Korean J Transplant.  2023 Nov;37(Suppl 1):S88. 10.4285/ATW2023.F-6698.

Effect of renal transplantation on pulmonary artery hypertension: a single-center study

• Tiwari V
• Chowdhary D
• Gupta A
• Bhalla A
• Rana D

• KMID: 2551675
• DOI: http://doi.org/10.4285/ATW2023.F-6698

Abstract

Background
Moderate to severe pulmonary artery hypertension (PAH) is a strong independent predictor of mortality in hemodialysis (HD) patients and in those undergoing noncardiac surgery. We aimed to study the effect of renal transplantation on pulmonary artery systolic pressure (PASP) in chronic kidney disease stage 5 patients on maintenance HD.
Methods
Patients on maintenance HD who are prospective renal allograft recipients were included in the study. PAH was defined as patients with PASP 35 mmHg. Pulmonary artery pressure by two-dimensional echocardiography was measured within a month before transplantation and followed up at 3 and 6 months postrenal transplantation. The primary outcome was to as-sess the change in PASP before transplantation and after 3 and 6 months postrenal transplantation. The secondary outcome was to evaluate the association of delayed graft function postrenal transplantation with PASP.
Results
A total of 35 patients were included in the study over 3 years. The mean age of patients was 41.60±12.43. A total of 12 patients (34%) had pulmonary hypertension with 14%, 11%, and 9% as mild, moderate and severe, respectively. PAH was posi-tively associated with the duration of chronic kidney disease (CKD; P=0.004) and the presence of arteriovenous fistula (P=0.03). However, no association was found with the duration of HD. The comparison of change in mean PASP at 0, 3 and 6 months was statistically significant (P<0.001). No association was found between delayed graft function with PASP.
Conclusions
Renal transplantation may have a positive impact on PAH in CKD stage 5 patients on maintenance HD. The decrease in PASP following transplantation indicates an improvement in pulmonary artery pressures and suggests that renal transplantation could potentially alleviate the burden of PAH in these patients.