyen Lepine, 69500 Bron, Lyon, France.
Abstract
BACKGROUND
Most frequent post lung transplantation challenges include issues related to immunosuppressive drug use, graft dysfunction and bronchial stenosis. However, data on less frequent complications-particularly those affecting the pulmonary vasculature-remain limited. This study aimed to evaluate the incidence, clinical features, and impact on survival of symptomatic pulmonary vascular complications following lung transplantation.
METHODS
We conducted a retrospective study involving 550 patients who underwent lung transplantation between 2012 and 2022.
RESULTS
Within this cohort, 63 (11.5%) patients experienced pulmonary vascular complications, comprising pulmonary vein obstruction in 20 (3.8%) patients, pulmonary arterial obstruction in 4 (0.8%) patients, pulmonary embolism in 33 (6.0%) patients, and pulmonary hypertension in 6 (1.1%) of them. Vascular obstructions were diagnosed after a median time of 4 days [1-9 days] post-surgery. The one-year survival rate after transplantation was 83.2% for patients without pulmonary vascular complications, compared with 58.3% in those with pulmonary vein obstruction, 25.0% in those with pulmonary arterial obstruction, 86.9% in patients with pulmonary embolism (Log-rank, p = 0.001). Clinical variables associated with survival were evaluated using multivariate analysis, revealing a significantly poorer prognosis in the context of surgical complications, with a hazard ratio of 3.44 (95% CI: 1.80-6.35; p < 0.001).
CONCLUSIONS
Post-surgical vascular obstruction is a rare yet severe complication that can lead to early mortality after lung transplantation. By contrast, the incidences of pulmonary embolism and pulmonary hypertension are similar to those observed in the general population.
MeSH
Pulmonary Veins, Hypertension, Lung, Hypertension, Pulmonary, Embolism, Incidence, Pulmonary Embolism, Lung Diseases, Lung Transplantation, Veins, Transplantation