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Am J Transplant. 2019 Apr 3. doi: 10.1111/ajt.15378. [Epub ahead of print]

Pirfenidone exerts beneficial effects in patients with IPF undergoing single lung transplantation.

Author information

1
Department of Internal Medicine V, Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research (DZL), University of Munich, LMU, Munich, Germany.
2
Transplant Center, University of Munich, Munich, Germany.
3
Department of Anaesthesiology, University of Munich, LMU, Munich, Germany.
4
Clinic of Cardiac Surgery, University of Munich, LMU, Munich, Germany.
5
Department of Thoracic Surgery, University of Munich, LMU, Munich, Germany.
6
IBE - Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilian University Munich, Munich, Germany.

Abstract

Pirfenidone demonstrated pleiotropic antiinflammatory effects in various experimental and clinical settings. The aim of this study was to assess the impact of previous treatment with pirfenidone on short-term outcomes after single lung transplantation (SLTx). Therefore, patients with idiopathic pulmonary fibrosis (IPF) who were undergoing SLTx were screened retrospectively for previous use of pirfenidone and compared to respective controls. Baseline parameters and short-term outcomes were recorded and analyzed. In total, 17 patients with pirfenidone were compared with 26 patients without antifibrotic treatment. Baseline characteristics and severity of disease did not differ between groups. Use of pirfenidone did not increase blood loss, wound-healing, or anastomotic complications. Severity of primary graft dysfunction at 72 hours was less (0.3 ± 0.6 vs 1.4 ± 1.3, P = .002), and length of mechanical ventilation (37.5 ± 34.8 vs 118.5 ± 151.0 hours, P = .016) and intensive care unit (ICU) stay (6.6 ± 7.1 vs 15.6 ± 20.3, P = .089) were shorter in patients with pirfenidone treatment. An independent beneficial effect of pirfenidone was confirmed by regression analysis while controlling for confounding variables (P = .016). Finally, incidence of acute cellular rejections within the first 30 days after SLTx was lower in patients with previous pirfenidone treatment (0.0% vs 19.2%; P = .040). Our data suggest a beneficial role of previous use of pirfenidone in patients with IPF who were undergoing SLTx.

KEYWORDS:

clinical research/practice; critical care/intensive care management; lung (allograft) function/dysfunction; lung (native) function/dysfunction; lung disease; lung transplantation/pulmonology; organ transplantation in general

PMID:
30942945
DOI:
10.1111/ajt.15378

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