Orthostatic Hypotension and Concurrent Autonomic Dysfunction: A Novel Complication of Lung Transplantation

• Published in: Journal of transplantation 2022-03, Vol.2022, p.3308939-8
• Main Authors: Razia, Deepika, Tokman, Sofya, Israr, Sharjeel, Mohamed, Hesham, Abdelrazek, Hesham, Buddhdev, Bhuvin, Arjuna, Ashwini, McAnally, Kendra, Hashimi, Samad, Smith, Michael A., Bremner, Ross M., Walia, Rajat, Omar, Ashraf
• Format: Article
• Language: English
• Subjects: Analysis; Body mass index; Care and treatment; Hypotension, Orthostatic; Immunosuppressive agents; Tachycardia; Transplantation of organs, tissues, etc
• ISSN: 2090-0007; 2090-0015
• DOI: 10.1155/2022/3308939

Background. Persistent orthostatic hypotension (OH) is a lesser-known complication of lung transplantation (LTx). In this retrospective case series, we describe the clinical manifestations, complications, and treatment of persistent OH in 13 LTx recipients. Methods. We identified LTx recipients who underwent transplantation between March 1, 2018, and March 31, 2020, with persistent symptomatic OH and retrospectively queried the records for clinical information. Results. Thirteen patients were included in the analysis, 9 (69%) had underlying pulmonary fibrosis, and 12 (92%) were male. The median age, height, and body mass index at LTx were 68 years, 70 inches, and 27 kg/m2, respectively. Six (46%) patients were deceased at the time of chart abstraction with a median (IQR) posttransplant survival of 12.6 months (6, 21); the 7 remaining living patients were a median of 19.6 months (18, 32) posttransplant. Signs and symptoms of OH developed a median of 60 (7, 75) days after transplant. Patients were treated with pharmacological agents and underwent extensive physical therapy. Most patients required inpatient rehabilitation (n = 10, 77%), and patients commonly developed comorbid conditions including weight loss, renal insufficiency with eGFR