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Lung transplantation for interstitial lung disease: evolution over three decades
Swee W Leong1,2, Saskia Bos1,3, James L Lordan1
1Institute of Transplantation, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
BMJ Open Respiratory Research
|February 28, 2023
Summary
Older age and specific lung conditions like fibrotic non-specific interstitial pneumonia negatively impact lung transplant survival. Bilateral transplants offer less benefit in older patients, suggesting single transplants may be suitable.
Area of Science:
- Pulmonology
- Transplant Surgery
- Critical Care Medicine
Background:
- Interstitial lung disease (ILD) is the leading reason for lung transplantation worldwide.
- Lung transplant survival rates are influenced by disease type and patient comorbidities.
- Understanding factors affecting post-transplant outcomes is crucial for improving patient survival.
Purpose of the Study:
- To analyze demographics, disease classifications, and outcomes in a large cohort of lung transplant recipients for ILD.
- To identify factors associated with post-transplant survival in ILD patients.
- To evaluate survival trends across different eras of lung transplantation.
Main Methods:
- Retrospective analysis of 284 lung transplant recipients for ILD between 1987 and 2020.
- Stratification of patient characteristics and outcomes by three distinct time periods.
- Statistical analysis to determine factors influencing post-transplant survival.
Main Results:
- Median recipient age at transplantation increased significantly over time.
- Patients over 50 years old experienced worse overall survival post-transplant.
- Fibrotic non-specific interstitial pneumonia was associated with reduced survival compared to idiopathic pulmonary fibrosis.
Conclusions:
- Older age and fibrotic non-specific interstitial pneumonia are linked to poorer lung transplant survival in ILD.
- The survival advantage of bilateral over single lung transplantation decreases with age.
- Single lung transplantation may be a viable option for older lung transplant candidates.
