Lung transplantation in systemic sclerosis: A single center cohort study

Andreu Fernández-Codina, Cristina Berastegui, Iago Pinal-Fernández, María Guadalupe Silveira, Manuel López-Meseguer, Víctor Monforte, Alfredo Guillén-del Castillo, Carmen Pilar Simeón-Aznar, Vicent Fonollosa-Plà, Joan Solé, Carlos Bravo-Masgoret, Antonio Román-Broto

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12 Citations (Scopus)

Abstract

© 2017 Objective Lung transplantation (LT) has been proposed as a treatment for advanced interstitial lung disease (ILD) and/or pulmonary hypertension (PH) associated to systemic sclerosis (SSc) but few studies have been reported. The aim of this study was to describe the clinical features, complications and survival of a single-center cohort of patients with SSc that underwent LT and to compare their survival with a group of non-SSc transplanted patients. Methods Fifteen patients with SSc were transplanted between May 2005 and April 2015. Standard international criteria were used to determine eligibility for LT. The severity of gastroesophageal involvement was not considered as a major contraindication if symptoms were under control. Results Eight (53.3%) patients had diffuse cutaneous SSc. Eleven (73%) underwent bilateral LT. The main indication for LT was ILD, with or associated PH in 4 cases. Acute cellular rejection and infections were the most frequent complications. Functional lung tests tended to keep stable after transplantation. Median survival was 2.4 years (Q1–Q3: 0.7–3.7 years). We did not find differences in survival between patients transplanted with SSc versus those transplanted due to non-SSc ILD or PH. SSc complications were scarce with no patient developing PH after LT. Conclusions LT was an effective treatment for advanced ILD and/or PH associated to SSc in our study. Gastroesophageal reflux was not a limitation for LT in SSc in this study. Complications and survival did not differ from non-SSc patients undergoing LT.
Original languageEnglish
Pages (from-to)79-84
JournalJoint Bone Spine
Volume85
Issue number1
DOIs
Publication statusPublished - 1 Jan 2018

Keywords

  • Lung diseases
  • Systemic sclerosis
  • Transplantation

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