Abstract：
Antifibrotic drugs are the standard treatments for patients with idiopathic pulmonary fibrosis (IPF). This study aims to assess the safety of antifibrotic treatment in IPF patients undergoing lung transplantation.
Patients with a diagnosis of IPF who received a lung transplant between January 2015 and June 2019 at four Spanish hospitals specialized in lung transplantation were retrospectively recruited. Cases were defined as patients receiving antifibrotic treatments at time of transplant. Each case was matched with a control who did not receive antifibrotic treatment.
A total of 164 patients were included in the study cohort (103 cases and 61 controls). There were no statistically significant differences between the cases and controls in any of the items studied related to transplantation except the time until the appearance of chest wall dehiscence: although there were no differences in the incidence of wall dehiscence in either group (12.3% vs. 13.7%; p = 0.318), the patients on antifibrotic drugs experienced it earlier (21 days [IQR = 12.5-41.5] vs. 63 days [IQR = 46.75-152.25]; p = 0.012). There were no differences in overall post-transplant survival between the two groups (p = 0.698) or in conditional survival at 30 days, 90 days, 3 years or 5 years. However, 1 year survival was significantly greater among controls (80.6% vs. 93.3%; p = 0.028).
There was evidence that chest wall dehiscences appeared earlier post-transplant in patients using antifibrotics, even though this factor did not significantly impact survival.
Patients with a diagnosis of IPF who received a lung transplant between January 2015 and June 2019 at four Spanish hospitals specialized in lung transplantation were retrospectively recruited. Cases were defined as patients receiving antifibrotic treatments at time of transplant. Each case was matched with a control who did not receive antifibrotic treatment.
A total of 164 patients were included in the study cohort (103 cases and 61 controls). There were no statistically significant differences between the cases and controls in any of the items studied related to transplantation except the time until the appearance of chest wall dehiscence: although there were no differences in the incidence of wall dehiscence in either group (12.3% vs. 13.7%; p = 0.318), the patients on antifibrotic drugs experienced it earlier (21 days [IQR = 12.5-41.5] vs. 63 days [IQR = 46.75-152.25]; p = 0.012). There were no differences in overall post-transplant survival between the two groups (p = 0.698) or in conditional survival at 30 days, 90 days, 3 years or 5 years. However, 1 year survival was significantly greater among controls (80.6% vs. 93.3%; p = 0.028).
There was evidence that chest wall dehiscences appeared earlier post-transplant in patients using antifibrotics, even though this factor did not significantly impact survival.
摘要：
抗纤维化药物是特发性肺纤维化（IPF）患者的标准治疗方法。本研究旨在评估接受肺移植的IPF患者抗纤维化治疗的安全性。
回顾性招募了在2015年1月至2019年6月期间在四家西班牙专门从事肺移植的医院接受肺移植的IPF诊断患者。病例定义为在移植时接受抗纤维化治疗的患者。每个病例与未接受抗纤维化治疗的对照相匹配。
共有164例患者被纳入研究队列（103例和61例对照）。除胸壁开裂出现前的时间外，与移植相关的任何研究项目在病例和对照组之间均无统计学差异：尽管两组的壁开裂发生率均无差异（12.3％vs.13.7%；p=0.318），服用抗纤维化药物的患者较早（21天[IQR=12.5-41.5]与63天[IQR=46.75-152.25];p=0.012)。两组的移植后总生存率（p=0.698）或30天的条件生存率没有差异，90天,3年或5年。然而,对照组的1年生存率明显更高（80.6%vs.93.3%；p=0.028)。
有证据表明，使用抗纤维化药物的患者在移植后较早出现胸壁开裂，尽管这一因素对生存率没有显著影响.
回顾性招募了在2015年1月至2019年6月期间在四家西班牙专门从事肺移植的医院接受肺移植的IPF诊断患者。病例定义为在移植时接受抗纤维化治疗的患者。每个病例与未接受抗纤维化治疗的对照相匹配。
共有164例患者被纳入研究队列（103例和61例对照）。除胸壁开裂出现前的时间外，与移植相关的任何研究项目在病例和对照组之间均无统计学差异：尽管两组的壁开裂发生率均无差异（12.3％vs.13.7%；p=0.318），服用抗纤维化药物的患者较早（21天[IQR=12.5-41.5]与63天[IQR=46.75-152.25];p=0.012)。两组的移植后总生存率（p=0.698）或30天的条件生存率没有差异，90天,3年或5年。然而,对照组的1年生存率明显更高（80.6%vs.93.3%；p=0.028)。
有证据表明，使用抗纤维化药物的患者在移植后较早出现胸壁开裂，尽管这一因素对生存率没有显著影响.
