Comparison of short-term outcomes for connective tissue disease-related interstitial lung disease and idiopathic pulmonary fibrosis after lung transplantation

Park, Ji Eun; Kim, Song Yee; Song, Joo Han; Kim, Young Sam; Chang, Joon; Lee, Jin Gu; Paik, Hyo Chae; Park, Moo Suk

doi:10.21037/jtd.2018.02.50

Cited by 23 publications

(24 citation statements)

References 34 publications

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“…Because of similar post transplantation survival rates between idiopathic and CTD-ILDs,165 the current guidelines propose the application of the same criteria to those CTDs in which no extrapulmonary contraindication to transplantation coexist 18…”

Section: Management and Treatmentmentioning

confidence: 99%

Management of Chronic Respiratory Failure in Interstitial Lung Diseases: Overview and Clinical Insights

Faverio¹,

Giacomi²,

Bonaiti³

et al. 2019

Int. J. Med. Sci.

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Interstitial lung diseases (ILDs) may be complicated by chronic respiratory failure (CRF), especially in the advanced stages. Aim of this narrative review is to evaluate the current evidence in management of CRF in ILDs. Many physiological mechanisms underlie CRF in ILDs, including lung restriction, ventilation/perfusion mismatch, impaired diffusion capacity and pulmonary vascular damage. Intermittent exertional hypoxemia is often the initial sign of CRF, evolving, as ILD progresses, into continuous hypoxemia. In the majority of the cases, the development of CRF is secondary to the worsening of the underlying disease; however, associated comorbidities may also play a role. When managing CRF in ILDs, the need for pulmonary rehabilitation, the referral to lung transplant centers and palliative care should be assessed and, if necessary, promptly offered. Long-term oxygen therapy is commonly prescribed in case of resting or exertional hypoxemia with the purpose to decrease dyspnea and improve exercise tolerance. High-Flow Nasal Cannula oxygen therapy may be used as an alternative to conventional oxygen therapy for ILD patients with severe hypoxemia requiring both high flows and high oxygen concentrations. Non-Invasive Ventilation may be used in the chronic setting for palliation of end-stage ILD patients, although the evidence to support this application is very limited.

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Section: Management and Treatmentmentioning

confidence: 99%

Management of Chronic Respiratory Failure in Interstitial Lung Diseases: Overview and Clinical Insights

Faverio¹,

Giacomi²,

Bonaiti³

et al. 2019

Int. J. Med. Sci.

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“…Post-transplant survival rates of 93%, 76%, and 60% after 1, 3, and 5 years were reported in a retrospective analysis of 30 patients with SSc-ILD who underwent lung or heart–lung transplant at 14 centres between 1993 and 2016 [59]. Data on post-transplant survival in patients with other ILDs are limited to small short-term studies [60–62]. In an analysis of five patients with ILD associated with idiopathic inflammatory myopathy, all patients survived for 1 year after transplant.…”

Section: Lung Transplantationmentioning

confidence: 99%

“…Among a cohort of 37 patients with non-IPF ILDs (14 with HP, 9 with RA, 6 with SSc, 3 with systemic lupus erythematosus), the 1-, 2- and 5-year survival rates after lung transplant were 86%, 63% and 57% [61]. A recent analysis of 15 patients with autoimmune ILDs (5 with polymyositis/dermatomyositis, 4 with RA, 3 with SSc) who underwent lung transplant at a Korean centre showed a 1-year survival rate of 80% [62].…”

Section: Lung Transplantationmentioning

confidence: 99%

Management of Fibrosing Interstitial Lung Diseases

Maher

Wuyts

2019

Adv Ther

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A proportion of patients with interstitial lung diseases (ILDs), including the ILDs that are commonly associated with autoimmune diseases, develop a progressive fibrosing phenotype characterised by worsening of lung function, dyspnoea and quality of life, and early mortality. No drugs are approved for the treatment of ILDs other than idiopathic pulmonary fibrosis (IPF). At present, immunomodulatory medications are the mainstay of treatment for non-IPF ILDs. However, with the exception of systemic sclerosis-associated ILD, the evidence to suggest that immunosuppression may preserve lung function in patients with these ILDs comes only from retrospective, observational, or uncontrolled studies. In this article, we review the evidence for the treatments currently used to treat ILDs associated with autoimmune diseases and other ILDs and the ongoing trials of immunosuppressant and antifibrotic therapies in patients with these ILDs.Funding: Boehringer Ingelheim.

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“…Patients with IPF and some connective tissue disease-related interstitial lung diseases are often older. Many of these patients present with a combination of coronary diseases, diabetes, secondary pulmonary hypertension, and right-side heart dysfunction or failure [13,14]. Residual right heart dysfunction is also common in patients with IPAH after transplantation, and in such patients, it is necessary to pay particular attention to cardiac hemodynamics, as they frequently require increased right-side filling pressures to ensure hemodynamic stability.…”

Section: Critical Care For Ltx Candidatesmentioning

confidence: 99%

Critical Care before Lung Transplantation

et al. 2018

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Lung transplantation is widely accepted as the only viable treatment option for patients with end-stage lung disease. However, the imbalance between the number of suitable donor lungs available and the number of possible candidates often results in intensive care unit (ICU) admission for the latter. In the ICU setting, critical care is essential to keep these patients alive and to successfully bridge to lung transplantation. Proper management in the ICU is also one of the key factors supporting long-term success following transplantation. Critical care includes the provision of respiratory support such as mechanical ventilation (MV) and extracorporeal life support (ECLS). Accordingly, a working knowledge of the common critical care issues related to these unique patients and the early recognition and management of problems that arise before and after transplantation in the ICU setting are crucial for long-term success. In this review, we discuss the management and selection of candidates for lung transplantation as well as existing respiratory support strategies that involve MV and ECLS in the ICU setting.

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Comparison of short-term outcomes for connective tissue disease-related interstitial lung disease and idiopathic pulmonary fibrosis after lung transplantation

Cited by 23 publications

References 34 publications

Management of Chronic Respiratory Failure in Interstitial Lung Diseases: Overview and Clinical Insights

Management of Chronic Respiratory Failure in Interstitial Lung Diseases: Overview and Clinical Insights

Management of Fibrosing Interstitial Lung Diseases

Critical Care before Lung Transplantation

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