Heart-Lung Transplant Found to Benefit Eisenmenger Syndrome

Heart-lung transplantation may offer a survival benefit to patients with Eisenmenger Syndrome, especially those with ventricular septal defect.

Canadian and American researchers report that Eisenmenger Syndrome appears to be a heterogeneous condition, with prognosis depending to some extent on the underlying cause. Their study showed that patients with ventricular septal defect or multiple congenital anomalies appear to have a better prognosis than those with atrial septal defect or patent ductus arteriosus.

Their findings are based on analysis of the United Network for Organ Sharing/International Society for Heart and Lung Transplantation Joint Thoracic Registry for predictors of survival among patients with Eisenmenger Syndrome who received lung or heart-lung transplants.

Between 1988 and 1998, there were 430 heart-lung, 106 bilateral lung, and 69 single lung transplants.

Survival after heart-lung transplantation at 30 days was 80.7 percent and at one year was 70.1 percent. This compared favourably with single lung transplant, which had corresponding survival rates of 68 percent and 55.2 percent.

Further analysis found that for patients with ventricular septal defect, heart-lung transplantation was especially favourable over lung transplantation.

Overall, diagnosis was a significant predictor of survival, with patients having ventricular septal defect or multiple congenital anomalies doing best.

They had one-year survival rates of 71.4 percent and 77.6 percent, respectively.

The researchers conclude that clinicians should consider heart-lung transplantation as the operation of choice for patients with Eisenmenger Syndrome secondary to ventricular septal defect.

The Journal of Heart and Lung Transplantation, volume 21, issue 7, pages 731-737.