marker of mortality in heart-lung transplantation

Q: Which of the following marker is a good predictor of mortality in patients with severe pulmonary hypertension who undergoes heart-lung transplant?

A) Thrombocytopenia
B) Hyperbilirubinemia
C) Hypercalcium 
D) High LDH  level
E) baseline PO2 on room air prior to transplant


Answer: B

End stage pulmonary hypertension  results in hyperbilirubinemia due to chronic passive hepatic congestion. Persistent hyperbilirubinemia has been found to be a good marker of postoperative mortality in heart-lung transplant recipients due to end stage pulmonary hypertension.


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Reference:

Reichenberger F, Pepke-Zaba J, McNeil K, et al. Atrial septostomy in the treatment of severe pulmonary arterial hypertension. Thorax 2003; 58:797.