Journal of transplantation · 2026
Right Ventricular Stroke Work Index and Its Prognostic Value in a Lung Transplant Population With Group 3 Pulmonary Hypertension.
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Marquet Yann, Jacqmin Sébastien, Fessler Julien, Sage Edouard, Hammoum Pierre, Le Guen Morgan
Аннотация
BACKGROUND: Lung transplantation requires meticulous preoperative assessment. Recipients with Group 3 pulmonary hypertension can be at higher risk of mortality and primary graft dysfunction (PGD). We conducted a study to determine whether the right ventricular stroke work index (RVSWI), a right-heart catheterisation haemodynamic indicator assessing right ventricle function, could predict 1-year survival in this setting.
METHODS: Monocentric, retrospective, observational cohort study approved by our local ethics review board, between January 2013 and December 2023. We included lung transplant recipients who underwent preprocedural right-heart catheterisation assessment and presented with Group 3 pulmonary hypertension. We first determined a clinically relevant RVSWI threshold. The primary endpoint was mortality at 1 year amongst two groups of patients according to this threshold.
RESULTS: 66 patients (age 57.0 ± 11.4 years, male 56%) were included amongst a study population of 699 patients. Double-lung transplantations represented most of the procedures (91%). In univariate analysis, RVSWI was statistically associated with PGD Grade 3 at Day 3 and intraoperative veno-arterial extracorporeal membrane oxygenation (ECMO) at a threshold of RVSWI = 13.5. Mortality at 1 year did not differ between the groups RVSWI ≤ 13.5 (6 patients, 14.6%) and RVSWI > 13.5 (6 patients, 24%) even after accounting for potential confounding factors.
CONCLUSIONS: In our lung transplant population with Group 3 pulmonary hypertension, RVSWI was not associated with mortality at 1 year. A higher RVSWI seemed associated with significant events such as intraoperative ECMO and PGD Grade 3. Further studies are needed to assess RVSWI's prognostic value in this setting.
METHODS: Monocentric, retrospective, observational cohort study approved by our local ethics review board, between January 2013 and December 2023. We included lung transplant recipients who underwent preprocedural right-heart catheterisation assessment and presented with Group 3 pulmonary hypertension. We first determined a clinically relevant RVSWI threshold. The primary endpoint was mortality at 1 year amongst two groups of patients according to this threshold.
RESULTS: 66 patients (age 57.0 ± 11.4 years, male 56%) were included amongst a study population of 699 patients. Double-lung transplantations represented most of the procedures (91%). In univariate analysis, RVSWI was statistically associated with PGD Grade 3 at Day 3 and intraoperative veno-arterial extracorporeal membrane oxygenation (ECMO) at a threshold of RVSWI = 13.5. Mortality at 1 year did not differ between the groups RVSWI ≤ 13.5 (6 patients, 14.6%) and RVSWI > 13.5 (6 patients, 24%) even after accounting for potential confounding factors.
CONCLUSIONS: In our lung transplant population with Group 3 pulmonary hypertension, RVSWI was not associated with mortality at 1 year. A higher RVSWI seemed associated with significant events such as intraoperative ECMO and PGD Grade 3. Further studies are needed to assess RVSWI's prognostic value in this setting.