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. 2018 Jan;85(1):79-84.
doi: 10.1016/j.jbspin.2017.03.012. Epub 2017 Apr 11.

Lung transplantation in systemic sclerosis: A single center cohort study

Andreu Fernández-Codina  1 , Cristina Berastegui  2 , Iago Pinal-Fernández  1 , María Guadalupe Silveira  2 , Manuel López-Meseguer  2 , Víctor Monforte  2 , Alfredo Guillén-Del Castillo  1 , Carmen Pilar Simeón-Aznar  1 , Vicent Fonollosa-Plà  1 , Joan Solé  3 , Carlos Bravo-Masgoret  4 , Antonio Román-Broto  2
Affiliations

Lung transplantation in systemic sclerosis: A single center cohort study

Andreu Fernández-Codina et al. Joint Bone Spine. 2018 Jan.

Abstract

Objective: Lung transplantation (LT) has been proposed as a treatment for advanced interstitial lung disease (ILD) and/or pulmonary hypertension (PH) associated to systemic sclerosis (SSc) but few studies have been reported. The aim of this study was to describe the clinical features, complications and survival of a single-center cohort of patients with SSc that underwent LT and to compare their survival with a group of non-SSc transplanted patients.

Methods: Fifteen patients with SSc were transplanted between May 2005 and April 2015. Standard international criteria were used to determine eligibility for LT. The severity of gastroesophageal involvement was not considered as a major contraindication if symptoms were under control.

Results: Eight (53.3%) patients had diffuse cutaneous SSc. Eleven (73%) underwent bilateral LT. The main indication for LT was ILD, with or associated PH in 4 cases. Acute cellular rejection and infections were the most frequent complications. Functional lung tests tended to keep stable after transplantation. Median survival was 2.4 years (Q1-Q3: 0.7-3.7 years). We did not find differences in survival between patients transplanted with SSc versus those transplanted due to non-SSc ILD or PH. SSc complications were scarce with no patient developing PH after LT.

Conclusions: LT was an effective treatment for advanced ILD and/or PH associated to SSc in our study. Gastroesophageal reflux was not a limitation for LT in SSc in this study. Complications and survival did not differ from non-SSc patients undergoing LT.

Keywords: Lung diseases; Systemic sclerosis; Transplantation.

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Conflict of interest statement

Disclosure of interest

The authors declare that they have no competing interest.

Figures

Fig. 1.
Fig. 1.
Kaplan–Meier curves describing the survival of patients with systemic sclerosis (SSc) who underwent lung transplantation versus the non-SSc transplantation group.
Fig. 2.
Fig. 2.
A: Kaplan–Meier curves describing the survival of patients with systemic sclerosis (SSc) who underwent lung transplantation versus the subgroup of individuals transplanted due to non-SSc interstitial lung disease (ILD). B: Kaplan–Meier curves describing the survival of patients with systemic sclerosis (SSc) who underwent lung transplantation versus the subgroup of subjects transplanted because of non-SSc pulmonary hypertension (PH).
See this image and copyright information in PMC

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