Lung transplantation after allogeneic stem cell transplantation : a pan-European experience

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Greer , M , Berastegui , C , Jaksch , P , Benden , C , Aubert , J , Roux , A , Lhuillier , E , Hirschi , S , Reynaud-Gaubert , M , Philit , F , Claustre , J , LePalud , P , Stern , M , Knoop , C , Vos , R , Verschuuren , E , Fisher , A , Riise , G , Hansson , L , Iversen , M , Hämmäinen , P , Wedel , H , Smits , J , Gottlieb , J & Holm , A M 2018 , ' Lung transplantation after allogeneic stem cell transplantation : a pan-European experience ' , European Respiratory Journal , vol. 51 , no. 2 , 1701330 . https://doi.org/10.1183/13993003.01330-2017

Title: Lung transplantation after allogeneic stem cell transplantation : a pan-European experience
Author: Greer, Mark; Berastegui, Cristina; Jaksch, Peter; Benden, Christian; Aubert, John; Roux, Antoine; Lhuillier, Elodie; Hirschi, Sandrine; Reynaud-Gaubert, Martine; Philit, Francois; Claustre, Johanna; LePalud, Pierre; Stern, Marc; Knoop, Christiane; Vos, Robin; Verschuuren, Erik; Fisher, Andrew; Riise, Gerdt; Hansson, Lennart; Iversen, Martin; Hämmäinen, Pekka; Wedel, Hans; Smits, Jacqueline; Gottlieb, Jens; Holm, Are M.
Other contributor: University of Helsinki, Department of Surgery



Date: 2018-02-01
Language: eng
Number of pages: 10
Belongs to series: European Respiratory Journal
ISSN: 0903-1936
DOI: https://doi.org/10.1183/13993003.01330-2017
URI: http://hdl.handle.net/10138/234637
Abstract: Late-onset noninfectious pulmonary complications (LONIPCs) affect 6% of allogeneic stem cell transplantation (SCT) recipients within 5 years, conferring subsequent 5-year survival of 50%. Lung transplantation is rarely performed in this setting due to concomitant extrapulmonary morbidity, excessive immunosuppression and concerns about recurring malignancy being considered contraindications. This study assesses survival in highly selected patients undergoing lung transplantation for LONIPCs after SCT. SCT patients undergoing lung transplantation at 20 European centres between 1996 and 2014 were included. Clinical data pre- and post-lung transplantation were reviewed. Propensity score-matched controls were generated from the Eurotransplant and Scandiatransplant registries. Kaplan-Meier survival analysis and Cox proportional hazard regression models evaluating predictors of graft loss were performed. Graft survival at 1, 3 and 5 years of 84%, 72% and 67%, respectively, among the 105 SCT patients proved comparable to controls (p=0.75). Sepsis accounted for 15 out of 37 deaths (41%), with prior mechanical ventilation (HR 6.9, 95% CI 1.0-46.7; p Lung transplantation outcomes following SCT were comparable to other end-stage diseases. Lung transplantation should be considered feasible in selected candidates. No SCT-specific factors influencing outcome were identified within this carefully selected patient cohort.
Subject: VERSUS-HOST-DISEASE
BRONCHIOLITIS-OBLITERANS-SYNDROME
ACUTE LYMPHOBLASTIC-LEUKEMIA
ALLOGRAFT DYSFUNCTION
INTERNATIONAL SOCIETY
ALLO-SCT
MORTALITY
CHILDREN
CRITERIA
UPDATE
3121 Internal medicine
3126 Surgery, anesthesiology, intensive care, radiology
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