TY - JOUR
T1 - Lung transplantation for interstitial lung disease in idiopathic inflammatory myositis
T2 - A cohort study
AU - Rivière, Amélie
AU - Picard, Clément
AU - Berastegui, Cristina
AU - Mora, Victor Manuel
AU - Bunel, Vincent
AU - Godinas, Laurent
AU - Salvaterra, Elena
AU - Rossetti, Valeria
AU - Savale, Laurent
AU - Israel-Biet, Dominique
AU - Demant, Xavier
AU - Bermudez, Julien
AU - Meloni, Federica
AU - Jaksch, Peter
AU - Magnusson, Jesper
AU - Beaumont, Laurence
AU - Perch, Michael
AU - Mornex, Jean-François
AU - Knoop, Christiane
AU - Aubert, John-David
AU - Hervier, Baptiste
AU - Nunes, Hilario
AU - Humbert, Marc
AU - Gottlieb, Jens
AU - Uzunhan, Yurdagul
AU - Le Pavec, Jérôme
N1 - © 2022 The Authors. American Journal of Transplantation published by Wiley Periodicals LLC on behalf of The American Society of Transplantation and the American Society of Transplant Surgeons.
PY - 2022/12
Y1 - 2022/12
N2 - In patients with interstitial lung disease (ILD) complicating classical or amyopathic idiopathic inflammatory myopathy (IIM), lung transplantation outcomes might be affected by the disease and treatments. Here, our objective was to assess survival and prognostic factors in lung transplant recipients with IIM-ILD. We retrospectively reviewed data for 64 patients who underwent lung transplantation between 2009 and 2021 at 19 European centers. Patient survival was the primary outcome. At transplantation, the median age was 53 [46-59] years, 35 (55%) patients were male, 31 (48%) had classical IIM, 25 (39%) had rapidly progressive ILD, and 21 (33%) were in a high-priority transplant allocation program. Survival rates after 1, 3, and 5 years were 78%, 73%, and 70%, respectively. During follow-up (median, 33 [7-63] months), 23% of patients developed chronic lung allograft dysfunction. Compared to amyopathic IIM, classical IIM was characterized by longer disease duration, higher-intensity immunosuppression before transplantation, and significantly worse posttransplantation survival. Five (8%) patients had a clinical IIM relapse, with mild manifestations. No patient experienced ILD recurrence in the allograft. Posttransplantation survival in IIM-ILD was similar to that in international all-cause-transplantation registries. The main factor associated with worse survival was a history of muscle involvement (classical IIM). In lung transplant recipients with idiopathic inflammatory myopathy, survival was similar to that in all-cause transplantation and was worse in patients with muscle involvement compared to those with the amyopathic disease.
AB - In patients with interstitial lung disease (ILD) complicating classical or amyopathic idiopathic inflammatory myopathy (IIM), lung transplantation outcomes might be affected by the disease and treatments. Here, our objective was to assess survival and prognostic factors in lung transplant recipients with IIM-ILD. We retrospectively reviewed data for 64 patients who underwent lung transplantation between 2009 and 2021 at 19 European centers. Patient survival was the primary outcome. At transplantation, the median age was 53 [46-59] years, 35 (55%) patients were male, 31 (48%) had classical IIM, 25 (39%) had rapidly progressive ILD, and 21 (33%) were in a high-priority transplant allocation program. Survival rates after 1, 3, and 5 years were 78%, 73%, and 70%, respectively. During follow-up (median, 33 [7-63] months), 23% of patients developed chronic lung allograft dysfunction. Compared to amyopathic IIM, classical IIM was characterized by longer disease duration, higher-intensity immunosuppression before transplantation, and significantly worse posttransplantation survival. Five (8%) patients had a clinical IIM relapse, with mild manifestations. No patient experienced ILD recurrence in the allograft. Posttransplantation survival in IIM-ILD was similar to that in international all-cause-transplantation registries. The main factor associated with worse survival was a history of muscle involvement (classical IIM). In lung transplant recipients with idiopathic inflammatory myopathy, survival was similar to that in all-cause transplantation and was worse in patients with muscle involvement compared to those with the amyopathic disease.
KW - Cohort Studies
KW - Female
KW - Humans
KW - Lung Diseases, Interstitial/surgery
KW - Lung Transplantation/adverse effects
KW - Male
KW - Middle Aged
KW - Myositis/surgery
KW - Retrospective Studies
KW - connective tissue disease
KW - idiopathic inflammatory myopathy
KW - interstitial lung disease
KW - lung transplantation
UR - http://www.scopus.com/inward/record.url?scp=85137375442&partnerID=8YFLogxK
U2 - 10.1111/ajt.17177
DO - 10.1111/ajt.17177
M3 - Journal article
C2 - 35988032
SN - 1600-6135
VL - 22
SP - 2990
EP - 3001
JO - American Journal of Transplantation
JF - American Journal of Transplantation
IS - 12
ER -