Abstract:
:Heart transplantation is contraindicated in patients with acute irreversible pulmonary hypertension (PH), but new drugs are opening up therapeutic possibilities. Sildenafil citrate is a nonselective pulmonary vasodilator that is being used in our hospital to treat several patients with PH and which has allowed the inclusion of 1 patient on the waiting list for heart transplantation. A 20-year-old man with Becker muscular dystrophy was diagnosed at the age of 19 years with dilated cardiomyopathy with severe pulmonary artery systolic pressure (PH = 60 mm Hg). A pretransplantation study, including a right hemodynamic analysis with an acute vasodilator test using intravenous epoprostenol, revealed the irreversible character of the PH. Inasmuch as the administration of dobutamine did not achieve an adequate reduction of PH, oral sildenafil was started (25 mg every 12 hours) as salvage therapy. An echocardiogram obtained 2 months after starting sildenafil therapy showed normal right cavities, previously dilated, as well as minimal protosystolic tricuspid regurgitation without PH. A new right hemodynamic study performed after 4 months showed a reduction in pulmonary vascular resistance, from 8 U to 3.5 U Woods. As a result, the patient has now been included on the waiting list for heart transplantation. The promising example of this patient confirms the necessity to carry out controlled trials to establish definitively the indications for the use of sildenafil in patients with irreversible PH.
journal_name
Transplant Procjournal_title
Transplantation proceedingsauthors
Gómez-Moreno S,Lage E,Hernández A,Campos A,Cabezón S,Ordóñez A,Hinojosa Rdoi
10.1016/j.transproceed.2005.02.013subject
Has Abstractpub_date
2005-04-01 00:00:00pages
1550-1issue
3eissn
0041-1345issn
1873-2623pii
S0041-1345(05)00127-2journal_volume
37pub_type
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journal_title:Transplantation proceedings
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doi:10.1016/j.transproceed.2005.02.074
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journal_title:Transplantation proceedings
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journal_title:Transplantation proceedings
pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.1016/j.transproceed.2015.03.031
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pub_type: 杂志文章
doi:10.1016/s0041-1345(03)00661-4
更新日期:2003-08-01 00:00:00
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journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2008.01.066
更新日期:2008-06-01 00:00:00
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journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2009.02.060
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pub_type: 杂志文章
doi:10.1016/j.transproceed.2006.11.001
更新日期:2007-01-01 00:00:00
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journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2010.05.033
更新日期:2010-07-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.transproceed.2004.12.232
更新日期:2005-01-01 00:00:00
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journal_title:Transplantation proceedings
pub_type: 杂志文章
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更新日期:1990-04-01 00:00:00
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pub_type: 杂志文章,评审
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pub_type: 杂志文章
doi:10.1016/j.transproceed.2007.07.001
更新日期:2007-09-01 00:00:00
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pub_type: 杂志文章
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更新日期:2010-11-01 00:00:00
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pub_type: 杂志文章
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更新日期:2004-04-01 00:00:00
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更新日期:2018-10-01 00:00:00
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journal_title:Transplantation proceedings
pub_type: 杂志文章
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更新日期:2020-11-01 00:00:00
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journal_title:Transplantation proceedings
pub_type: 杂志文章
doi:10.1016/j.transproceed.2008.08.031
更新日期:2008-10-01 00:00:00
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journal_title:Transplantation proceedings
pub_type: 杂志文章,评审
doi:10.1016/j.transproceed.2010.02.031
更新日期:2010-04-01 00:00:00
abstract:OBJECTIVE:We investigated the efficacy of immunoadsorption (IA) in combination with tacrolimus (FK506) and mycophenolate mofetil (MMF) rescue therapy for C4d-positive acute humoral rejection (AHR) of renal transplants. METHODS:Six of 185 cadaveric renal allograft recipients developed AHR at a mean of 4.8 +/- 0.8 days ...
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pub_type: 杂志文章
doi:10.1016/j.transproceed.2004.07.071
更新日期:2004-09-01 00:00:00