# The Potential of Pulmonary Vasodilators as a Bridging Therapy for Lung Transplantation: Two Cases of Interstitial Pneumonia With Pulmonary Hypertension During the Waiting Period for Lung Transplantation

## TL;DR

Two patients with interstitial pneumonia and pulmonary hypertension improved with vasodilators before lung transplantation, suggesting these drugs could help bridge the waiting period.

## Contribution

Demonstrates the potential of pulmonary vasodilators as a bridging therapy for patients with interstitial pneumonia and pulmonary hypertension awaiting lung transplantation.

## Key findings

- Sildenafil improved pulmonary hypertension in a patient with scleroderma-related interstitial pneumonia before successful lung transplantation.
- Tadalafil and macitentan helped manage pulmonary hypertension in a patient with rheumatoid arthritis-related interstitial pneumonia, leading to successful lung transplantation.

## Abstract

Pulmonary hypertension (PH) associated with interstitial pneumonia (IP) has a poor prognosis, and lung transplantation (LT) is the only effective treatment option for severe cases. However, the waiting period for LT often exceeds the median survival time in these patients, and the effectiveness of pulmonary vasodilators during this period is not well established. In Case 1, a patient with scleroderma‐related IP and PH was treated with sildenafil, which resulted in improved PH and successful single‐lung transplantation. In Case 2, a patient with rheumatoid arthritis‐related IP and PH was treated with tadalafil and macitentan, leading to successful single‐lung transplantation. These cases suggest that pulmonary vasodilators may be valuable bridging therapies for patients with PH associated with IP who are awaiting LT.

This report presents two cases of pulmonary hypertension (PH) associated with interstitial pneumonia (IP) that were successfully managed with pulmonary vasodilators while awaiting lung transplantation (LT), which ultimately led to successful transplantation.