Right ventricular systolic dysfunction early after lung transplantation: prevalence and impact on 1-year survival

Introduction Prevalence and 1-year impact of right ventricular systolic dysfunction (RVSD) early after lung transplantation (LTx), in a population without pulmonary hypertension (PHT), is not well documented. In this retrospective study, we hypothesized that, as after heart Tx, occurrence of early RVSD after LTx in those patients (pts) would be associated with impaired 1-year survival.¹ Methods After ICU admission of LTx pts, we routinely perform a comprehensive transoesophageal echocardiographic (TOE) to check pulmonary veins’ patency. After exclusion of pts transplanted for PHT and of pts under ECMO, we retrospectively reviewed RV systolic data acquired during this TOE. At the time of TOE, all pts were mechanically ventilated. RVSD was defined based on visual assessment (RV dilation and/or RV hypokinesia) and RV fractional area change (FAC) Results From January 2004 to March 2018, 166 LTx pts underwent comprehensive TOE in ICU. Indications for LTx were COPD in 117 pts (70.5%), fibrosis in 25 (15.1%), cystic fibrosis in 7 (4.2%), bronchiectasis in 7 pts (4.2%) and other indications in 10 (6.0%). RV visual assessment was reported as abnormal in 56/166 pts (33.7%). RV FAC was reported in 112 pts and was Discussion Based on this retrospective TOE and single-center experience, prevalence of early RVSD after LTx, in a population without PHT, ranges from 34 to 39%, depending on the used criteria (visual assessment or RV FAC). However, occurrence of early RVSD after LTx was not associated with impaired 1-year survival.