A team of specialists in pulmonary hypertension and lung transplantation from the Marqués de Valdecilla University Hospital (HUMV) and the Marqués de Valdecilla Research Institute (IDIVAL) has just published a study in the journal Pulmonary Circulation addressing a question that, until now, has received little attention: what happens to patients with group 2 pulmonary hypertension prior to a lung transplant?
This work, led by pulmonologist Víctor M. Mora-Cuesta, stems from something as essential in medicine as correctly applying the scientific method. As the researcher himself explains, “It all began with a clinical observation: a lung transplant patient was presenting heart failure that was difficult to manage. When we reviewed her medical history, we saw that before the transplant she already met criteria for postcapillary pulmonary hypertension (group 2), something unusual in these patients, and which could explain her progression.”
From this observation, a question emerged: how often does this occur in other patients awaiting lung transplantation, and what are the implications?
A Rarely Studied Topic
Although there are five types of pulmonary hypertension, two of them — that associated with respiratory diseases (group 3) and that caused by left ventricular dysfunction (group 2) — account for the vast majority of cases. However, patients with group 2 pulmonary hypertension are typically excluded as candidates for lung transplantation because of the added risk of concurrent heart involvement. As a result, very little literature exists on this specific patient profile.
The Valdecilla team reviewed the hemodynamic tests of all lung transplant candidates in recent years and found that 10.9% met the criteria for group 2 pulmonary hypertension. Analysis of their outcomes after transplantation showed that these appropriately selected patients achieved clinical results similar to those of other pulmonary hypertension profiles — and even to patients without pulmonary hypertension.
A High-Level Collaborative Study
This study involved leading specialists in pulmonary hypertension and transplantation from across Spain, including Dr. Pilar Escribano from Hospital 12 de Octubre, and Drs. Diego A. Rodríguez and Esther Barreiro from Hospital del Mar in Barcelona. In addition, the research was carried out within the framework of the national CSUR network for lung transplantation, the ERN-Lung network, and IDIVAL.
Generating Practical Knowledge to Improve Clinical Decision-Making
The results suggest that patients with group 2 pulmonary hypertension, if carefully assessed and selected, can benefit from lung transplantation without a negatively affected prognosis. “It’s the kind of knowledge that allows us to make better decisions in the future for similar patients — which is, after all, the goal of applied clinical research,” concludes Víctor Mora.
You can read the full article here: https://pmc.ncbi.nlm.nih.gov/articles/PMC12130283/
Photo caption: Part of the Pulmonary Hypertension Unit team at Hospital Valdecilla.
