Survival following lung transplantation for silicosis and other occupational lung diseases.

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.

• Authors: J P Singer, H Chen, T Phelan, J Kukreja, J A Golden, P D Blanc
• Journal: Occupational medicine (Oxford, England) (Occup Med (Lond)) Vol. 62 Issue 2 Pg. 134-7 (Mar 2012) ISSN: 1471-8405 [Electronic] England
• PMID: 22071439 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, U.S. Gov't, P.H.S.)

Topics

• Adult
• Aged
• Body Mass Index
• Humans
• Lung Diseases (mortality)
• Lung Transplantation (mortality)
• Male
• Middle Aged
• Occupational Diseases (mortality)
• Proportional Hazards Models
• Retrospective Studies
• Silicosis (surgery)
• Survival Rate
• Time Factors