Survival benefit of lung transplantation for patients with idiopathic pulmonary fibrosis.

Abstract

OBJECTIVE:

Although lung transplantation is viewed as an acceptable option for patients with end-stage idiopathic pulmonary fibrosis, the survival benefit of this approach is still debated. This study examined whether there was a survival benefit of lung transplantation in a cohort of patients referred to our transplant center with a diagnosis of idiopathic pulmonary fibrosis according to American Thoracic Society criteria.

METHODS:

Forty-six patients accepted for lung transplantation during a 12-year period with a diagnosis of idiopathic pulmonary fibrosis form the basis of this study. Survival benefit offered by lung transplantation was assessed using Cox proportional-hazards modeling, with patients on a waiting list as the control group.

RESULTS:

Twenty-eight patients underwent lung transplantation (27 single and 1 double), 16 patients died while waiting, and 2 patients remained on the active waiting list. Diagnosis of idiopathic pulmonary fibrosis was made on histologic examination of the explanted lung or lung biopsy before lung transplantation. There was a pattern of usual interstitial pneumonia in 31 cases (67%). The 15 remaining patients fulfilled all American Thoracic Society criteria for idiopathic pulmonary fibrosis. The median waiting time for organs was 51 days. Survival after lung transplantation was 79.4% at 1 year, 63.5% at 2 years, and 39% at 5 years. The multivariable analysis showed that lung transplantation reduced the risk of death by 75% (95% confidence interval, 8%-86%; P =.03) after adjustment on potential confounding variables.

CONCLUSIONS:

Lung transplantation is effective in improving the survival of selected patients affected by idiopathic pulmonary fibrosis.

• Authors: Gabriel Thabut, Hervé Mal, Yves Castier, Odile Groussard, Olivier Brugière, Rolana Marrash-Chahla, Guy Lesèche, Michel Fournier
• Journal: The Journal of thoracic and cardiovascular surgery (J Thorac Cardiovasc Surg) Vol. 126 Issue 2 Pg. 469-75 (Aug 2003) ISSN: 0022-5223 [Print] United States
• PMID: 12928646 (Publication Type: Comparative Study, Journal Article)

Topics

• Adult
• Biopsy
• Cohort Studies
• Exercise Tolerance (physiology)
• Female
• Follow-Up Studies
• France
• Humans
• Lung (pathology, physiopathology)
• Lung Transplantation (mortality)
• Male
• Middle Aged
• Multivariate Analysis
• Pulmonary Fibrosis (etiology, mortality, surgery)
• Severity of Illness Index
• Statistics as Topic
• Survival Analysis
• Time Factors
• Total Lung Capacity (physiology)
• Treatment Outcome
• Waiting Lists