Induction Therapy for Lung Transplantation in COPD: Analysis of the UNOS Registry

Autor:	Don Hayes, Bryan A. Whitson, Robert S.D. Higgins, Joseph S. Duffy, Amy Pope-Harman, Dmitry Tumin
Rok vydání:	2016
Předmět:	Pulmonary and Respiratory Medicine Graft Rejection Male medicine.medical_specialty Basiliximab medicine.medical_treatment Recombinant Fusion Proteins 030204 cardiovascular system & hematology 030230 surgery Infections 03 medical and health sciences Pulmonary Disease Chronic Obstructive 0302 clinical medicine Postoperative Complications Internal medicine medicine Lung transplantation Humans Registries Alemtuzumab Aged Antilymphocyte Serum Retrospective Studies COPD Thymoglobulin business.industry Hazard ratio Induction chemotherapy Antibodies Monoclonal Induction Chemotherapy Middle Aged medicine.disease United States Transplantation Survival Rate Immunology Female business Immunosuppressive Agents medicine.drug Lung Transplantation
Zdroj:	COPD. 13(5)
ISSN:	1541-2563
Popis:	Although studies demonstrate that induction therapy improves outcomes after lung transplantation, its influence on survival in patients with chronic obstructive pulmonary disease (COPD) is not clear. The United Network for Organ Sharing database was queried to obtain data regarding adult patients with COPD receiving lung transplant between May 2005 and June 2014. Therapies evaluated include anti-thymocyte globulin, anti-lymphocyte globulin, thymoglobulin, basiliximab, and alemtuzumab. Data were categorized based on receiving induction (INDUCED) and no induction (NONE). Kaplan-Meier plots, Cox proportional hazards models of patient survival, and competing-risks regression models for secondary endpoints were utilized. A total of 3,405 patients who underwent lung transplantation for COPD were enrolled with 1,761 (52%) receiving induction therapy. Of INDUCED, 1,146 (65%) received basiliximab, 380 (22%) received alemtuzumab, and 235 (13%) received a polyclonal preparation. The hazard ratio for INDUCED vs. NONE was 0.793 (95% CI = 0.693, 0.909; p = 0.001) in the fully adjusted Cox model. A multivariable competing-risks model also found a protective influence of induction therapy with respect to delayed onset of bronchiolitis obliterans syndrome after transplantation (SHR = 0.801; 95% CI = 0.694, 0.925; p = 0.003). In a cohort of recently transplanted patients with COPD, there appears to be a benefit from contemporary induction agents with no concurrent increase in the risk of death due to infection.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::65c6f1442960ab8cd9ef1e55ac687e4f https://pubmed.ncbi.nlm.nih.gov/26829054 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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