Antifibrotics and lung transplantation: A Spanish multicentre case-controlled study

Area of Science:

• Pulmonology
• Transplant Surgery
• Pharmacology

Background:

• Idiopathic pulmonary fibrosis (IPF) is treated with antifibrotic drugs.
• Lung transplantation is a critical intervention for advanced IPF.
• Assessing the safety of peri-transplant antifibrotic use is crucial.

Purpose of the Study:

• To evaluate the safety profile of antifibrotic treatment in patients with IPF undergoing lung transplantation.
• To compare outcomes between IPF patients receiving antifibrotics versus those who do not prior to lung transplant.

Main Methods:

• Retrospective cohort study of IPF patients who underwent lung transplantation between 2015-2019.
• Matching cases (antifibrotic users) with controls (non-users).
• Analysis of post-transplant complications, including chest wall dehiscence, and survival rates.

Main Results:

• 164 patients included: 103 cases (antifibrotic users) and 61 controls.
• No significant difference in the incidence of chest wall dehiscence between groups (12.3% vs 13.7%).
• Chest wall dehiscence occurred significantly earlier in antifibrotic users (21 days vs 63 days).
• No significant difference in overall or conditional post-transplant survival, but 1-year survival was lower in antifibrotic users (80.6% vs 93.3%).

Conclusions:

• Antifibrotic drug use in IPF patients undergoing lung transplantation is associated with earlier onset of chest wall dehiscence.
• This earlier dehiscence did not significantly affect overall post-transplant survival.
• Further investigation into the implications of early dehiscence and the impact on long-term survival is warranted.