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Med Clin (Barc). 2014 Sep 15;143(6):239-44. doi: 10.1016/j.medcli.2013.06.026. Epub 2013 Sep 9.

[Lung transplantation in pulmonary fibrosis and other interstitial lung diseases].

[Article in Spanish]

Author information

1
Servei de Pneumologia, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Hospital General Universitari Vall d'Hebron, Barcelona, España.
2
Servei de Cirurgia Toràcica, Hospital General Universitari Vall d'Hebron, Barcelona, España.
3
Servei de Malalties Infeccioses, Hospital General Universitari Vall d'Hebron, Barcelona, España.
4
Servei de Cures Intensives, Hospital General Universitari Vall d'Hebron, Barcelona, España.
5
Servei d'Anestesiologia, Hospital General Universitari Vall d'Hebron, Barcelona, España.
6
Servei de Pneumologia, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Hospital General Universitari Vall d'Hebron, Barcelona, España. Electronic address: aroman@vhebron.net.

Abstract

BACKGROUND AND OBJECTIVE:

Interstitial lung disease (ILD) is the second indication for lung transplantation (LT) after emphysema. The aim of this study is to review the results of LT for ILD in Hospital Vall d'Hebron (Barcelona, Spain).

PATIENTS AND METHODS:

We retrospectively studied 150 patients, 87 (58%) men, mean age 48 (r: 20-67) years between August 1990 and January 2010. One hundred and four (69%) were single lung transplants (SLT) and 46 (31%) bilateral-lung transplants (BLT). The postoperative diagnoses were: 94 (63%) usual interstitial pneumonia, 23 (15%) nonspecific interstitial pneumonia, 11 (7%) unclassifiable interstitial pneumonia and 15% miscellaneous. We describe the functional results, complications and survival.

RESULTS:

The actuarial survival was 87, 70 and 53% at one, 3 and 5 years respectively. The most frequent causes of death included early graft dysfunction and development of chronic rejection in the form of bronchiolitis obliterans (BOS). The mean postoperative increase in forced vital capacity and forced expiratory volume in the first second (FEV1) was similar in SLT and BLT. The best FEV1 was reached after 10 (r: 1-36) months. Sixteen percent of patients returned to work. At some point during the evolution, proven acute rejection was diagnosed histologically in 53 (35%) patients. The prevalence of BOS among survivors was 20% per year, 45% at 3 years and 63% at 5 years.

CONCLUSIONS:

LT is the best treatment option currently available for ILD, in which medical treatment has failed.

KEYWORDS:

Enfermedad pulmonar intersticial; Fibrosis Pulmonar; Interstitial lung disease; Lung transplantation; Pulmonary fibrosis; Trasplante pulmonar

PMID:
24029451
DOI:
10.1016/j.medcli.2013.06.026
[Indexed for MEDLINE]

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