{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T22:39:55Z","timestamp":1778884795608,"version":"3.51.4"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"25","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2013,6,25]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Lung transplantation and heart-lung transplantation represent surgical options for treatment of medically refractory idiopathic pulmonary arterial hypertension. The effect of the lung allocation score on wait-list and transplantation outcomes in patients with idiopathic pulmonary arterial hypertension is poorly described.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>Adults diagnosed with idiopathic pulmonary arterial hypertension and listed for transplantation in the 80 months before and after the lung allocation score algorithm was implemented (n=1430) were identified in the United Network for Organ Sharing thoracic registry. Patients were stratified by organ listed and pre\u2013 and post\u2013lung allocation score era. The cumulative incidences of transplantation and mortality for wait-listed patients in both eras were appraised with competing outcomes analysis. Posttransplantation survival was assessed with the Kaplan-Meier method. These analyses were repeated in propensity-matched subgroups. Cox proportional hazards analysis evaluated the effect of prelisting and pretransplantation characteristics on mortality. We found that patients in the post\u2013lung allocation score era had significantly worse comorbidities; nevertheless, both lung transplantation and heart-lung transplantation candidates in this era enjoyed lower wait-list mortality and a higher incidence of transplantation in unmatched and propensity-matched analyses. On multivariable analysis, heart-lung transplantation and double-lung transplantation were associated with improved survival from the time of wait-listing, as was being listed at a medium- to high-volume institution. Donor\/recipient sex matching predicted posttransplantation survival.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>The incidence of transplantation has increased while wait-list mortality has decreased in patients with idiopathic pulmonary arterial hypertension wait-listed for transplantation in the post\u2013lung allocation score era. Both heart-lung transplantation and double-lung transplantation are predictive of survival in transplantation candidates with idiopathic pulmonary arterial hypertension, as is being listed at a medium- to high-volume institution. Donor\/recipient sex matching is associated with better posttransplantation survival.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.112.001080","type":"journal-article","created":{"date-parts":[[2013,5,23]],"date-time":"2013-05-23T12:06:02Z","timestamp":1369310762000},"page":"2503-2513","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":60,"title":["Transplantation for Idiopathic Pulmonary Arterial Hypertension"],"prefix":"10.1161","volume":"127","author":[{"given":"Justin M.","family":"Schaffer","sequence":"first","affiliation":[{"name":"From the Departments of Cardiothoracic Surgery (J.M.S., S.K.S., D.L.J., B.A.R., R.C.R.) and Medicine (R.T.Z.), Division of Pulmonary and Critical Care Medicine, Vera Moulton Wall Center for Pulmonary Vascular Disease, Stanford Hospital and Clinics, Stanford, CA; and Department of Surgery, Division of Cardiothoracic Surgery, Baylor College of Medicine and Center for Cardiac Support, Texas Heart Institute, Houston, TX (H.R.M.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steve K.","family":"Singh","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiothoracic Surgery (J.M.S., S.K.S., D.L.J., B.A.R., R.C.R.) and Medicine (R.T.Z.), Division of Pulmonary and Critical Care Medicine, Vera Moulton Wall Center for Pulmonary Vascular Disease, Stanford Hospital and Clinics, Stanford, CA; and Department of Surgery, Division of Cardiothoracic Surgery, Baylor College of Medicine and Center for Cardiac Support, Texas Heart Institute, Houston, TX (H.R.M.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David L.","family":"Joyce","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiothoracic Surgery (J.M.S., S.K.S., D.L.J., B.A.R., R.C.R.) and Medicine (R.T.Z.), Division of Pulmonary and Critical Care Medicine, Vera Moulton Wall Center for Pulmonary Vascular Disease, Stanford Hospital and Clinics, Stanford, CA; and Department of Surgery, Division of Cardiothoracic Surgery, Baylor College of Medicine and Center for Cardiac Support, Texas Heart Institute, Houston, TX (H.R.M.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce A.","family":"Reitz","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiothoracic Surgery (J.M.S., S.K.S., D.L.J., B.A.R., R.C.R.) and Medicine (R.T.Z.), Division of Pulmonary and Critical Care Medicine, Vera Moulton Wall Center for Pulmonary Vascular Disease, Stanford Hospital and Clinics, Stanford, CA; and Department of Surgery, Division of Cardiothoracic Surgery, Baylor College of Medicine and Center for Cardiac Support, Texas Heart Institute, Houston, TX (H.R.M.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert C.","family":"Robbins","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiothoracic Surgery (J.M.S., S.K.S., D.L.J., B.A.R., R.C.R.) and Medicine (R.T.Z.), Division of Pulmonary and Critical Care Medicine, Vera Moulton Wall Center for Pulmonary Vascular Disease, Stanford Hospital and Clinics, Stanford, CA; and Department of Surgery, Division of Cardiothoracic Surgery, Baylor College of Medicine and Center for Cardiac Support, Texas Heart Institute, Houston, TX (H.R.M.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roham T.","family":"Zamanian","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiothoracic Surgery (J.M.S., S.K.S., D.L.J., B.A.R., R.C.R.) and Medicine (R.T.Z.), Division of Pulmonary and Critical Care Medicine, Vera Moulton Wall Center for Pulmonary Vascular Disease, Stanford Hospital and Clinics, Stanford, CA; and Department of Surgery, Division of Cardiothoracic Surgery, Baylor College of Medicine and Center for Cardiac Support, Texas Heart Institute, Houston, TX (H.R.M.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hari R.","family":"Mallidi","sequence":"additional","affiliation":[{"name":"From the Departments of Cardiothoracic Surgery (J.M.S., S.K.S., D.L.J., B.A.R., R.C.R.) and Medicine (R.T.Z.), Division of Pulmonary and Critical Care Medicine, Vera Moulton Wall Center for Pulmonary Vascular Disease, Stanford Hospital and Clinics, Stanford, CA; and Department of Surgery, Division of Cardiothoracic Surgery, Baylor College of Medicine and Center for Cardiac Support, Texas Heart Institute, Houston, TX (H.R.M.)."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199701093360207"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-115-5-343"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccm.2011.02.015"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehp022"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1183\/09059180.00008211"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10-0260"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.192230"},{"key":"e_1_3_3_9_2","first-page":"370","article-title":"Pulmonary arterial hypertension: an update on diagnosis and treatment.","volume":"82","author":"Stringham R","year":"2010","unstructured":"Stringham R, Shah NR. 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