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Nosotti M, Leiva-Juarez M, D'Ovidio F, Van Raemdonck D, Ceulemans L, Keshavjee S, Rackauskas M, Paladini P, Luzzi L, Casado PM, Alvarez A, Inci I, Ehrsam J, Krueger T, Roth A, Rea F, Schiavon M, Rosso L. Survival After Lung Transplantation for Chronic Hypersensitivity Pneumonitis: Results From a Large International Cohort Study. Transpl Int 2022; 35:10450. [PMID: 35431638 PMCID: PMC9008138 DOI: 10.3389/ti.2022.10450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 03/03/2022] [Indexed: 11/13/2022]
Abstract
Repeated exposure to antigens via inhalation is the primary cause of hypersensitivity pneumonitis, a form of interstitial pneumonia. The chronic form of hypersensitivity pneumonitis leads to progressive loss of respiratory function; lung transplantation is the only therapeutic option for chronically ill patients. The ESTS Lung Transplantation Working Group conducted a retrospective multicentred cohort study to increase the body of knowledge available on this rare indication for lung transplantation. Data were collected for every patient who underwent lung transplant for hypersensitivity pneumonitis in participating centres between December 1996 and October 2019. Primary outcome was overall survival; secondary outcome was freedom from chronic lung allograft dysfunction. A total of 114 patients were enrolled from 9 centres. Almost 90% of patients were diagnosed with hypersensitivity pneumonitis before transplantation, yet the antigen responsible for the infection was identified in only 25% of cases. Eighty per cent of the recipients received induction therapy. Survival at 1, 3, and 5 years was 85%, 75%, and 70%, respectively. 85% of the patients who survived 90 days after transplantation were free from chronic lung allograft dysfunction after 3 years. The given study presents a large cohort of HP patients who underwent lung transplants. Overall survival rate is higher in transplanted hypersensitivity pneumonitis patients than in those suffering from any other interstitial lung diseases. Hypersensitivity pneumonitis patients are good candidates for lung transplantation.
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Affiliation(s)
- Mario Nosotti
- Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Miguel Leiva-Juarez
- Department of Surgery, Columbia University Medical Center, New York, NY, United States
| | - Frank D'Ovidio
- Department of Surgery, Columbia University Medical Center, New York, NY, United States
| | - Dirk Van Raemdonck
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Laurens Ceulemans
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Shaf Keshavjee
- Toronto Lung Transplant Program, University Health Network, Toronto, ON, Canada
| | | | - Piero Paladini
- Thoracic Surgery, University Hospital of Siena (AOUS), Siena, Italy
| | - Luca Luzzi
- Thoracic Surgery, University Hospital of Siena (AOUS), Siena, Italy
| | - Paula Moreno Casado
- Division of Thoracic Surgery and Lung Transplantation, Reina Sofia University Hospital, Córdoba, Spain
| | - Antonio Alvarez
- Division of Thoracic Surgery and Lung Transplantation, Reina Sofia University Hospital, Córdoba, Spain
| | - Ilhan Inci
- Department of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Jonas Ehrsam
- Department of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Thorsten Krueger
- Department of Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - Andrey Roth
- Department of Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - Federico Rea
- Thoracic Surgery Unit, Department of Cardiologic, Thoracic and Vascular Sciences, University Hospital, Padova, Italy
| | - Marco Schiavon
- Thoracic Surgery Unit, Department of Cardiologic, Thoracic and Vascular Sciences, University Hospital, Padova, Italy
| | - Lorenzo Rosso
- Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
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