TOPLINE:
Complications in the native lung after single-lung transplants (SLTs) in patients with interstitial lung disease (ILD) included pneumothorax, pulmonary aspergillosis, and acute exacerbation.
METHODOLOGY:
- Single-lung transplantation is often preferred in areas of donor shortage, but data on complications and temporal changes are limited.
- The researchers reviewed data from 34 adults with ILD who underwent single-SLTs at a single center; another 54 adults who underwent SLTs for other conditions served as controls.
- The median ages of the patients in the ILD and non-ILD groups were similar (53 years and 47 years, respectively), but the ILD group included significantly more men (67.7% vs 22.2%) and patients with significantly higher body mass index (median 22.2 vs 17.7).
- Patients were assessed at three specific time points: before transplantation, 6 months post-transplantation, and 2 years post-transplantation.
TAKEAWAY:
- Overall, native lung volume decreased over time, with medians of 1.134 L, 0.747 L, and 0.653 L at baseline, 6 months post-transplant, and 2 years post-transplant, respectively.
- In the ILD group, perfusion showed a downward trend over time; radiographic changes were present but minimal.
- The top complications in the retained native lung in patients with ILD included pneumothorax (29.4%), pulmonary aspergillosis (11.8%), and acute exacerbation (8.9%).
- Three-month mortality rates and long-term prognoses were similar for patients with and without ILD.
IN PRACTICE:
"Our analysis, alongside previous reports, suggests that ILD continues to slowly progress and erode its structural and functional integrity even after SLTx, supporting the notion that native-lung fibrosis continues to deteriorate despite high dosages of an immunosuppressive drug post-SLTx," the researchers wrote.
SOURCE:
The joint lead authors on the study were Toshikazu Watanabe, MD, and Takashi Hirama, MD, of Tohoku University, Sendai, Miyagi, Japan. The study was published online on April 24, 2024, in BMC Pulmonary Medicine.
LIMITATIONS:
The small sample size and use of data from a single center as well as the limited number of native lung events and variation in management of complications were among the factors limiting the study findings.
DISCLOSURES:
The study was supported by Grant-in-Aid for Scientific Research C from the Japan Society for the Promotion of Science, the Takeda Science Foundation (Visionary Research 2021), and Tokyo-Hokenkai Byotai-Seiri Laboratory. The researchers had no financial conflicts to disclose.