Assessment and management of elevated pulmonary vascular resistance in adult cardiac transplantation candidates

* Refer to UpToDate content on indications for cardiac transplantation.
¶ For all cardiac transplantation candidates, right heart catheterization is required prior to listing. Right heart catheterization should be repeated periodically in adult transplant candidates with frequency individualized according to the patient's clinical condition.
Δ Refer to UpToDate content regarding choice of a vasodilator to test the acute reversibility of pulmonary hypertension.
◊ Consensus is lacking on the optimum duration of medical therapy prior to repeat right heart catheterization. Refer to UpToDate content regarding components of optimized medical therapy.
§ However, some centers have successfully performed cardiac transplantation in patients with irreversible pulmonary vascular resistance >3 Wood units on a case-by case basis.