Survival Associated With Sirolimus Plus Tacrolimus Maintenance Without Induction Therapy Compared With Standard Immunosuppression After Lung Transplant

Wijesinha, M.; Hirshon, Jon Mark; Terrin, Michael L.; Magder, Laurence S.; Brown, Clayton H.; Stafford, Kristen A.; Iacono, Aldo

doi:10.1001/jamanetworkopen.2019.10297

Cited by 10 publications

(4 citation statements)

References 28 publications

(80 reference statements)

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“…The patient’s survival to 12 years after transplant and 13 years after the initial diagnosis, despite his multiple sequential recurrences, is in stark contrast to the lethal natural history of the lung-limited, lepidic-predominant adenocarcinoma, 1 far exceeding the typical long-term survival in patients who received lung transplantation for this type of cancer 4 , 10 or for any indication. 11 This case supports the notion that concern for a high rate of recurrence after lung transplantation should be weighed against the ability to sequentially salvage recurrences with close radiographic surveillance.…”

Section: Discussionsupporting

confidence: 71%

Thirteen-Year Survival in a Patient With Diffuse Bilateral Lepidic-Predominant Adenocarcinoma: A Case Report of Lung Transplantation and Local Salvage

Zhang-Velten

Gerber

Westover

2020

JTO Clinical and Research Reports

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Section: Discussionsupporting

confidence: 71%

Thirteen-Year Survival in a Patient With Diffuse Bilateral Lepidic-Predominant Adenocarcinoma: A Case Report of Lung Transplantation and Local Salvage

Zhang-Velten

Gerber

Westover

2020

JTO Clinical and Research Reports

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“…De fato, a terapia de indução, tacrolimus em vez de ciclosporina e transplante bilateral estão em consonância com a atividade clínica mais recente do centro, em paralelo com a literatura e com a experiência adquirida pela equipe do centro. (28,29) Na coorte FP, o uso de basiliximabe mostrou-se associado a melhor resultado em termos de sobrevida global e sobrevida livre de CLAD (p = 0,05, HR = 0,503 [0,247-1,027] e p = 0,003, HR = 0,165 [0,050-0,543], respectivamente). A maioria dos pacientes com FPF foi transplantada desde 2009, quando o protocolo já havia sofrido alterações substanciais (apenas um paciente foi transplantado anteriormente, em 2006).…”

Section: /9unclassified

Lung transplant in patients with familial pulmonary fibrosis

Bennett¹,

Fossi²,

Lanzarone³

et al. 2020

J Bras Pneumol.

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Objective: Familial pulmonary fibrosis (FPF) is defined as an idiopathic interstitial lung disease affecting two or more members of the same family; poor outcome with high risk of death and chronic lung allograft dysfunction (CLAD) after lung transplant has been reported in these patients. The present study aimed to compare the short- and long term outcome of lung transplants in patients with FPF and patients transplanted because of other interstitial lung diseases. Method: Clinical pre- and post-transplant data from 83 consecutive patients with pulmonary fibrosis who underwent lung transplant at our centre were collected retrospectively. Patients were divided into those with familial (n=9 FPF group) and those with non-familial pulmonary fibrosis (n=74 controls). Results: The FPF group was composed of 4 females and 5 males; 44.5% were ex-smokers. The majority presented their CT scan and pathology evidence of usual interstitial pneumonia. Patients with FPF had significantly lower pre-transplant levels of haemoglobin and haematocrit. No other differences in pre- and post-transplant characteristics were observed concerning controls. The clinical post-operative course was similar in the two groups. No significant difference in one-year CLAD-free survival and overall survival was observed. Conclusion: The post-transplant course of patients with FPF was similar to patients with non-familial pulmonary fibrosis, although more patients with FPF had pre-transplant anaemia. Short- and long-term outcome was comparable in both groups. Lung transplant proved to be a valid option for patients with FPF as it was for patients with other types of pulmonary fibrosis.

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“…Of note, in one retrospective review utilizing data from the UNOS registry, 219 patients receiving sirolimus were compared with 5,782 patients receiving MMF. 265 Conditioned on 1-year survival and excluding patients with malignancy or chronic rejection in the first year, sirolimus treatment was associated with significantly better survival.…”

Section: Maintenance Immune Suppressionmentioning

confidence: 98%

Chronic Lung Allograft Dysfunction: Evolving Concepts and Therapies

Amubieya

Ramsey

Derhovanessian

et al. 2021

Semin Respir Crit Care Med

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The primary factor that limits long-term survival after lung transplantation is chronic lung allograft dysfunction (CLAD). CLAD also impairs quality of life and increases the costs of medical care. Our understanding of CLAD continues to evolve. Consensus definitions of CLAD and the major CLAD phenotypes were recently updated and clarified, but it remains to be seen whether the current definitions will lead to advances in management or impact care. Understanding the potential differences in pathogenesis for each CLAD phenotype may lead to novel therapeutic strategies, including precision medicine. Recognition of CLAD risk factors may lead to earlier interventions to mitigate risk, or to avoid risk factors all together, to prevent the development of CLAD. Unfortunately, currently available therapies for CLAD are usually not effective. However, novel therapeutics aimed at both prevention and treatment are currently under investigation. We provide an overview of the updates to CLAD-related terminology, clinical phenotypes and their diagnosis, natural history, pathogenesis, and potential strategies to treat and prevent CLAD.

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Survival Associated With Sirolimus Plus Tacrolimus Maintenance Without Induction Therapy Compared With Standard Immunosuppression After Lung Transplant

Cited by 10 publications

References 28 publications

Thirteen-Year Survival in a Patient With Diffuse Bilateral Lepidic-Predominant Adenocarcinoma: A Case Report of Lung Transplantation and Local Salvage

Thirteen-Year Survival in a Patient With Diffuse Bilateral Lepidic-Predominant Adenocarcinoma: A Case Report of Lung Transplantation and Local Salvage

Lung transplant in patients with familial pulmonary fibrosis

Chronic Lung Allograft Dysfunction: Evolving Concepts and Therapies

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