Lung transplantation for acute exacerbation of interstitial lung disease.
Lung transplantation for acute exacerbation of interstitial lung disease.
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DOI：
10.1136/thoraxjnl-2020-215681
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发表时间：
2022-04
期刊：
影响因子：
10
通讯作者：
Gomez-Manjarres D
中科院分区：
文献类型：
--
作者：
Chizinga M;Machuca TN;Shahmohammadi A;Patel DC;Innabi A;Alzghoul B;Scheuble V;Pipkin M;Mehrad B;Pelaez A;Lin C;Gomez-Manjarres D
间质性肺疾病急性加重期（AE-ILD）死亡率高，缺乏有效的药物治疗。肺移植是AE-ILD患者潜在的救命选择，但其作用尚不明确。本研究的目的是确定与病情稳定的移植患者相比，AE-ILD期间的这种治疗是否显著影响移植后的预后。我们对2015年至2018年住院的AE-ILD患者进行了回顾性研究。对照组包括同期肺移植的稳定ILD患者。主要终点为AE-ILD住院患者的住院死亡率和移植患者的1年生存率。在53例因AE-ILD入院的患者中，28例单独接受药物治疗，25例接受移植。所有接受移植的AE-ILD患者存活至出院，而接受药物治疗的AE-ILD患者只有43%存活。在同一时期，67例稳定型ILD患者接受了移植。AE-ILD组与稳定ILD组的移植患者一年生存率无差异（96% vs 92.5%）。两组间的原发性移植物功能障碍率、移植后住院时间和ACR相似。在AE-ILD期间移植的ILD患者与病情稳定的移植患者相比，在总生存率、原发性移植物功能障碍率或急性排斥反应方面没有显著差异。我们的研究结果表明，肺移植可以被认为是选定AE-ILD患者的一种治疗选择。
Acute exacerbations of interstitial lung diseases (AE-ILD) have a high mortality rate with no effective medical therapies. Lung transplantation is a potentially life-saving option for patients with AE-ILD, but its role is not well-established. The aim of this study is to determine if this therapy during AE-ILD significantly affects post-transplant outcomes in comparison to those transplanted with stable disease. We conducted a retrospective study of consecutive patients with AE-ILD admitted to our institution from 2015 to 2018. The comparison group included patients with stable ILD listed for lung transplant during the same period. The primary end-points were in-hospital mortality for patients admitted with AE-ILD and one-year survival for the transplanted patients. Of 53 patients admitted for AE-ILD, 28 were treated with medical therapy alone and 25 underwent transplantation. All patients with AE-ILD who underwent transplantation survived to hospital discharge whereas only 43% of the AE-ILD medically treated did. During the same period, 67 patients with stable ILD underwent transplantation. Survival at one-year for the transplanted patients was not different for the AE-ILD group versus stable ILD group (96 % vs 92.5%). The rates of primary graft dysfunction, post-transplant hospital length-of-stay, and ACR were similar between the groups. ILD patients transplanted during AE-ILD had no meaningful difference in overall survival, rate of primary graft dysfunction, or acute rejection compared to those transplanted with stable disease. Our results suggest that lung transplantation can be considered as a therapeutic option for selected AE-ILD patients.
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影响因子：
4.6
作者：
Bermudez, Christian A.;Shiose, Akira;Pilewski, Joseph M.
通讯作者：
Pilewski, Joseph M.
影响因子：
4.2
作者：
Hoechter, Dominik J.;Shen, Yu-Ming;von Dossow, Vera
通讯作者：
von Dossow, Vera
影响因子：
3.9
作者：
Leuschner G;Behr J
通讯作者：
Behr J
DOI：
10.1164/rccm.2009-040gl
发表时间：
2011-03-15
影响因子：
24.7
作者：
Raghu, Ganesh;Collard, Harold R.;Schuenemann, Holger J.
通讯作者：
Schuenemann, Holger J.
影响因子：
8.8
作者：
Valapour, M.;Lehr, C. J.;Kasiske, B. L.
通讯作者：
Kasiske, B. L.