Skip Navigation LinksHome > September 2012 - Volume 18 - Issue 6 > Survival and Extrapulmonary Course of Connective Tissue Dise...
JCR: Journal of Clinical Rheumatology:
doi: 10.1097/RHU.0b013e3182676089
Original Articles

Survival and Extrapulmonary Course of Connective Tissue Disease After Lung Transplantation

Takagishi, Troy MD*; Ostrowski, Rochella MD*; Alex, Charles MD; Rychlik, Karen MS; Pelletiere, Karen RN; Tehrani, Rodney MD*

Collapse Box

Abstract

Background: Connective tissue disease (CTD)–related lung dysfunction is a common cause of morbidity and mortality; however, few lung transplantations (LTs) are performed in this population secondary to uncertainty regarding the posttransplant survival, outcome, and management.

Objectives: The objectives were to evaluate the survival and the pulmonary and extrapulmonary courses of CTD after LT.

Methods: Survival outcomes of patients documented within the Organ Procurement and Transplantation Network who had undergone a LT for CTD were compared with those who underwent LT for chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary fibrosis (IPF). In addition, the pulmonary and extrapulmonary courses of the CTD were evaluated after LT.

Results: From 1991 to 2009, there were 284 documented LT in patients with CTD. Post-LT cumulative survival of patients with CTD was less than that for COPD through 5 years, with a difference that peaked at 1 year (72.7% vs. 83.1%, P < 0.001). When patients with CTD were compared with those with IPF, a difference was only noted at 1 year (72.7% vs. 77.7%, P = 0.049). There were no documented post-LT pulmonary recurrences of the CTD, and extrapulmonary flares of the CTD were rare (1 possible flare per 20.3 patient-years and 1 probable flare per 81.0 patient-years).

Conclusions: Cumulative survival of patients with CTD who underwent LT is similar to those with IPF and slightly less than those with COPD, with an increased risk of mortality that was most prominent at 6 months after transplant followed by subsequent narrowing of the survival differences over time. Lung transplantation may be a viable therapeutic option for patients with end-stage lung dysfunction resulting from a CTD.

© 2012 Lippincott Williams & Wilkins, Inc.

Follow Us!

Login

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.