Comparison of ILD at risk of PH between transplant center and referral care settings

<bold>Introduction:</bold> Pulmonary hypertension (PH) screening is recommended for lung transplant candidates, differing from referral centers where suspicion drives evaluation. This study aims to compare population characteristics and factors associated with PH in both populations. Methodology: This cross-sectional study compares subjects with interstitial lung disease (ILD) from referral centers (RC) undergoing usual care PH assessment and those assessed during pre-transplant evaluation (TC). Univariate and multivariate logistic regression models were employed to evaluate PH risk in both groups. <bold>Results:</bold> We included 128 patients from RC and 77 from TC. Comparing PH-ILD: TC group mean age 57.9 vs. RC group 68.9 years, FVC (%) 50.06±14.27 vs. 66±16, mean DLco (%) 34.76±13.95 vs. 38±18, mean 6MWT distance 219±129 vs. 303±124 meters, and PA diameter on CT scan 31.4±4.15 vs. 33±6 mm respectively. Mean pulmonary pressure by right heart catheterization was 26.8 vs. 35.5 mmHg. Multivariate analysis in RC group revealed increased PH risk with lower DLCO (OR 0.33 p=0.089), higher BORG score post-6MWT (OR 1.7 p=0.022), and higher PA diameter (OR 1.4 p=0.001). In TC group, higher FVC (OR 1.08, p=0.042), shorter 6MWT distance (OR 0.99, p=0.014), and higher PA diameter (OR 1.43, p=0.005) were associated with higher PH risk. <bold>Conclusions:</bold> In TC group, PH was linked to higher FVC, shorter 6MWT distance, and larger PA diameter on CT, contrasting lower FVC, DLco, shorter 6MWT distance, and milder PH in RHC, where RC group exhibited more severe PH. These differences and similarities in PH-associated factors should inform risk assessment in both populations.