Outcomes of Lung Transplantation in Coal Workers Pneumoconiosis: Analysis of UNOS Database

IF 1.9 4区医学 Q2 SURGERY Clinical Transplantation Pub Date : 2024-12-02 DOI:10.1111/ctr.70042

Sravanthi Nandavaram, Xiaonan Mei, Tahir Khan, Muhammad Asad Faruqi, Zachary Fyffe, Suresh Keshavamurthy, Satish Chandrashekaran

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Abstract

Background

Coal worker's pneumoconiosis (CWP) poses a significant burden on affected individuals and is associated with increased morbidity and mortality. Lung transplantation (LT) is the only effective treatment for this progressive and fatal lung disease. This study aims to evaluate the outcomes of patients who have undergone LT for primary diagnosis of CWP.

Methods

The Scientific Registry of Transplant Recipients (SRTR) data from the United Network of Organ Sharing (UNOS) was queried to identify recipients who underwent lung transplantation (LT) between May 2005 and June 2021 in the lung allocation score (LAS) era across all transplant centers reporting to SRTR. A comparison was conducted between baseline characteristics, perioperative variables, and post-transplant outcomes of patients who underwent LT for CWP and those who received LT for other indications. Kaplan–Meier survival analysis and multivariable Cox regression analysis were performed to assess graft and patient survival post LT.

Results

Between May 2005 and June 2021, 158 patients underwent LT for CWP. Overall graft survival (Log-rank p = 0.889) and patient survival (Log-rank p = 0.910) were not significantly different between the two groups. CWP group was noted to have higher mean pulmonary artery pressures, LAS, need for prolonged intubation and extracorporeal membrane oxygenation (ECMO) at 72 h and the need for dialysis at the time of discharge.

Conclusion

Patients who underwent LT for coal workers' pneumoconiosis (CWP) had comparable post-transplant outcomes to those with other diagnoses. Therefore, LT for CWP can be safely performed. It is crucial to recognize the severity of the illness and be aware of the potential challenges in the perioperative transplant course to effectively manage this population.

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煤工尘肺肺移植的预后：UNOS数据库分析

煤炭工人尘肺病（CWP）对患者造成了重大负担，并与发病率和死亡率增加有关。肺移植（LT）是治疗这种进行性和致命性肺病的唯一有效方法。本研究旨在评估行肝移植的CWP患者的初步诊断结果。方法查询来自联合器官共享网络（UNOS）的移植受者科学登记处（SRTR）数据，以确定2005年5月至2021年6月间在肺分配评分（LAS）时代接受肺移植（LT）的所有移植中心的移植受者。比较了因CWP接受肝移植的患者和因其他适应症接受肝移植的患者的基线特征、围手术期变量和移植后结果。Kaplan-Meier生存分析和多变量Cox回归分析评估移植后移植物和患者的生存。结果2005年5月至2021年6月，158例患者因CWP接受了移植。两组间移植物总生存率（Log-rank p = 0.889）和患者生存率（Log-rank p = 0.910）无显著差异。注意到CWP组有较高的平均肺动脉压，LAS，在72小时需要延长插管和体外膜氧合（ECMO），并且在出院时需要透析。结论煤工尘肺（CWP）患者接受肝移植后的预后与其他诊断的患者相当。因此，可以安全地进行CWP的LT。重要的是要认识到疾病的严重性，并意识到在围手术期移植过程中的潜在挑战，以有效地管理这一人群。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Transplantation 医学-外科

CiteScore

3.70

自引率

4.80%

发文量

286

审稿时长

2 months

期刊介绍： Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.