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Leuschner, G.* ; Stocker, F.* ; Veit, T.* ; Kneidinger, N.* ; Winter, H.* ; Schramm, R.* ; Weig, T.* ; Matthes, S.* ; Ceelen, F.* ; Arnold, P.* ; Munker, D.* ; Klenner, F.* ; Hatz, R.* ; Frankenberger, M. ; Behr, J.* ; Neurohr, C.*

Outcome of lung transplantation in idiopathic pulmonary fibrosis with previous anti-fibrotic therapy.

J. Heart Lung Transpl. 37, 268-274 (2018)
DOI PMC
Open Access Green as soon as Postprint is submitted to ZB.
BACKGROUND: Anti-fibrotic drugs may interfere with wound-healing after major surgery, theoretically preventing sufficient bronchial anastomosis formation after lung transplantation (LTx). The aim of this study was to assess the impact of previous treatment with pirfenidone and nintedanib on outcomes after LTx in patients with idiopathic pulmonary fibrosis (IPF). METHODS: All patients with IPF undergoing LTx at the University of Munich between January 2012 and November 2016 were retrospectively screened for previous use of anti-fibrotics. Post-transplant outcome and survival of patients with and without anti-fibrotic treatment were analyzed. RESULTS: A total of 62 patients with IPF were transplanted (lung allocation score [mean +/- SD] +/- 53.1 16.1). Of these, 23 (37.1%) received pirfenidone and 7 (11.3%) received nintedanib before LTx; the remaining 32 (51.6%) did not receive any anti-fibrotic drug (control group). Patients receiving anti-fibrotics were significantly older (p = 0.004) and their carbon monoxide diffusion capacity was significantly higher (p = 0.008) than in controls. Previous anti-fibrotic treatment did not increase blood product utilization, wound-healing or anastomotic complications after LTx. Post-transplant surgical revisions due to bleeding and/or impaired wound-healing were necessary in 18 (29.0%) patients (pirfenidone 30.4%, nintedanib 14.3%, control 31.3%; p = 0.66). Anastomosis insufficiency occurred in 2 (3.2%) patients, both in the control group. No patient died within the first 30 days post-LTx, and no significant differences regarding survival were seen during the follow-up (12-month survival: pirfenidone 77.0%, nintedanib 100%, control 90.6%; p = 0.29). CONCLUSION: Our data show that previous use of anti-fibrotic therapy does not increase surgical complications or post-operative mortality after LTx. (C) 2018 International Society for Heart and Lung Transplantation. All rights reserved.
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Publication type Article: Journal article
Document type Scientific Article
Keywords Lung Transplantation ; Idiopathic Pulmonary Fibrosis ; Anti-fibrotic Therapy ; Pirfenidone ; Nintedanib ; Post-operative Complications; International-society; United-states; Pirfenidone; Nintedanib; Efficacy; System; Fibroblasts; Dysfunction; Diagnosis; Capacity
Language english
Publication Year 2018
Prepublished in Year 2017
HGF-reported in Year 2017
ISSN (print) / ISBN 1053-2498
e-ISSN 1557-3117
Journal Journal of Heart and Lung Transplantation, The
Quellenangaben Volume: 37, Issue: 2, Pages: 268-274 Article Number: , Supplement: ,
Publisher Elsevier
Publishing Place New York
Reviewing status Peer reviewed
Institute(s) Institute of Lung Health and Immunity (LHI)
POF-Topic(s) 30202 - Environmental Health
Research field(s) Lung Research
PSP Element(s) G-501600-012
DOI 10.1016/j.healun.2017.07.002
WOS ID WOS:000424293900015
Scopus ID 85024859484
PubMed ID 28734935
Erfassungsdatum 2017-08-02
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