Korean J Transplant.  2022 Nov;36(Supple 1):S245. 10.4285/ATW2022.F-3852.

Bridging to lung transplantation in idiopathic pulmonary fibrosis

• Kim G
• Oh DK
• Shim TS
• Kim DK
• Choi S
• Lee GD
• Kim W
• Park SI
• Hong SB

• KMID: 2535462
• DOI: http://doi.org/10.4285/ATW2022.F-3852

Abstract

Background
Among interstitial lung diseases (ILD), idiopathic pulmonary fibrosis (IPF) and connective tissue diseases (CTD) have different characteristics and prognosis; IPF is associated with older age and poor prognosis. Donor scarcity limits timely lung transplantation for progressive end-stage interstitial lung disease (ILD) and bridging to transplantation (BTT) with extra-corporeal life support (ECLS) helps maintain the best possible physical conditions. To date, few studies have investigated lung transplantation in IPF, especially with BTT. This study examines the outcome of lung transplantation especially with BTT in pa-tients with IPF compared those with non-IPF ILD.
Methods
Lung transplantation cases of ILD patients at Asan Medical Center, Seoul, Korea from 2008 and 2021 were collected and retrospectively analyzed (n=112). Cases were divided into IPF and CTD groups based on the diagnosis. Student's t-test and Fischer's exact test were performed for intergroup differences.
Results
From 2008 to 2021, 112 ILD cases were subject to lung transplantation, among whom 53 (47.3%) were IPF and 59 (52.7%) were CTD. The median age was 61 (interquartile range [IQR]; 56–65) in IPF group, which was older than 57 (IQR; 4–63) in CTD group (P<0.01). Preoperatively, 31 (58.5%) IPF and 40 (67.8%) CTD cases were bridged on ECLS. Statistical significance between IPF and CTD was absent for mortality at 28 days, 90 days, and 6 months, regardless of BTT status. No significant differences were found in BTT duration, ICU stay, hospital stay, or duration of postoperative mechanical ventilation.
Conclusions
The patients with IPF are older than those with CTD, but lung transplantation and BTT outcomes do not significantly differ between the disease groups. This single-center observational study shows lung transplantation with BTT may be a treatment option for IPF.