Lung Transplant Outcomes in Systemic Sclerosis with Significant Esophageal Dysfunction. A Comprehensive Single-Center...

Area of Science:

• Pulmonology
• Immunology
• Gastroenterology

Background:

• Lung transplantation in systemic sclerosis (SSc) is approached cautiously due to concerns about esophageal dysfunction.
• Esophageal dysfunction in SSc may lead to allograft injury and poorer post-transplant outcomes.

Purpose of the Study:

• To report single-center lung transplantation outcomes in SSc patients.
• To specifically investigate the impact of esophageal dysfunction in SSc lung transplant recipients.

Main Methods:

• Retrospective review of 562 lung transplants (2000-2012).
• Comparison of SSc patients (n=35) with non-SSc groups.
• Evaluation of survival, graft dysfunction, rejection, and microbiology.
• Definition of severe esophageal dysfunction via manometry and CT morphometry.

Main Results:

• SSc patients had similar 1-, 3-, and 5-year survival rates (94%, 77%, 70%) compared to other groups.
• Post-transplant outcomes (graft dysfunction, rejection, microbiology) were comparable between SSc and non-SSc groups.
• Severe esophageal dysfunction affected ~60% of SSc patients, with abnormal esophageal morphometry on CT.

Conclusions:

• Lung transplantation in SSc patients yields outcomes similar to other indications.
• High prevalence of esophageal dysfunction in SSc did not significantly impact transplant outcomes.
• Esophageal dysfunction was an infrequent reason for denying lung transplantation in SSc.