Original articleGeneral thoracicLung Transplantation for Idiopathic Pulmonary Fibrosis
Section snippets
Patients
From February 1990 to November 2005, 469 patients underwent primary lung transplantation for end-stage lung disease at Cleveland Clinic, exclusive of heart–lung transplantation. Eighty-two patients (17%) fulfilled the criteria for IPF as outlined by the American Thoracic Society [9]. Thirty-two (39%) of the 82 IPF patients underwent double lung transplantation.
Recipient, donor, and surgical data were extracted from the Unified Transplant Database, which has been approved for use in research by
Idiopathic Pulmonary Fibrosis Versus Non–Idiopathic Pulmonary Fibrosis Survival Comparison
Risk-unadjusted survival after transplantation for IPF was 95%, 73%, 56%, 44%, and 36% at 30 days and 1, 3, 5, and 7 years, which was similar to 95%, 81%, 61%, 48%, and 38% at these same intervals after transplantation for non-IPF indications (p[early hazard phase] = 0.6, p[late hazard phase] = 0.5; Fig 1A). Instantaneous risk of death after lung transplantation for both IPF and non-IPF consisted of two hazard phases that differed early, but fell to equivalent levels after about 6 months, with
Comment
Lung transplantation for IPF has been shown to confer a survival benefit over best medical therapy, but survival appears to be worse than that for non-IPF indications without clear explanation [2, 15]. In addition, whether or not survival is worse with single versus double lung transplantation remains unclear. Although multi-institutional studies focusing on these questions have benefited from large numbers for statistical analysis, they have included centers with varied experience with
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