RATIONALE: Consideration of lung transplantation in patients with systemic sclerosis (SSc) remains guarded, often due to the concern for esophageal dysfunction and the associated potential for allograft injury and suboptimal post-lung transplantation outcomes. OBJECTIVES: The purpose of this study was to systematically report our single-center experience regarding lung transplantation in the setting of SSc, with a particular focus on esophageal dysfunction. METHODS: We retrospectively reviewed all lung transplants at our center from January 1, 2000 through August 31, 2012 (n = 562), comparing the SSc group (n = 35) to the following lung transplant diagnostic subsets: all non-SSc (n = 527), non-SSc diffuse fibrotic lung disease (n = 264), and a non-SSc matched group (n = 109). We evaluated post-lung transplant outcomes, including survival, primary graft dysfunction, acute rejection, bronchiolitis obliterans syndrome, and microbiology of respiratory isolates. In addition, we defined severe esophageal dysfunction using esophageal manometry and esophageal morphometry criteria on the basis of chest computed tomography images. For patients with SSc referred for lung transplant but subsequently denied (n = 36), we queried the reason(s) for denial with respect to the concern for esophageal dysfunction. MEASUREMENTS AND MAIN RESULTS: The 1-, 3-, and 5-year post-lung transplant survival for SSc was 94, 77, and 70%, respectively, and similar to the other groups. The remaining post-lung transplant outcomes evaluated were also similar between SSc and the other groups. Approximately 60% of the SSc group had severe esophageal dysfunction. Pre-lung transplant chest computed tomography imaging demonstrated significantly abnormal esophageal morphometry for SSc when compared with the matched group. Importantly, esophageal dysfunction was the sole reason for lung transplant denial in a single case. CONCLUSIONS: Relative to other lung transplant indications, our SSc group experienced comparable survival, primary graft dysfunction, acute rejection, bronchiolitis obliterans syndrome, and microbiology of respiratory isolates, despite the high prevalence of severe esophageal dysfunction. Esophageal dysfunction rarely precluded active listing for lung transplantation.
RATIONALE: Consideration of lung transplantation in patients with systemic sclerosis (SSc) remains guarded, often due to the concern for esophageal dysfunction and the associated potential for allograft injury and suboptimal post-lung transplantation outcomes. OBJECTIVES: The purpose of this study was to systematically report our single-center experience regarding lung transplantation in the setting of SSc, with a particular focus on esophageal dysfunction. METHODS: We retrospectively reviewed all lung transplants at our center from January 1, 2000 through August 31, 2012 (n = 562), comparing the SSc group (n = 35) to the following lung transplant diagnostic subsets: all non-SSc (n = 527), non-SSc diffuse fibrotic lung disease (n = 264), and a non-SSc matched group (n = 109). We evaluated post-lung transplant outcomes, including survival, primary graft dysfunction, acute rejection, bronchiolitis obliterans syndrome, and microbiology of respiratory isolates. In addition, we defined severe esophageal dysfunction using esophageal manometry and esophageal morphometry criteria on the basis of chest computed tomography images. For patients with SSc referred for lung transplant but subsequently denied (n = 36), we queried the reason(s) for denial with respect to the concern for esophageal dysfunction. MEASUREMENTS AND MAIN RESULTS: The 1-, 3-, and 5-year post-lung transplant survival for SSc was 94, 77, and 70%, respectively, and similar to the other groups. The remaining post-lung transplant outcomes evaluated were also similar between SSc and the other groups. Approximately 60% of the SSc group had severe esophageal dysfunction. Pre-lung transplant chest computed tomography imaging demonstrated significantly abnormal esophageal morphometry for SSc when compared with the matched group. Importantly, esophageal dysfunction was the sole reason for lung transplant denial in a single case. CONCLUSIONS: Relative to other lung transplant indications, our SSc group experienced comparable survival, primary graft dysfunction, acute rejection, bronchiolitis obliterans syndrome, and microbiology of respiratory isolates, despite the high prevalence of severe esophageal dysfunction. Esophageal dysfunction rarely precluded active listing for lung transplantation.
Authors: Jason D Christie; Martin Carby; Remzi Bag; Paul Corris; Marshall Hertz; David Weill Journal: J Heart Lung Transplant Date: 2005-06-04 Impact factor: 10.247
Authors: Dean E Schraufnagel; Jon C Michel; Todd J Sheppard; Patricia Cole Saffold; George T Kondos Journal: AJR Am J Roentgenol Date: 2008-09 Impact factor: 3.959
Authors: R Saggar; D Khanna; D E Furst; J A Belperio; G S Park; S S Weigt; B Kubak; A Ardehali; A Derhovanessian; P J Clements; S Shapiro; C Hunter; A Gregson; M C Fishbein; J P Lynch Iii; D J Ross; R Saggar Journal: Eur Respir J Date: 2010-03-29 Impact factor: 16.671
Authors: Irfan Y Khan; Lianne G Singer; Marc de Perrot; John T Granton; Shaf Keshavjee; Cathy Chau; Amie Kron; Sindhu R Johnson Journal: Respir Med Date: 2013-09-26 Impact factor: 3.415
Authors: Peter D Sottile; David Iturbe; Tamiko R Katsumoto; M Kari Connolly; Harold R Collard; Lorriana A Leard; Steven Hays; Jeffrey A Golden; Charles Hoopes; Jasleen Kukreja; Jonathan P Singer Journal: Transplantation Date: 2013-04-15 Impact factor: 4.939
Authors: Lionel Schachna; Thomas A Medsger; James H Dauber; Fredrick M Wigley; Neil A Braunstein; Barbara White; Virginia D Steen; John V Conte; Stephen C Yang; Kenneth R McCurry; Marvin C Borja; David E Plaskon; Jonathan B Orens; Allan C Gelber Journal: Arthritis Rheum Date: 2006-12
Authors: Denis Hadjiliadis; R Duane Davis; Mark P Steele; Robert H Messier; Christine L Lau; Steve S Eubanks; Scott M Palmer Journal: Clin Transplant Date: 2003-08 Impact factor: 2.863
Authors: Geert M Verleden; Lieven Dupont; Jonas Yserbyt; Veronique Schaevers; Dirk Van Raemdonck; Arne Neyrinck; Robin Vos Journal: J Thorac Dis Date: 2017-09 Impact factor: 2.895
Authors: Lorriana E Leard; Are M Holm; Maryam Valapour; Allan R Glanville; Sandeep Attawar; Meghan Aversa; Silvia V Campos; Lillian M Christon; Marcelo Cypel; Göran Dellgren; Matthew G Hartwig; Siddhartha G Kapnadak; Nicholas A Kolaitis; Robert M Kotloff; Caroline M Patterson; Oksana A Shlobin; Patrick J Smith; Amparo Solé; Melinda Solomon; David Weill; Marlies S Wijsenbeek; Brigitte W M Willemse; Selim M Arcasoy; Kathleen J Ramos Journal: J Heart Lung Transplant Date: 2021-07-24 Impact factor: 13.569
Authors: Jake G Natalini; Joshua M Diamond; Mary K Porteous; David J Lederer; Keith M Wille; Ann B Weinacker; Jonathan B Orens; Pali D Shah; Vibha N Lama; John F McDyer; Laurie D Snyder; Chadi A Hage; Jonathan P Singer; Lorraine B Ware; Edward Cantu; Michelle Oyster; Laurel Kalman; Jason D Christie; Steven M Kawut; Elana J Bernstein Journal: J Heart Lung Transplant Date: 2021-01-23 Impact factor: 10.247
Authors: Anna-Maria Hoffmann-Vold; Yannick Allanore; Elisabeth Bendstrup; Cosimo Bruni; Oliver Distler; Toby M Maher; Marlies Wijsenbeek; Michael Kreuter Journal: Respir Res Date: 2020-07-23
Authors: Caterina Vacchi; Marco Sebastiani; Giulia Cassone; Stefania Cerri; Giovanni Della Casa; Carlo Salvarani; Andreina Manfredi Journal: J Clin Med Date: 2020-02-03 Impact factor: 4.241
Authors: Dinesh Khanna; Donald P Tashkin; Christopher P Denton; Martin W Lubell; Cristina Vazquez-Mateo; Stephen Wax Journal: Rheumatology (Oxford) Date: 2019-04-01 Impact factor: 7.580