Survival With β-Adrenergic Suppression After Lung Transplantation

Survival following lung transplant (LT) surgery presents an ongoing challenge, and adverse LT outcomes are linked to cardiac arrhythmias. Current guidelines indicate that the role of β-adrenergic suppression (BAS) after LT remains unclear.

This retrospective observational study included adult patients who underwent LT at the University of Florida between 2016 and 2021. Their pre- and post-LT antiarrhythmic medication use was correlated with long-term survival after a 10-day post-LT blanking window.

The LT recipients (N=299) had a mean age of 60±11 years, 45% were women, and mean body mass index was 26±6 kg/m². Available mean follow-up was 4.5±1.9 years. The primary analysis included 299 patients, of whom 209 (70%) were prescribed BAS. Prescription of BAS after LT correlated with prolonged survival, even after adjusting for potential confounders (P=0.008). A comparable survival benefit was observed in patients who continued BAS from pre-LT to those who were newly initiated on BAS after LT, relative to patients not receiving BAS (P=0.03 and P=0.03, respectively). No survival benefit was observed for other classes of antiarrhythmic drugs used after LT.

This large, retrospective, single-center study identified a correlation between BAS prescriptions and prolonged survival following LT. This association applied to both patients initiating BAS after transplant and those continuing preexisting BAS therapy. These findings underscore the promise of BAS in this population, and further prospective studies are warranted to confirm the beneficial role of BAS after LT.