J P Singer1, H Chen, T Phelan, J Kukreja, J A Golden, P D Blanc. 1. Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California, San Francisco, CA 94143, USA. jon.singer@ucsf.edu
Abstract
BACKGROUND: Information is scant assessing outcomes in lung transplantation (LT) in advanced occupational lung diseases (OLD). AIMS: To analyse survival after LT for OLD. METHODS: Using data from the US Organ Procurement and Transplantation Network Registry (OPTN-R), we identified subjects aged ≥ 18 years transplanted for OLD from 2005 to 2010. OPTN-R selected referents of corresponding age, sex and body mass index (BMI) who underwent LT for other diagnoses were also identified. Post-LT survival time was estimated with Cox proportional hazard models. Baseline age, BMI, forced expiratory volume in 1 s, creatinine, lung allocation score, donor age, donor lung ischaemic time and transplant type (single versus bilateral) were included as covariates. Time-dependent covariates were used to model differences in relative risk over time. RESULTS: Thirty-seven males underwent LT for silicosis (n = 19) or other OLD (n = 18) during the analytic period (0.5% of all LTs). For non-silicotic OLD, 6-month and 1- and 3-year survival estimates were 66, 55 and 55%, compared with the silicotic group (86, 86 and 76%) and referent group (89, 84 and 67%). During the first year post-transplant, those with OLD (silicosis and others combined) manifested an overall 2-fold increased mortality risk [hazard ratio (HR) 2.3, 95% CI 1.3-4.4; P < 0.05] compared to referents. In stratified analysis, this increased risk of death was restricted to those with non-silicotic OLD (HR 3.1, 95% CI 1.5-6.6; P < 0.01). Poorer survival was limited to the first year post-LT. CONCLUSIONS: Subjects undergoing LT for OLD other than silicosis may be at increased risk of death in the first year post-transplantation.
BACKGROUND: Information is scant assessing outcomes in lung transplantation (LT) in advanced occupational lung diseases (OLD). AIMS: To analyse survival after LT for OLD. METHODS: Using data from the US Organ Procurement and Transplantation Network Registry (OPTN-R), we identified subjects aged ≥ 18 years transplanted for OLD from 2005 to 2010. OPTN-R selected referents of corresponding age, sex and body mass index (BMI) who underwent LT for other diagnoses were also identified. Post-LT survival time was estimated with Cox proportional hazard models. Baseline age, BMI, forced expiratory volume in 1 s, creatinine, lung allocation score, donor age, donor lung ischaemic time and transplant type (single versus bilateral) were included as covariates. Time-dependent covariates were used to model differences in relative risk over time. RESULTS: Thirty-seven males underwent LT for silicosis (n = 19) or other OLD (n = 18) during the analytic period (0.5% of all LTs). For non-silicotic OLD, 6-month and 1- and 3-year survival estimates were 66, 55 and 55%, compared with the silicotic group (86, 86 and 76%) and referent group (89, 84 and 67%). During the first year post-transplant, those with OLD (silicosis and others combined) manifested an overall 2-fold increased mortality risk [hazard ratio (HR) 2.3, 95% CI 1.3-4.4; P < 0.05] compared to referents. In stratified analysis, this increased risk of death was restricted to those with non-silicotic OLD (HR 3.1, 95% CI 1.5-6.6; P < 0.01). Poorer survival was limited to the first year post-LT. CONCLUSIONS: Subjects undergoing LT for OLD other than silicosis may be at increased risk of death in the first year post-transplantation.
Authors: Jason D Christie; Leah B Edwards; Anna Y Kucheryavaya; Paul Aurora; Fabienne Dobbels; Richard Kirk; Axel O Rahmel; Josef Stehlik; Marshall I Hertz Journal: J Heart Lung Transplant Date: 2010-10 Impact factor: 10.247
Authors: Cynthia J Gries; Tessa C Rue; Patrick J Heagerty; Jeffrey D Edelman; Michael S Mulligan; Christopher H Goss Journal: J Heart Lung Transplant Date: 2010-04-09 Impact factor: 10.247
Authors: F Derom; F Barbier; S Ringoir; J Versieck; G Rolly; G Berzsenyi; P Vermeire; L Vrints Journal: J Thorac Cardiovasc Surg Date: 1971-06 Impact factor: 5.209
Authors: Jeremiah G Allen; George J Arnaoutakis; Eric S Weiss; Christian A Merlo; John V Conte; Ashish S Shah Journal: J Heart Lung Transplant Date: 2010-06-16 Impact factor: 10.247
Authors: T M Egan; S Murray; R T Bustami; T H Shearon; K P McCullough; L B Edwards; M A Coke; E R Garrity; S C Sweet; D A Heiney; F L Grover Journal: Am J Transplant Date: 2006 Impact factor: 8.086
Authors: Michelangelo Di Giuseppe; Federica Gambelli; Gary W Hoyle; Giuseppe Lungarella; Sean M Studer; Thomas Richards; Sam Yousem; Ken McCurry; James Dauber; Naftali Kaminski; George Leikauf; Luis A Ortiz Journal: PLoS One Date: 2009-05-25 Impact factor: 3.240
Authors: David J Blackley; Cara N Halldin; Robert A Cohen; Kristin J Cummings; Eileen Storey; A Scott Laney Journal: J Heart Lung Transplant Date: 2017-02-24 Impact factor: 10.247
Authors: P G Trentin; T P T Ferreira; A C S Arantes; B T Ciambarella; R S B Cordeiro; R J Flower; M Perretti; M A Martins; P M R Silva Journal: Br J Pharmacol Date: 2015-04-10 Impact factor: 8.739