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Published on: August 15, 2022
Systemic sclerosis and bilateral lung transplantation: a single centre experience.
R Saggar1, D Khanna, D E Furst
1Division of Pulmonary and Critical Care Medicine, Dept of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-1690, USA. rsaggar@mednet.ucla.edu
The European Respiratory Journal
|March 31, 2010
Summary
Lung transplantation outcomes for systemic sclerosis (SSc) patients are similar to idiopathic pulmonary fibrosis (IPF) patients at one year. However, SSc recipients may face higher rates of acute rejection after lung transplant.
Area of Science:
- Pulmonology
- Transplantation immunology
Background:
- Lung involvement is a primary cause of mortality in systemic sclerosis (SSc).
- Lung transplantation (LT) for SSc remains a debated procedure.
- Outcomes of LT in SSc patients compared to other conditions are not well-defined.
Purpose of the Study:
- To compare one-year post-LT outcomes between SSc and idiopathic pulmonary fibrosis (IPF) patients.
- To evaluate differences in acute rejection, pulmonary function, and infection rates.
Main Methods:
- Retrospective analysis of bilateral LT recipients with SSc (n=14) or IPF (n=38) from 2003-2007.
- Primary endpoint: 1-year all-cause mortality.
- Secondary endpoints: acute rejection (AR), pulmonary function, infection, and chronic rejection.
Main Results:
- One-year all-cause mortality was comparable between SSc (6.6%) and IPF (13.1%) groups after age adjustment.
- Significantly higher rates of acute rejection (AR ≥2) were observed in the SSc group (HR 2.91, p=0.007).
- No significant differences were found in chronic rejection, infection rates, or pulmonary function between groups.
Conclusions:
- Systemic sclerosis patients exhibit similar one-year survival post-LT compared to IPF patients.
- Increased acute rejection rates may pose a challenge for SSc lung transplant recipients.
- Further long-term follow-up is needed to assess the impact of AR and gastrointestinal issues on graft survival in SSc LTRs.
