Lung transplantation for sarcoidosis: outcome and prognostic factors.

Autor:	Le Pavec J; Service de Chirurgie Thoracique, Vasculaire et Transplantation Cardio-pulmonaire, Hôpital Marie-Lannelongue, Le Plessis-Robinson, France.; Université Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin Bicêtre, France.; UMR_S 999, Université Paris-Sud, INSERM, Hôpital Marie Lannelongue, Le Plessis Robinson, France., Valeyre D; INSERM UMR 1272, Université Sorbonne Paris Nord, AP-HP, Hôpital Avicenne Service de Pneumologie, Bobigny, France.; Groupe Hospitalier Paris Saint Joseph, Paris, France.; These authors contributed equally to this work., Gazengel P; Service de Chirurgie Thoracique, Vasculaire et Transplantation Cardio-pulmonaire, Hôpital Marie-Lannelongue, Le Plessis-Robinson, France.; Université Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin Bicêtre, France.; UMR_S 999, Université Paris-Sud, INSERM, Hôpital Marie Lannelongue, Le Plessis Robinson, France.; These authors contributed equally to this work., Holm AM; Dept of Respiratory Medicine, Oslo University Hospital and Institute for Clinical Medicine University of Oslo, Oslo, Norway.; These authors contributed equally to this work., Schultz HH; Dept of Cardiology, Section for Lung Transplantation, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.; These authors contributed equally to this work., Perch M; Dept of Cardiology, Section for Lung Transplantation, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Le Borgne A; Pôle des voies respiratoires-Hôpital Larrey, Centre Hopitalo-Universitaire, Toulouse, France., Reynaud-Gaubert M; Service de Pneumologie et Equipe de Transplantation Pulmonaire, Centre Hospitalo-Universitaire Nord, Assistance Publique-Hôpitaux de Marseille, Aix-Marseille Université, Marseille, France., Knoop C; Brussels Lung Transplant Program, Dept of Chest Medicine, Erasme University, Brussels, Belgium., Godinas L; Dept of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium., Hirschi S; Service de Pneumologie, Groupe de Transplantation Pulmonaire, Hopitaux Universitaires de Strasbourg, Strasbourg, France., Bunel V; AP-HP, Service de Pneumologie, Hôpital Bichat, Paris, France., Laporta R; Pneumology Dept, Hospital Universitario Puerta de Hierro, Madrid, Spain., Harari S; Dept of Medical Sciences San Giuseppe Hospital MultiMedica IRCCS and Dept of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy., Blanchard E; Dept of Respiratory Medicine, Haut-Lévèque Hospital, Bordeaux University, Pessac, France., Magnusson JM; Dept of Internal Medicine/Respiratory Medicine and Allergology, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden., Tissot A; Service de Pneumologie, L'institut du thorax, Centre hospitalo-universitaire de Nantes, Nantes, France., Mornex JF; Université de Lyon, INRA, IVPC, Lyon, France.; Hospices Civils de Lyon, Lyon, France., Picard C; Service de Pneumologie, Hôpital Foch, Suresnes, France., Savale L; Université Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin Bicêtre, France.; UMR_S 999, Université Paris-Sud, INSERM, Hôpital Marie Lannelongue, Le Plessis Robinson, France.; AP-HP, Service de Pneumologie, Hôpital Kremlin Bicêtre, Kremlin Bicêtre, France., Bernaudin JF; INSERM UMR 1272, Université Sorbonne Paris Nord, Bobigny and Sorbonne Université Paris, Paris, France., Brillet PY; INSERM U1272, Université Paris Sorbonne Nord, AP-HP, Service de Radiologie, Hôpital Avicenne, Bobigny, France., Nunes H; INSERM UMR 1272, Université Sorbonne Paris Nord, AP-HP, Hôpital Avicenne Service de Pneumologie, Bobigny, France., Humbert M; Université Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin Bicêtre, France.; UMR_S 999, Université Paris-Sud, INSERM, Hôpital Marie Lannelongue, Le Plessis Robinson, France.; AP-HP, Service de Pneumologie, Hôpital Kremlin Bicêtre, Kremlin Bicêtre, France., Fadel E; Service de Chirurgie Thoracique, Vasculaire et Transplantation Cardio-pulmonaire, Hôpital Marie-Lannelongue, Le Plessis-Robinson, France.; Université Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin Bicêtre, France.; UMR_S 999, Université Paris-Sud, INSERM, Hôpital Marie Lannelongue, Le Plessis Robinson, France., Gottlieb J; Dept of Respiratory Medicine, Hannover Medical School, Hanover, Germany.
Jazyk:	angličtina
Zdroj:	The European respiratory journal [Eur Respir J] 2021 Aug 05; Vol. 58 (2). Date of Electronic Publication: 2021 Aug 05 (Print Publication: 2021).
DOI:	10.1183/13993003.03358-2020
Abstrakt:	Study Question: In patients with sarcoidosis, past and ongoing immunosuppressive regimens, recurrent disease in the transplant and extrapulmonary involvement may affect outcomes of lung transplantation. We asked whether sarcoidosis lung phenotypes can be differentiated and, if so, how they relate to outcomes in patients with pulmonary sarcoidosis treated by lung transplantation. Patients and Methods: We retrospectively reviewed data from 112 patients who met international diagnostic criteria for sarcoidosis and underwent lung or heart-lung transplantation between 2006 and 2019 at 16 European centres. Results: Patient survival was the main outcome measure. At transplantation, median (interaquartile range (IQR)) age was 52 (46-59) years; 71 (64%) were male. Lung phenotypes were individualised as follows: 1) extended fibrosis only; 2) airflow obstruction; 3) severe pulmonary hypertension (sPH) and airflow obstruction; 4) sPH, airflow obstruction and fibrosis; 5) sPH and fibrosis; 6) airflow obstruction and fibrosis; 7) sPH; and 8) none of these criteria, in 17%, 16%, 17%, 14%, 11%, 9%, 5% and 11% of patients, respectively. Post-transplant survival rates after 1, 3, and 5 years were 86%, 76% and 69%, respectively. During follow-up (median (IQR) 46 (16-89) months), 31% of patients developed chronic lung allograft dysfunction. Age and extended lung fibrosis were associated with increased mortality. Pulmonary fibrosis predominating peripherally was associated with short-term complications. Answer to the Study Question: Post-transplant survival in patients with pulmonary sarcoidosis was similar to that in patients with other indications for lung transplantation. The main factors associated with worse survival were older age and extensive pre-operative lung fibrosis. Competing Interests: Conflict of interest: J. Le Pavec has nothing to disclose. Conflict of interest: D. Valeyre has nothing to disclose. Conflict of interest: P. Gazengel has nothing to disclose. Conflict of interest: A.M. Holm has nothing to disclose. Conflict of interest: H.H. Schultz has nothing to disclose. Conflict of interest: M. Perch has nothing to disclose. Conflict of interest: A. Le Borgne has nothing to disclose. Conflict of interest: M. Reynaud-Gaubert has nothing to disclose. Conflict of interest: C. Knoop has nothing to disclose. Conflict of interest: L. Godinas has nothing to disclose. Conflict of interest: S. Hirschi has nothing to disclose. Conflict of interest: V. Bunel has nothing to disclose. Conflict of interest: R. Laporta has nothing to disclose. Conflict of interest: S. Harari has nothing to disclose. Conflict of interest: E. Blanchard has nothing to disclose. Conflict of interest: J.M. Magnusson has nothing to disclose. Conflict of interest: A. Tissot has nothing to disclose. Conflict of interest: J-F. Mornex has nothing to disclose. Conflict of interest: C. Picard has nothing to disclose. Conflict of interest: L. Savale has nothing to disclose. Conflict of interest: J-F. Bernaudin has nothing to disclose. Conflict of interest: P-Y. Brillet has nothing to disclose. Conflict of interest: H. Nunes has nothing to disclose. Conflict of interest: M. Humbert has nothing to disclose. Conflict of interest: E. Fadel has nothing to disclose. Conflict of interest: J. Gottlieb has nothing to disclose. (Copyright ©The authors 2021. For reproduction rights and permissions contact permissions@ersnet.org.)
Databáze:	MEDLINE
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