A large US registry study of 1,671 patients with pulmonary arterial hypertension (PAH) over 4607 person-years of follow up found that lung transplant referrals are occurring far too infrequently and too late in the disease course. Despite professional society recommendations for early referral, only 12% of patients were referred for transplantation over the study period. Most concerning, even among the highest-risk patients – those with severe functional limitations or high-risk disease classifications – only 18-29% were referred for transplant. Of those who were referred, 30% successfully underwent transplantation while 21% died waiting.
The study identified factors that increased referral likelihood (specific disease subtypes, high-risk scores, and advanced medication use) and those that decreased it (older age and higher body weight). However, even when accounting for potential transplant contraindications, referral rates remained inadequately low.
The researchers concluded that current referral practices are “unacceptably low” and occur too late, emphasizing the need for increased awareness about the benefits of early transplant referral, even at specialized expert centers that treat pulmonary arterial hypertension patients.
Read more at this link on the Journal of Heart and Lung Transplant
Citation
Kolaitis NA, Singer JP, Bartolome S, Chakinala MM, Grinnan D, Hemnes AR, Heresi GA, Leary PJ, Shlobin OA, Ventetuolo CE, De Marco T. The landscape of referrals for lung transplantation in pulmonary arterial hypertension: a report from the Pulmonary Hypertension Association Registry. J Heart Lung Transplant. 2025 Jun 26:S1053-2498(25)02055-8. doi: 10.1016/j.healun.2025.06.019. Epub ahead of print. PMID: 40581270.Cop