Evaluation of Pre-Transplant Antifibrotic Agents on Post-Transplant Outcomes

PurposeAntifibrotic therapy, i.e. pirfenidone or nintedanib, is commonly used for idiopathic pulmonary fibrosis (IPF) patients awaiting lung transplantation. However, they are inferred to cause increased wound healing complications post-transplant. This study compares post-transplant outcomes in IPF on the basis of pre-transplant antifibrotic treatment.MethodsIPF transplanted after January 2015 were included a cohort with three groups: no antifibrotic, pirfenidone, and nintedanib. Pre-specified interest included: PGD grades immediately transplant (T0) post-operative day 3 (T72), duration mechanical ventilation, dehiscence, anastomosis complications, time CLAD development, overall survival.ResultsOf 85 eligible patients, 26 received medication, 31 28 Fewer female but groups otherwise similar regards demographics clinical variables (Table). There differences between status at T0 T72, who antifibrotics more likely resolve T72 than did not (mean change grade: nintedanib -0.3±0.9 vs. -0.5±1.3 +0.3±1.5, p=0.026). was trend toward decreased ventilation receiving treatment (no-antifibrotic any medication p=0.025, all group p=0.07). Anastomosis stenosis less common (p=0.020). No observed incidence CLAD, mortality.ConclusionReceiving therapy associated resolution PGD, shorter stenosis. Antifibrotic treatment. survival. Of mortality. Receiving