Ten-Year Survival in Patients with Idiopathic Pulmonary Fibrosis After Lung Transplantation

Klooster, Liesbeth ten; Nossent, George; Erp, Johanna M. Kwakkel-van; Kessel, Diana A. van; Oudijk, Erik-Jan; Graaf, E.A. van de; Luijk, Bart; Hoek, Rogier A.S.; Blink, Bernt van den; Hal, P.T. van; Verschuuren, Erik; Bij, Wim van der; Moorsel, Coline Hm van; Grutters, Jan C.

doi:10.1007/s00408-015-9794-7

Cited by 20 publications

(13 citation statements)

References 31 publications

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“…The primary goal of lung transplantation is to provide a survival benefit for patients with chronic end-stage lung disorders, including IPF. Results from current published articles have implied that there might be a preference to perform DLT for interstitial lung diseases with better survival rates, especially in high-risk patients, young patients, and patients with high mPAP [27,29]. Recently, Villavicencio et al retrospectively analyzed recipients of lung transplants for pulmonary fibrosis between 1987 to 2015, and found that DLT improved survival compared with SLT, which should be considered the procedure of choice in patients younger than 70 years old [30].…”

Section: Discussionmentioning

confidence: 99%

“…After detailed evaluation, 10 studies were excluded for lacking sufficient data to extract (n = 2), or the survival outcome evaluated in other diseases other than IPF (n = 8). Ultimately, 16 studies with 17,872 IPF cases distributed in five countries were included in this meta-analysis [4][5][6][7][17][18][19][20][21][22][23][24][25][26][27][28] (Fig 1). These studies were published between 2005 and 2019, among which six were single-center studies, while the other ten were multi-center studies.…”

Section: Baseline Characteristics Of Eligible Studiesmentioning

confidence: 99%

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Single versus bilateral lung transplantation in idiopathic pulmonary fibrosis: A systematic review and meta-analysis

Liu

Wang

2020

PLoS ONE

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Lung transplantation remains the only curative treatment for end-stage lung disease, conferring a better survival for some IPF patients, but whether they should receive double lung transplantation (DLT) or single lung transplantation (SLT) is still controversial. The aim of this study was to determine which type of lung transplantation was more effective and relatively safe in IPF patients by meta-analysis. Methods Publications comparing overall survival (OS) or other perioperative characteristics between IPF patients undergoing SLT and DLT were selected from electronic databases. The hazard ratios (HRs) were abstracted or calculated to evaluate the survival outcome. Odds ratios (ORs) or mean differences (MDs) were used to compare the causes of death or perioperative parameters. A random-effect model was used to combine data. Heterogeneity was quantified by means of an I 2 with 95% confidence interval (95% CI). The publication bias was estimated using the Eggers test with Begg's funnel plots. Results 16 studies with 17,872 IPF cases who met the inclusion criteria were included in this metaanalysis. SLT was associated with declined post-transplant FEV1% (

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Section: Discussionmentioning

confidence: 99%

Section: Baseline Characteristics Of Eligible Studiesmentioning

confidence: 99%

Single versus bilateral lung transplantation in idiopathic pulmonary fibrosis: A systematic review and meta-analysis

Liu

Wang

2020

PLoS ONE

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“…To date, no randomized controlled studies have weighed the superiority of SLT to BLT in patients with IPF. We compared the data collected at our centre with those published in other countries 10,11,[15][16][17][18][19][20][21][22] (Table 4). Weiss ES and his colleagues reviewed 1256 patients with pulmonary fibrosis and identified that BLT was associated with a lower risk of mortality at 1 year for those with highest LAS.…”

Section: Discussionmentioning

confidence: 99%

Single versus bilateral lung transplantation for idiopathic pulmonary fibrosis

Dong

Gao

et al. 2019

Clinical Respiratory J

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Background Lung transplantation, either single or bilateral, serves as the only effective treatment for end‐stage idiopathic pulmonary fibrosis (IPF), but their superiority is still being debated, and its application in Chinese patients has not been data analysed. Methods We reviewed 109 IPF patients who received lung transplantation at our centre between January 1, 2015 and December 31, 2017. The patients were divided into single lung transplantation (SLT) group and bilateral lung transplantation (BLT) group. We compared the two groups’ demographic characteristics and clinical indexes (intraoperative conditions, postoperative complications, follow‐ups and life qualities). Results Patients in BLT group were significantly younger than those in SLT group (P < 0.001), and had more pretransplant infections (P = 0.007). The total ischemic time (P < 0.001) was shorter and intraoperative blood loss was less (P = 0.001) in SLT group. No significant difference was found in the proportion of patients in using anti‐fibrosis drugs, pulmonary artery pressure, extracorporeal membrane oxygenation during the surgery; the length of intensive care unit stay; the incidence of complication; and the overall survival rate between two groups. However, the hierarchical analysis found that patients aged > 60 years showed a better survival in SLT group (P = 0.008). Both groups got normal MOS 36‐item Short Form (SF‐36) scores, and the scores of BLT were higher than those of SLT. The BLT group had better lung function than SLT group 1 year post‐lung transplantation. Conclusions Both SLT and BLT are effective and SLT is more favourable for the patients of > 60 years.

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“…The unilateral transplant presents fewer perioperative complications than the bilateral one, due to the greater simplicity of the procedure. With bilateral transplantation long-term survival is greater due to greater functional reserve and avoidance of possible complications in the native lung, such as infection and neoplasia [ 42 , 43 , 44 ].…”

Section: Type Of Transplantmentioning

confidence: 99%

Lung Transplantation in Idiopathic Pulmonary Fibrosis

et al. 2018

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Despite the advances in recent years in the treatment of idiopathic pulmonary fibrosis (IPF), it continues to be a progressive disease with poor prognosis. In selected patients, lung transplantation may be a treatment option, with optimal results in survival and quality of life. Currently, pulmonary fibrosis is the main cause of lung transplantation. However, mortality on the waiting list of these patients is high, since many patients are referred to the transplant units with advanced disease. There is not a parameter that can predict the survival of a specific patient. Different variables are to be considered in order to decide the right time to send them to a transplant unit. It is also very difficult to decide when to include these patients on the waiting list. Every patient diagnosed with IPF, without contraindications for surgery, should be referred early to a transplant unit for assessment. A uni or bilateral transplantation will be decided based on the characteristics of the patient and the experience of each center. The post-transplant survival of recipients with IPF is lower than that observed in other diseases, such as cystic fibrosis or chronic obstructive pulmonary disease as a consequence of their older age and the frequent presence of associated comorbidity. Post-transplant follow-up must be tight in order to assure optimal level of immunosuppressive treatment, detect complications associated with it, and avoid graft rejection. The main cause of long-term mortality is late graft dysfunction as a consequence of chronic rejection. Other complications, such as infections and tumors, must be considered.

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Ten-Year Survival in Patients with Idiopathic Pulmonary Fibrosis After Lung Transplantation

Abstract: This study demonstrated a 10-year survival time after LTX in IPF. Furthermore, our study demonstrated a significantly better survival after bilateral LTX in IPF compared to single LTX although bilateral LTX patients were significantly younger.

Cited by 20 publications

References 31 publications

Single versus bilateral lung transplantation in idiopathic pulmonary fibrosis: A systematic review and meta-analysis

Single versus bilateral lung transplantation in idiopathic pulmonary fibrosis: A systematic review and meta-analysis

Single versus bilateral lung transplantation for idiopathic pulmonary fibrosis

Lung Transplantation in Idiopathic Pulmonary Fibrosis

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