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 .

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.
Contributor organization: Department of Surgery
III kirurgian klinikka
HUS Heart and Lung Center
Date: 2018-02-01
Language: eng
Number of pages: 10
Belongs to series: European Respiratory Journal
ISSN: 0903-1936
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.
3121 General medicine, internal medicine and other clinical medicine
3126 Surgery, anesthesiology, intensive care, radiology
Peer reviewed: Yes
Usage restriction: openAccess
Self-archived version: publishedVersion

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