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

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.