December 12, 2024
2 minute read
WASHINGTON — Systemic autoimmune rheumatoid arthritis patients who develop interstitial lung disease have a similar 1-year risk of death after a single or double lung transplant, data show.
The findings, presented at ACR Convergence 2024, show that single-lung transplantation can effectively increase the number of lungs available for transplantation for patients with end-stage lung disease due to ILD and systemic autoimmune rheumatic diseases (SARDs). This suggests that it is a reasonable strategy. said the lead author.
“Similar 1-year mortality rates have been demonstrated for other forms of ILD, including idiopathic pulmonary fibrosis (IPF).” Dr. Harry Hurley, Albert Einstein College of Medicine professor told attendees: “However, there was another study showing that overall survival was longer for IPF patients who received a double lung transplant (DLT) than a single lung transplant (SLT). So, naturally, our question… Is there any benefit to DLT for patients with SARD ILD?”
To compare the outcomes of single and double lung transplants in patients with SARD-ILD, Hurley et al. conducted a retrospective cohort study using data from the Organ Sharing Network. This study consisted of procedures performed from May 4, 2005 to December 31, 2019.
The analysis included 606 adults (mean age 54 years, 59% women) with SARD-ILD, 37% of whom had systemic sclerosis. We compared 1-year mortality between the two procedures using a stratified Cox model adjusted for donor, recipient, and procedure characteristics. Some missing covariate data were filled by multiple imputation.
Overall, 76% of the cohort underwent double lung transplantation. According to the researchers, the unadjusted 1-year mortality rate was 17.24 deaths per 100 person-years for single-lung transplants and 14.97 deaths for double-lung transplants.
Additionally, single lung transplantation was significantly less likely than double lung transplantation in either the unadjusted model (HR = 1.19; 95% CI, 0.75-1.19) or the fully adjusted model (HR = 1.49; 95% CI, 0.75-1.19). It was not associated with a significant increase in 1-year mortality. 95% CI, 0.34-6.57).
The risk of death in the two groups over a one-year period was “comparable,” Hurley said.
“This study is the first of its kind to evaluate the impact of single and double lung transplant patients on SARD-ILD,” he added. “We were able to control for a number of possible confounders and therefore believe that this accurately reflects modern transplant outcomes in SARD-ILD. There is a need to prospectively study adult SARD-ILD patients during the transplant evaluation process to identify risk factors and improve outcomes.”
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Harley H. Abstract #1694. Presentation location: ACR Convergence 2024; November 14-19, 2024. Washington DC
Disclosure:
Elana Bernstein Reports professional relationships with AstraZeneca, aTyr, Boehringer Ingelheim, Bristol-Myers Squibb, Cabaletta, and Kadmon.
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