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Long-term survival of lung transplantation for interstitial lung disease associated with connective tissue diseases:a study of 26 cases from a referral centre

Abstract: Objectives: Interstitial lung disease (ILD) is a leading cause of mortality in patients with connective tissue diseases (CTD). Lung transplantation has become a viable option for patients with end-stage CTD-ILD. However, patients with CTD are often considered suboptimal candidates for lung transplantation because of concerns of worse outcomes. We assessed post-transplant survival of patients with CTD-ILD compared to patients with idiopathic pulmonary fibrosis (IPF). Methods: Medical records of patients who underwent lung transplantation for CTD-ILD at a single referral centre for lung transplantation in Northern Spain between 1998 and 2018 were reviewed. This cohort was compared with patients with IPF (group-matched for age ±3.3 years, transplant year and use of basiliximab induction previous to transplant). Cumulative survival rates after transplantation were estimated by the Kaplan-Meier method and compared between groups using the log-rank test. Results: We studied 26 patients with CTD-ILD and 26 patients with IPF. The underlying diseases of CTD-ILD patients were rheumatoid arthritis (n=9), scleroderma (n=6), Sjögren's syndrome (n=4), ANCA-associated vasculitis (n=3), anti-synthetase syndrome (n=2), and dermatomyositis, systemic lupus erythematosus (1 each). Baseline characteristics were similar in both groups. CTD-ILD patients experienced acute graft rejection less commonly than those with IPF (32.0% vs. 62.5%; p=0.032). However, a non-statistically significant increased frequency of chronic graft rejection was observed in CTD-ILD patients (20.0% vs. 8.3%; p=0.417). In this regard, the 5-year cumulative survival rates after transplantation was reduced in CTD-ILD (42.4% vs. 65.8%) but the difference did not achieve statistical significance (p=0.075). Conclusions: Long-term post-transplant survival in Northern Spanish patients with CTD-ILD is reduced compared with IPF.

 Fuente: Clinical and Experimental Rheumatology 2020, 38, 615-620

 Editorial: Clinical and Experimental Rheumatology

 Año de publicación: 2020

 Nº de páginas: 6

 Tipo de publicación: Artículo de Revista

 ISSN: 0392-856X,1593-098X

Autoría

PRIETO PEÑA, DIANA

MARTÍNEZ MEÑACA, AMAYA

CALDERÓN GOERCKE, MÓNICA

MORA CUESTA, VICTOR

FERNÁNDEZ ROZAS, SONIA

ITURBE FERNÁNDEZ, DAVID

GÓMEZ ROMAN, JOSÉ J

CIFRIÁN MARTÍNEZ, JOSÉ M.

CASTAÑEDA, SANTOS

HERNÁNDEZ, JOSÉ L