Randomized trial demonstrates poorer outcomes in lung transplant recipients with prior immunosuppressive exposure, suggesting careful pre-transplant management.
Key Points
This research investigates how prior exposure to immunosuppressive agents affects outcomes in lung transplant recipients with interstitial lung disease.
Retrospective analysis of adults who underwent lung transplantation for interstitial lung disease between April 2011 and June 2024.
Comparison of outcomes between patients receiving immunosuppressive agents within one year before transplantation and those who did not.
Systemic steroids exposure was adjusted during the analysis.
Patients exposed to immunosuppressive agents had a 12-month retransplantation-free survival of 62% compared to 80% for those not exposed (HR 1.99, 95% CI [1.11–3.56], p = 0.022).
Immunosuppressive agent exposure increased the odds of grade 3 primary graft dysfunction (OR 3.20, 95% CI [1.42–7.45], p = 0.005).
Incidence of pneumonia episodes in the first 6 months was higher for exposed patients (median 2 vs. 1, p = 0.001).