Clinical Management and Transplant Considerations in Pediatric Pulmonary Hypertension Due to Left Heart Disease

Published: December 09, 2024

Transplant Considerations illustration
  • Children with left heart disease are at risk for developing pulmonary hypertension, initially secondary to elevated pulmonary venous pressures from heart failure or obstruction. Over time, this can affect the arterial bed and elevate the pulmonary vascular resistance, known as combined pre- and postcapillary pulmonary hypertension.
  • Elevated pulmonary vascular resistance is an important consideration for heart transplant eligibility due to the risk of right heart failure after transplant. However, the optimal diagnostic and treatment approaches remain unclear because of lack of evidence, particularly in pediatrics.
  • There is considerable practice heterogeneity with respect to hemodynamic assessment, use of pulmonary vasodilator therapies, and heart transplant listing. This scientific statement aims to synthesize the available data and highlight areas of general consensus as well as important knowledge gaps.