Impact of Acute Exacerbation of Idiopathic Pulmonary Fibrosis on Outcomes after Lung Transplantation

Tomic, Rade; Keenan, Andrew; Dincer, Erhan; Kim, H.

doi:10.1016/j.healun.2016.01.659

Cited by 4 publications

(3 citation statements)

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“…Previous retrospective studies have no difference in posttransplant 1 y survival between IPF patients transplanted at steady state and patients transplanted during an AE. [25][26][27] Another published abstract demonstrated higher rates of PGD in patients transplanted during AE-IPF, albeit not significantly. 27 However, a major study from 2018 showed a significant difference in survival, both short term and longer term, between those patients transplanted with stable IPF and those with AE-IPF (Table 3).…”

Section: Discussionmentioning

confidence: 96%

“…[25][26][27] Another published abstract demonstrated higher rates of PGD in patients transplanted during AE-IPF, albeit not significantly. 27 However, a major study from 2018 showed a significant difference in survival, both short term and longer term, between those patients transplanted with stable IPF and those with AE-IPF (Table 3). 19 In contrast, our study, which is the largest cohort of IPF patients undergoing LTX studied thus far, demonstrated no difference in posttransplant mortality in the early postoperative period or at 3 y posttransplant between the 2 groups.…”

Section: Discussionmentioning

confidence: 96%

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Impact of Acute Exacerbation of Idiopathic Pulmonary Fibrosis on Lung Transplant Outcomes

Warrior,

Sayad,

O’Hara

et al. 2024

Transplantation

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Background. Acute exacerbations of idiopathic pulmonary fibrosis (AE-IPF) are acute, significant respiratory deteriorations in patients with IPF and can lead to increased morbidity and mortality. It remains unclear how AE-IPF impacts lung transplant (LTX) outcomes. Methods. All adult patients who were listed for LTX between July 2005 and October 2020 at the Loyola University Medical Center with a diagnosis of IPF were included. Pretransplant characteristics and posttransplant outcomes were gathered via retrospective chart review. The primary outcome was short- and long-term survival for patients transplanted during stable IPF versus those with AE-IPF. Results. One hundred fifty-nine patients were included in this study, 17.6% of whom were transplanted during AE-IPF. AE-IPF patients were more likely to have higher oxygen needs pretransplant, have higher lung allocation score, and were more likely to be intubated or be on extracorporeal membrane oxygenation as compared with stable IPF patients. Survival by AE status at transplant did not differ at 90 d or 1 y posttransplantation. There were also no significant differences in rates of severe primary graft dysfunction or acute rejection within 1 y. Conclusions. Patients with AE-IPF were more likely to have higher oxygenation requirements and higher lung allocation score at the time of LTX than those with stable IPF. Despite this, there were no differences in survival at 90 d, 1 y, or 3 y, or differences in incidence of severe primary graft dysfunction or acute cellular rejection. Transplantation of patients with AE-IPF has clinical outcomes comparable with transplantation of patients with stable IPF. This contrasts with previous studies examining LTX in patients with AE-IPF.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 96%

Impact of Acute Exacerbation of Idiopathic Pulmonary Fibrosis on Lung Transplant Outcomes

Warrior,

Sayad,

O’Hara

et al. 2024

Transplantation

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“…Indeed, in some institutions, patients may be emergently evaluated and urgently listed for lung transplantation candidacy during an otherwise lethal acute exacerbation. Very few limited studies have addressed the problem of outcomes after a lung transplant in stable condition as compared with an acute exacerbation condition [25,26,27] and concluded with a recommendation of still going on towards transplant even during the acute worsening of the clinical condition. However, these experiences are limited to single-center retrospective studies with short follow-up, until 1 year of observation after transplant and without long-term mortality analysis.…”

Section: A Focus On Acute Exacerbation: a Good Or A Bad Indication?mentioning

confidence: 99%

Idiopathic Pulmonary Fibrosis and Lung Transplantation: When it is Feasible

et al. 2019

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Despite the availability of antifibrotic therapies, many patients with idiopathic pulmonary fibrosis (IPF) will progress to advanced disease and require lung transplantation. International guidelines for transplant referral and listing of patients with interstitial lung disease are not specific to those with IPF and were published before the widespread use of antifibrotic therapy. In this review, we discussed difficulties in decision-making when dealing with patients with IPF due to the wide variability in clinical course and life expectancy, as well as the acute deterioration associated with exacerbations. Indeed, the ideal timing for referral and listing for lung transplant remains challenging, and the acute deterioration might be influenced after transplant outcomes. Of note, patients with IPF are frequently affected by multimorbidity, thus a screening program for occurring conditions, such as coronary artery disease and pulmonary hypertension, before lung transplant listing is crucial to candidate selection, risk stratification, and optimal outcomes. Among several comorbidities, it is of extreme importance to highlight that the prevalence of lung cancer is increased amongst patients affected by IPF; therefore, candidates’ surveillance is critical to avoid organ allocation to unsuitable patients. For all these reasons, early referral and close longitudinal follow-up for potential lung transplant candidates are widely encouraged.

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Effect of Acute Exacerbation of Idiopathic Pulmonary Fibrosis on Lung Transplantation Outcome

Dotan

Vaidy

Shapiro

et al. 2018

Chest

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Impact of Acute Exacerbation of Idiopathic Pulmonary Fibrosis on Outcomes after Lung Transplantation

Cited by 4 publications

References 0 publications

Impact of Acute Exacerbation of Idiopathic Pulmonary Fibrosis on Lung Transplant Outcomes

Impact of Acute Exacerbation of Idiopathic Pulmonary Fibrosis on Lung Transplant Outcomes

Idiopathic Pulmonary Fibrosis and Lung Transplantation: When it is Feasible

Effect of Acute Exacerbation of Idiopathic Pulmonary Fibrosis on Lung Transplantation Outcome

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