Pulmonary hypertension in pediatric heart transplantation.

Pulmonary hypertension can pose a significant problem in the management of children with congestive heart failure. Assessment of pulmonary artery anatomy, pressures and (when possible) pulmonary vascular resistance is critically important in the evaluation of these children when they are under consideration for heart transplantation. Severe, fixed elevation of the pulmonary vascular resistance is a contraindication to heart transplantation because of concerns of acute post-transplant donor right ventricular failure. However, even modest degrees of pulmonary hypertension can complicate the post-operative management of pediatric heart transplant recipients. This review will provide information regarding the recognition, diagnosis, and pre-operative and post-operative management of pulmonary hypertension in patients under consideration for heart transplantation.