An understanding of expected survival after LTx is critical to the decision to list a patient with PPH for transplantation. This is due to many factors. They may also have a congestive hepatopathy. Both of these factors increase the risk of bleeding at transplantation. Additionally, the hemodynamics may be altered by the dilated, hypertrophied right ventricle and a small noncompliant left ventricle.
Arrhythmias are common.
One problem effecting timing after LTx for pulmonary hypertension is the expected time on the waiting list. Small women, and patients with blood type O or preformed antibodies wait the longest. Inordinate delay in listing for LTx may cause the patient to miss the opportunity. Nonambulatory or ventilator-dependent patients are not candidates for transplantation. The development of renal and hepatic failure will also result in loss of candidacy.