Pirfenidone exerts beneficial effects in patients with IPF undergoing single lung transplantation. Issue 8 (29th April 2019)

• Record Type: Journal Article
• Authors: Veit, Tobias; Leuschner, Gabriela; Sisic, Alma; Ceelen, Felix; Munker, Dieter; Schmitzer, Magdalena; Weig, Thomas; Michel, Sebastian; Schneider, Christian; Meiser, Bruno; Crispin, Alexander; Neurohr, Claus; Behr, Jürgen; Milger, Katrin; Kneidinger, Nikolaus
• Is Part Of: American journal of transplantation. Volume 19:Issue 8(2019)
• Page Start: 2358
• Page End: 2365
• Publication Date: 2019-04-29
• Subjects: clinical research/practice -- critical care/intensive care management -- lung (allograft) function/dysfunction -- lung (native) function/dysfunction -- lung disease -- lung transplantation/pulmonology -- organ transplantation in general; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ajt.15378
• Languages: English
• ISSNs: 1600-6135

Abstract

Abstract : Pirfenidone demonstrated pleiotropic antiinflammatory effects in various experimental and clinical settings. The aim of this study was to assess the impact of previous treatment with pirfenidone on short‐term outcomes after single lung transplantation (SLTx). Therefore, patients with idiopathic pulmonary fibrosis (IPF) who were undergoing SLTx were screened retrospectively for previous use of pirfenidone and compared to respective controls. Baseline parameters and short‐term outcomes were recorded and analyzed. In total, 17 patients with pirfenidone were compared with 26 patients without antifibrotic treatment. Baseline characteristics and severity of disease did not differ between groups. Use of pirfenidone did not increase blood loss, wound‐healing, or anastomotic complications. Severity of primary graft dysfunction at 72 hours was less (0.3 ± 0.6 vs 1.4 ± 1.3, P = .002), and length of mechanical ventilation (37.5 ± 34.8 vs 118.5 ± 151.0 hours, P = .016) and intensive care unit (ICU) stay (6.6 ± 7.1 vs 15.6 ± 20.3, P = .089) were shorter in patients with pirfenidone treatment. An independent beneficial effect of pirfenidone was confirmed by regression analysis while controlling for confounding variables ( P = .016). Finally, incidence of acute cellular rejections within the first 30 days after SLTx was lower in patients with previous pirfenidone treatment (0.0% vs 19.2%; P = .040). Our data suggest a beneficial role of previous use of pirfenidone in patients with IPF who were undergoing SLTx. Abstract : Pretreatment with pirfenidone in patients with idiopathic pulmonary fibrosis undergoing single lung transplantation is associated with shorter length of mechanical ventilation and beneficial effects on alloimmunity.