Pulmonary fibrosis is a progressive disease with a bad prognosis. This situation makes rise lung transplant as a therapeutic option among carefully selected patients. Objective: Evaluate the results and survival rates of patients with pulmonary fibrosis that were transplanted through an 8 years period of follow-up, from the beginning of our transplant program. Methods: Descriptive study of the transplanted patients diagnosed with pulmonary fibrosis from august 2010 to july 2018. Results: Out of 76 transplants, 68.4% were due to pulmonary fibrosis, among these, the main diagnosis was idiopathic pulmonary fibrosis (75%). The average lung allocation score (LAS) was 53 and 32% of them had urgency criteria. Patients' age averaged 55 years-old and 98% of them underwent a single lung transplant. Early medical complications were seen in 26 patients with infectious episodes and 6 with acute rejection. The main late complication was chronic allograft dysfunction. The main surgical complication was bronchial stenosis (7.6%). In comparison to its base line reference values FVC means pre transplant and 1 and 3 years post-transplant were 49%, 70% and 71% respectively. A 40% of patients died during follow up period. Infections were the main cause of mortality during the first year. Survival rates at 1 st 3 rd and 5 th year were 86,2%; 65.2% and 59.8% respectively. Conclusions: Single lung transplant is a therapeutic option for patients with interstitial lung disease with a 59% survival rate in 5 years, 1/3 fulfilled urgency criteria at the transplant time. The infections were the main early complication and chronic graft dysfunction was the main late complication.

Pulmonary hypertension in patients with pulmonary fibrosis and survival after lung transplant Introduction: The presence of pulmonary hypertension (PH) in patients with pulmonary fibrosis is a predictor of severity and poor survival in patients awaiting lung transplantation. Little is known about the impact of PH on survival after lung transplantation. Objective: To evaluate the effect of PH in pulmonary fibrosis patient survival after lung transplantation. Methods: Retrospective study of patients diagnosed with pulmonary fibrosis subjected to lung transplantation at the Instituto Nacional del Tórax during the period of August 2010 to June 2015. Thresholds of ≥ 25 and ≥ 35 mm Hg were chosen for mean pulmonary artery pressure (PAmean) and systolic pulmonary artery pressure (PAsystolic), respectively, as indicators of PH. Results: Out of a total of 63 patients undergoing lung transplantation during the 2010-2015 period, 42 patients were diagnosed with pulmonary fibrosis. 35 of these patients had histologic diagnosis of usual interstitial pneumonia (UIP) and 7 of extrinsic allergic alveolitis in fibrotic stage. Of the total 25 patients with pulmonary fibrosis (60%) had PH in the pre-transplant period. A total of 15 patients died during the follow-up. There was no significant difference in survival between patients with and without PH (p = 0.74). Conclusions: Similar to international studies, we observed that the presence of PH in patients with pulmonary fibrosis did not increase risk of death in post-transplant period.

Results of lung transplant patients in emergency situation

Lung transplant in patients with idiopathic pulmonary fibrosis Pulmonary transplantation represents a therapeutic option in patients with advanced pulmonary fibrosis who have a progressive course despite medical treatment, improving their survival and quality of life. It is vital that the pulmonologist knows when to refer a patient and be familiar with the requirements and contraindications. Timely referral grants the necessary time for a complete study, in addition to identifying contraindications and clinical conditions that could be modified and / or corrected before a transplant.

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