Outcomes after lung transplantation among Chinese patients with connective tissue disease-associated interstitial lung disease and pulmonary hypertension: a retrospective cohort study

Chen, Ju; Lian, Qiaoyan; Chen, Ao; Xu, Xin; Zhang, Jianheng; Luo, Qun; Huang, Danxia; Chen, Rongchang; He, Jianxing

doi:10.55563/clinexprheumatol/hld9sf

Cited by 3 publications

(4 citation statements)

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“…The incidence of PGD in CTD patients after lung transplantation is shown in Table 2. Park et al reported that there was no significant difference in the incidence of PGD between CTD-ILD and IPF patients (P = 0.154) (15), and in 2021, findings from a multicenter retrospective study by Natalini et al demonstrated that the incidence of grade 3 PGD in patients with CTD-ILD is similar to that in patients with IPF (35), which was different from the study by Ju et al (17) that showed that PM/DM-ILD was associated with higher incidence of PGD (grade 3) (P = 0.006) and longer stay in the ICU (P < 0.001) (20). Cox proportional risk regression analysis after adjustment for age and sex showed that the occurrence of PGD after surgery and the length of stay in the ICU were independent risk factors for patient survival.…”

Section: Outcome In Ctd Patients After Lung Transplantationmentioning

confidence: 85%

“…Because the proportion of CTD patients receiving lung transplantation is smaller compared with that of other lung diseases (e.g., IPF, CF, COPD), there are few studies about the prognosis of lung transplantation in CTD patients. Recently, some studies have shown that the short‐term and long‐term survival rates of CTD–ILD patients posttransplant are comparable to those of IPF or non‐CTD patients (14–20) (see Table 2). These studies confirmed the effectiveness of lung transplantation in patients with CTD–ILD.…”

Section: Introductionmentioning

confidence: 99%

“…Cox proportional risk regression analysis after adjustment for age and sex showed that the occurrence of PGD after surgery and the length of stay in the ICU were independent risk factors for patient survival. Ju et al demonstrated that the incidence of PGD in CTD–ILD patients was significantly higher (90.3% versus 70.4%; P = 0.03), but there was no significant difference in mortality related to PGD between the 2 groups (6.5% versus 6.1%; P = 0.95) (17) (see Table 2). Therefore, there is no higher PGD‐related mortality in CTD patients after lung transplantation, except in PM/DM–ILD patients.…”

Section: Introductionmentioning

confidence: 99%

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Lung Transplantation: A Viable Option for Connective Tissue Disease?

Zhang

Liu

Zhang

et al. 2023

Arthritis Care & Research

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Interstitial lung disease (ILD) and pulmonary hypertension (PH) caused by connective tissue disease (CTD) are one of the main causes of morbidity and death in patients. Although the International Society for Heart & Lung Transplant suggested that ILD and PH related to CTD are rare indications for lung transplantation in 2006, many lung transplantation centers are concerned that the multisystem involvement of CTD will affect survival outcomes after lung transplantation, and CTD is regarded as a relative contraindication for lung transplantation. However, long‐term and short‐term survival after lung transplantation in CTD patients is similar compared with survival in common indications for lung transplantation such as idiopathic pulmonary fibrosis (IPF), and no higher incidence of complications after transplantation in many lung transplant centers. This suggests that lung transplantation may be beneficial in CTD patients with disease that progresses to end‐stage lung disease, and CTD should not be considered a contraindication for lung transplantation. In the future, more prospective studies are needed to analyze the risk factors of lung transplantation in CTD patients to improve survival rates and reduce the risk of complications. This narrative review summarizes the selection and evaluation of candidates for CTD before lung transplantation and describes the clinical outcomes in CTD after lung transplantation in large‐capacity lung transplantation center. The purpose of this review is to help rheumatologists decide when to refer patients with CTD‐related lung involvement to a lung transplantation center and the conditions to consider before transplantation and to provide confidence to lung transplant experts.

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Section: Outcome In Ctd Patients After Lung Transplantationmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Lung Transplantation: A Viable Option for Connective Tissue Disease?

Zhang

Liu

Zhang

et al. 2023

Arthritis Care & Research

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“…Moreover, autoimmune patients are often exposed for a long period to steroids and immunosuppressive treatment, which may affect the outcome of the organ transplant. However, interestingly, various studies reported similar outcomes between IPF-and CTD-related ILD patients undergoing pulmonary transplantation because of end-stage lung disease [93][94][95]. Similarly, a large retrospective cohort study analyzed the outcome of non-SSc CTD patients with ILD, including pSS-ILD, who underwent lung transplantation.…”

Section: Is Lung Transplantation a Feasible Option For Pss-ild Patien...mentioning

confidence: 99%

Primary-Sjögren’s-Syndrome-Related Interstitial Lung Disease: A Clinical Review Discussing Current Controversies

Rocca

Ferro

Sambataro

et al. 2023

JCM

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Lung involvement, especially interstitial lung disease, is a potentially severe extra-glandular manifestation of Primary Sjogren’s Syndrome (pSS-ILD). ILD can manifest either as a late complication of pSS or anticipate sicca symptoms, likely reflecting two different patho-physiological entities. Presence of lung involvement in pSS subjects can remain subclinical for a long time; therefore, patients should be actively screened, and lung ultrasound is currently being investigated as a potential low cost, radiation-free, easily repeatable screening tool for detection of ILD. In contrast, rheumatologic evaluation, serology testing, and minor salivary gland biopsy are crucial for the recognition of pSS in apparently idiopathic ILD patients. Whether the HRCT pattern influences prognosis and treatment response in pSS-ILD is not clear; a UIP pattern associated with a worse prognosis in some studies, but not in others. Many aspects of pSS-ILD, including its actual prevalence, association with specific clinical–serological characteristics, and prognosis, are still debated by the current literature, likely due to poor phenotypic stratification of patients in clinical studies. In the present review, we critically discuss these and other clinically relevant “hot topics” in pSS-ILD. More specifically, after a focused discussion, we compiled a list of questions regarding pSS-ILD that, in our opinion, are not easily answered by the available literature. We subsequently tried to formulate adequate answers on the basis of an extensive literature search and our clinical experience. At the same, we highlighted different issues that require further investigation.

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