Safety of nintedanib before lung transplant: an Italian case series

Idiopathic pulmonary fibrosis (IPF) is a progressive, fatal disease that can only be cured by lung transplantation. Pharmacological agents play a role in preserving lung function and prolonging survival until a suitable donor organ becomes available. However, data on the effects of newer antifibrotic therapies on lung transplantation outcomes in IPF patients are lacking. The nine patients included in this case series were treated with nintedanib 150 mg twice daily for 3-30 (mean 13 ± 9) months before lung transplant surgery. Lung function was relatively preserved during nintedanib therapy, and no acute IPF exacerbations occurred. Transplant surgery was generally uneventful; eight of the nine patients are still alive. There were no extraordinary bleeding complications or issues with postoperative thoracic wound healing or dehiscence. Only one patient experienced bronchial anastomotic stenosis a few months later. In conclusion, nintedanib preserved lung function up to transplantation, was well tolerated, and had no detrimental effects on the short-term outcome of lung transplant.