ArticlePediatric transplantation2025
Prostacyclin Therapy as Adjunctive Treatment for Pulmonary Hypertension in Pediatric Heart Transplantation: A Case Report.
Article in Pediatric transplantation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Prostacyclin Therapy as Adjunctive Treatment for Pulmonary Hypertension in Pediatric Heart Transplantation: A Case Report.Pediatric transplantation · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundElevated pulmonary vascular resistance is a significant risk factor for right-ventricle failure and poor outcomes following pediatric heart transplantation. Pulmonary vasodilator therapy can help manage symptoms and improve heart transplant candidacy. While phosphodiesterase type 5 inhibitors and endothelin receptor antagonists are commonly used, prostacyclin therapy remains less studied in this context. CASE DESCRIPTION: A 15-year-old female with Shone's complex developed heart failure with preserved ejection fraction and severe pulmonary hypertension. Given her indexed pulmonary vascular resistance (15 indexed wood units with vasodilator testing) on initial cardiac catheterizations was felt to be prohibitive to heart transplant, she was treated stepwise with tadalafil, ambrisentan, and selexipag. Serial cardiac catheterizations showed an improvement in her pulmonary vascular resistance as well as vasoreactivity of her pulmonary vasculature. She was listed for heart transplant and underwent transplantation with perioperative support including inhaled prostacyclin. Post-operatively, her mean pulmonary artery pressure and pulmonary vascular resistance improved, though she later required a transition to subcutaneous treprostinil for recurrence of pulmonary hypertension with right-ventricle failure despite only a mildly elevated left ventricle end-diastolic pressure. Over the following year, her pulmonary pressures stabilized, and she was transitioned back to oral therapies and continued to do well at 1 year post-transplantation.
conclusionThis case highlights that aggressive medical management, including prostacyclin therapy, can render even high-risk pediatric patients with elevated pulmonary vascular resistance eligible for heart transplant and improve post-operative outcomes. It supports emerging evidence that elevated pulmonary vascular resistance, particularly when responsive to vasodilators, should not be viewed as an absolute contraindication to heart transplantation and emphasizes the importance of tailored, ongoing pulmonary hypertension management in children with congenital heart disease.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.