Outcome of lung transplantation in non-idiopathic pulmonary fibrosis interstitial lung disease.
Hannelore BodeStijn E VerledenWim A WuytsJonas YserbytGeert M VerledenRobin VosPublished in: Clinical transplantation (2019)
Lung transplantation remains the only curative treatment option for selected patients with end-stage interstitial lung disease (ILD). Candidate selection is impeded by patient heterogeneity, particularly in the subgroup of non-idiopathic pulmonary fibrosis (non-IPF) interstitial lung diseases. We performed a descriptive analysis of all non-IPF ILD patients who underwent lung transplantation in our center between July 1991 and November 2016 (n = 129) and searched for pre-transplant variables correlating with graft loss and chronic lung allograft dysfunction (CLAD). Our study cohort was characterized by a significantly affected medical condition, an extensive pre-transplant corticosteroid use (73.8%), and a high prevalence of pulmonary hypertension (55.7%). Earlier year of transplantation (P = .004), higher bilirubin level (P < .0001), older recipient age (P = .04), and smaller recipient height (P = .02) were found to be associated with earlier graft loss in multivariate analysis. Moreover, pre-transplant corticosteroid treatment tended to be related to earlier graft loss (P = .06), while pulmonary hypertension did not significantly correlate. None of the pre-transplant variables were shown to be associated with CLAD development. Ongoing research is required to further explore this diverse patient population and the pre-transplant variables determining their post-transplant outcome.
Keyphrases
- idiopathic pulmonary fibrosis
- interstitial lung disease
- pulmonary hypertension
- systemic sclerosis
- extracorporeal membrane oxygenation
- rheumatoid arthritis
- case report
- healthcare
- newly diagnosed
- end stage renal disease
- clinical trial
- randomized controlled trial
- oxidative stress
- pulmonary arterial hypertension
- pulmonary artery
- body mass index
- ejection fraction
- cross sectional
- stem cells
- cell therapy
- data analysis
- kidney transplantation
- open label