What is expected in lung function after lung transplantation due to end‐stage pulmonary silicosis?

Abstract

In this study, we aimed to determine the impact of lung transplantation (LTx) on pulmonary function tests (PFTs) and survival among patients with end-stage silicosis. We included patients with end-stage silicosis on the wait list for LTx, between January 1989 and July 2015 (N = 26). Sixteen of these patients received LTx; 10 were eligible, but did not undergo LTx (non-LTx) during the study period. Retrospective information on PFTs (spirometry [volumes and flows], 6-minute walking test [6MWT], and DLCO) was retrieved from patients' medical charts, including baseline information for all patients and follow-up information for the LTx. At baseline, most patients presented with spirometric and 6MWT values that were suggestive of severe disease (FEV /FVC 76.5 ± 29.7; 6MWT 267.4 ± 104.5 m). Significant increases in these values were observed at follow-up in the LTx (P = .036 and .151, respectively). The overall median survival of patients in the LTx and non-LTx was 3.35 years (95% CI: 0.16-14.38) and 0.78 years (95% confidence interval [CI]: 0.12-3.65) (P = 0.002), respectively. For patients with end-stage silicosis, LTx offers significant benefits regarding pulmonary function and survival when compared to non-LTx, and is a reliable tool to help this critical population of patients, whose only treatment option is LTx.

Pulmonary hypertension in patients with pneumoconiosis with progressive massive fibrosis

“…In the current study, in patients with PMF, over a median follow-up of 32.8 months, the survival rate of the PH group was significantly lower than that of the non-PH group. Lung transplantation might be beneficial to patients with end-stage silicosis 33. The 5-year survival rate of PMF was 76.6% in a single medical centre in China 34.…”

Long-term survival following unilateral lung transplantation for end-stage silicosis relative to idiopathic pulmonary fibrosis

“…O procedimento geralmente tem um curso intraoperatório complicado devido ao sangramento e instabilidade hemodinâmica; portanto, apenas um número restrito de pacientes com silicose terminal em todo o mundo foi submetido a transplante. (1,2) Poucos estudos relataram as complicações intraoperatórias e os desfechos a longo prazo do TPx nesses pacientes, e a maioria dos dados deriva de estudos em centros localizados nos Estados Unidos. (2)(3)(4)(5)(6)(7)(8)(9) No entanto, pouco se sabe sobre os desfechos de sobrevida do procedimento na América Latina.…”

“…(10) A captação e o transplante de órgãos de doadores foram descritos em detalhe em outros estudos. (1) Após o transplante, todos os pacientes receberam um regime imunossupressor triplo padrão (ciclosporina, azatioprina e prednisona) e profilaxia antibiótica. Testes não paramétricos foram usados para comparar os dois grupos.…”