Survival of Adults With Systemic Sclerosis Following Lung Transplantation: A Nationwide Cohort Study
Objective Many transplant programs are hesitant to offer lung transplantation to patients with systemic sclerosis (SSc) due to concerns about extrapulmonary involvement that might affect survival. The aim of this study was to determine whether adults with SSc have higher 1‐year mortality rates after...
Gespeichert in:
| Veröffentlicht in: | Arthritis & rheumatology (Hoboken, N.J.) N.J.), 2015-05, Vol.67 (5), p.1314-1322 |
|---|---|
| Hauptverfasser: | , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1322 |
|---|---|
| container_issue | 5 |
| container_start_page | 1314 |
| container_title | Arthritis & rheumatology (Hoboken, N.J.) |
| container_volume | 67 |
| creator | Bernstein, Elana J. Peterson, Eric R. Sell, Jessica L. D'Ovidio, Frank Arcasoy, Selim M. Bathon, Joan M. Lederer, David J. |
| description | Objective
Many transplant programs are hesitant to offer lung transplantation to patients with systemic sclerosis (SSc) due to concerns about extrapulmonary involvement that might affect survival. The aim of this study was to determine whether adults with SSc have higher 1‐year mortality rates after lung transplantation compared to those with interstitial lung disease (ILD) or pulmonary arterial hypertension (PAH) not due to SSc.
Methods
Using data provided by the United Network for Organ Sharing, we performed a retrospective cohort study of 229 adults with SSc, 201 with PAH, and 3,333 with ILD who underwent lung transplantation in the US between May 4, 2005 and September 14, 2012. We examined associations between diagnosis and 1‐year survival after lung transplantation using stratified Cox models adjusted for recipient, donor, and procedure factors.
Results
Adults with SSc undergoing lung transplantation in the US had a multivariable‐adjusted 48% relative increase in the 1‐year mortality rate compared to those with non–SSc‐related ILD (hazard ratio 1.48 [95% confidence interval 1.01–2.17]). However, we did not detect a difference in the risk of death at 1 year between those with SSc and those with non–SSc‐related PAH (hazard ratio 0.85 [95% confidence interval 0.50–1.44]).
Conclusion
A diagnosis of SSc may confer an increased risk of death 1 year following lung transplantation compared to a diagnosis of ILD, but this risk is similar to that of PAH, a widely accepted indication for lung transplantation. Future work should identify modifiable risk factors that can improve transplant outcomes in this population. |
| doi_str_mv | 10.1002/art.39021 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1676596275</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1676596275</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3881-264a15e0fef72964998ff1959ec5ec246acd55eedbc38fdb4c645cc89ef512f43</originalsourceid><addsrcrecordid>eNp10EFLHDEUB_BQLFWsB79ACXixh9UkMy8z8bYstQpLC-6KxyGbeamR7GSbZFz22ze62kOhOby8w48_jz8hp5xdcMbEpY75olJM8A_kSFRCTkAwOHjfueKH5CSlJ1aeaphk8IkcCoCWC2BHpF-M8dk9a0-DpdN-9DnRB5cf6WKXMq6doQvjMYbkEr0O3oetG37R-VjGMuohbbwess4uDFd0Sn-8blvXI52FxxAzXeSx330mH632CU_e_mNyf_1tObuZzH9-v51N5xNTtS2fCFlrDsgs2kYoWSvVWssVKDSARtRSmx4AsV8Vb_tVbWQNxrQKLXBh6-qYnO9zNzH8HjHlbu2SQV9uxDCmjstGgpKigULP_qFPYYxDue5FgWIgm6qor3tlSgMpou020a113HWcdS_td6X97rX9Yr-8JY6rNfZ_5XvXBVzuwdZ53P0_qZveLfeRfwAoeY6Y</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1675905673</pqid></control><display><type>article</type><title>Survival of Adults With Systemic Sclerosis Following Lung Transplantation: A Nationwide Cohort Study</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>Alma/SFX Local Collection</source><creator>Bernstein, Elana J. ; Peterson, Eric R. ; Sell, Jessica L. ; D'Ovidio, Frank ; Arcasoy, Selim M. ; Bathon, Joan M. ; Lederer, David J.</creator><creatorcontrib>Bernstein, Elana J. ; Peterson, Eric R. ; Sell, Jessica L. ; D'Ovidio, Frank ; Arcasoy, Selim M. ; Bathon, Joan M. ; Lederer, David J.</creatorcontrib><description>Objective
Many transplant programs are hesitant to offer lung transplantation to patients with systemic sclerosis (SSc) due to concerns about extrapulmonary involvement that might affect survival. The aim of this study was to determine whether adults with SSc have higher 1‐year mortality rates after lung transplantation compared to those with interstitial lung disease (ILD) or pulmonary arterial hypertension (PAH) not due to SSc.
Methods
Using data provided by the United Network for Organ Sharing, we performed a retrospective cohort study of 229 adults with SSc, 201 with PAH, and 3,333 with ILD who underwent lung transplantation in the US between May 4, 2005 and September 14, 2012. We examined associations between diagnosis and 1‐year survival after lung transplantation using stratified Cox models adjusted for recipient, donor, and procedure factors.
Results
Adults with SSc undergoing lung transplantation in the US had a multivariable‐adjusted 48% relative increase in the 1‐year mortality rate compared to those with non–SSc‐related ILD (hazard ratio 1.48 [95% confidence interval 1.01–2.17]). However, we did not detect a difference in the risk of death at 1 year between those with SSc and those with non–SSc‐related PAH (hazard ratio 0.85 [95% confidence interval 0.50–1.44]).
Conclusion
A diagnosis of SSc may confer an increased risk of death 1 year following lung transplantation compared to a diagnosis of ILD, but this risk is similar to that of PAH, a widely accepted indication for lung transplantation. Future work should identify modifiable risk factors that can improve transplant outcomes in this population.</description><identifier>ISSN: 2326-5191</identifier><identifier>EISSN: 2326-5205</identifier><identifier>DOI: 10.1002/art.39021</identifier><identifier>PMID: 25581250</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adult ; Cohort Studies ; Confidence intervals ; Cystic fibrosis ; Female ; Humans ; Hypertension, Pulmonary - mortality ; Hypertension, Pulmonary - surgery ; Lung Diseases, Interstitial - mortality ; Lung Diseases, Interstitial - surgery ; Lung Transplantation ; Male ; Middle Aged ; Mortality ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Scleroderma, Systemic - mortality ; Scleroderma, Systemic - surgery ; Survival Rate ; Transplants & implants</subject><ispartof>Arthritis & rheumatology (Hoboken, N.J.), 2015-05, Vol.67 (5), p.1314-1322</ispartof><rights>2015, American College of Rheumatology</rights><rights>2015, American College of Rheumatology.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3881-264a15e0fef72964998ff1959ec5ec246acd55eedbc38fdb4c645cc89ef512f43</citedby><cites>FETCH-LOGICAL-c3881-264a15e0fef72964998ff1959ec5ec246acd55eedbc38fdb4c645cc89ef512f43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fart.39021$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fart.39021$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25581250$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bernstein, Elana J.</creatorcontrib><creatorcontrib>Peterson, Eric R.</creatorcontrib><creatorcontrib>Sell, Jessica L.</creatorcontrib><creatorcontrib>D'Ovidio, Frank</creatorcontrib><creatorcontrib>Arcasoy, Selim M.</creatorcontrib><creatorcontrib>Bathon, Joan M.</creatorcontrib><creatorcontrib>Lederer, David J.</creatorcontrib><title>Survival of Adults With Systemic Sclerosis Following Lung Transplantation: A Nationwide Cohort Study</title><title>Arthritis & rheumatology (Hoboken, N.J.)</title><addtitle>Arthritis Rheumatol</addtitle><description>Objective
Many transplant programs are hesitant to offer lung transplantation to patients with systemic sclerosis (SSc) due to concerns about extrapulmonary involvement that might affect survival. The aim of this study was to determine whether adults with SSc have higher 1‐year mortality rates after lung transplantation compared to those with interstitial lung disease (ILD) or pulmonary arterial hypertension (PAH) not due to SSc.
Methods
Using data provided by the United Network for Organ Sharing, we performed a retrospective cohort study of 229 adults with SSc, 201 with PAH, and 3,333 with ILD who underwent lung transplantation in the US between May 4, 2005 and September 14, 2012. We examined associations between diagnosis and 1‐year survival after lung transplantation using stratified Cox models adjusted for recipient, donor, and procedure factors.
Results
Adults with SSc undergoing lung transplantation in the US had a multivariable‐adjusted 48% relative increase in the 1‐year mortality rate compared to those with non–SSc‐related ILD (hazard ratio 1.48 [95% confidence interval 1.01–2.17]). However, we did not detect a difference in the risk of death at 1 year between those with SSc and those with non–SSc‐related PAH (hazard ratio 0.85 [95% confidence interval 0.50–1.44]).
Conclusion
A diagnosis of SSc may confer an increased risk of death 1 year following lung transplantation compared to a diagnosis of ILD, but this risk is similar to that of PAH, a widely accepted indication for lung transplantation. Future work should identify modifiable risk factors that can improve transplant outcomes in this population.</description><subject>Adult</subject><subject>Cohort Studies</subject><subject>Confidence intervals</subject><subject>Cystic fibrosis</subject><subject>Female</subject><subject>Humans</subject><subject>Hypertension, Pulmonary - mortality</subject><subject>Hypertension, Pulmonary - surgery</subject><subject>Lung Diseases, Interstitial - mortality</subject><subject>Lung Diseases, Interstitial - surgery</subject><subject>Lung Transplantation</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Retrospective Studies</subject><subject>Scleroderma, Systemic - mortality</subject><subject>Scleroderma, Systemic - surgery</subject><subject>Survival Rate</subject><subject>Transplants & implants</subject><issn>2326-5191</issn><issn>2326-5205</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10EFLHDEUB_BQLFWsB79ACXixh9UkMy8z8bYstQpLC-6KxyGbeamR7GSbZFz22ze62kOhOby8w48_jz8hp5xdcMbEpY75olJM8A_kSFRCTkAwOHjfueKH5CSlJ1aeaphk8IkcCoCWC2BHpF-M8dk9a0-DpdN-9DnRB5cf6WKXMq6doQvjMYbkEr0O3oetG37R-VjGMuohbbwess4uDFd0Sn-8blvXI52FxxAzXeSx330mH632CU_e_mNyf_1tObuZzH9-v51N5xNTtS2fCFlrDsgs2kYoWSvVWssVKDSARtRSmx4AsV8Vb_tVbWQNxrQKLXBh6-qYnO9zNzH8HjHlbu2SQV9uxDCmjstGgpKigULP_qFPYYxDue5FgWIgm6qor3tlSgMpou020a113HWcdS_td6X97rX9Yr-8JY6rNfZ_5XvXBVzuwdZ53P0_qZveLfeRfwAoeY6Y</recordid><startdate>201505</startdate><enddate>201505</enddate><creator>Bernstein, Elana J.</creator><creator>Peterson, Eric R.</creator><creator>Sell, Jessica L.</creator><creator>D'Ovidio, Frank</creator><creator>Arcasoy, Selim M.</creator><creator>Bathon, Joan M.</creator><creator>Lederer, David J.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7QP</scope><scope>7T5</scope><scope>7TM</scope><scope>7U7</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201505</creationdate><title>Survival of Adults With Systemic Sclerosis Following Lung Transplantation: A Nationwide Cohort Study</title><author>Bernstein, Elana J. ; Peterson, Eric R. ; Sell, Jessica L. ; D'Ovidio, Frank ; Arcasoy, Selim M. ; Bathon, Joan M. ; Lederer, David J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3881-264a15e0fef72964998ff1959ec5ec246acd55eedbc38fdb4c645cc89ef512f43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Cohort Studies</topic><topic>Confidence intervals</topic><topic>Cystic fibrosis</topic><topic>Female</topic><topic>Humans</topic><topic>Hypertension, Pulmonary - mortality</topic><topic>Hypertension, Pulmonary - surgery</topic><topic>Lung Diseases, Interstitial - mortality</topic><topic>Lung Diseases, Interstitial - surgery</topic><topic>Lung Transplantation</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Retrospective Studies</topic><topic>Scleroderma, Systemic - mortality</topic><topic>Scleroderma, Systemic - surgery</topic><topic>Survival Rate</topic><topic>Transplants & implants</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bernstein, Elana J.</creatorcontrib><creatorcontrib>Peterson, Eric R.</creatorcontrib><creatorcontrib>Sell, Jessica L.</creatorcontrib><creatorcontrib>D'Ovidio, Frank</creatorcontrib><creatorcontrib>Arcasoy, Selim M.</creatorcontrib><creatorcontrib>Bathon, Joan M.</creatorcontrib><creatorcontrib>Lederer, David J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Arthritis & rheumatology (Hoboken, N.J.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bernstein, Elana J.</au><au>Peterson, Eric R.</au><au>Sell, Jessica L.</au><au>D'Ovidio, Frank</au><au>Arcasoy, Selim M.</au><au>Bathon, Joan M.</au><au>Lederer, David J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Survival of Adults With Systemic Sclerosis Following Lung Transplantation: A Nationwide Cohort Study</atitle><jtitle>Arthritis & rheumatology (Hoboken, N.J.)</jtitle><addtitle>Arthritis Rheumatol</addtitle><date>2015-05</date><risdate>2015</risdate><volume>67</volume><issue>5</issue><spage>1314</spage><epage>1322</epage><pages>1314-1322</pages><issn>2326-5191</issn><eissn>2326-5205</eissn><abstract>Objective
Many transplant programs are hesitant to offer lung transplantation to patients with systemic sclerosis (SSc) due to concerns about extrapulmonary involvement that might affect survival. The aim of this study was to determine whether adults with SSc have higher 1‐year mortality rates after lung transplantation compared to those with interstitial lung disease (ILD) or pulmonary arterial hypertension (PAH) not due to SSc.
Methods
Using data provided by the United Network for Organ Sharing, we performed a retrospective cohort study of 229 adults with SSc, 201 with PAH, and 3,333 with ILD who underwent lung transplantation in the US between May 4, 2005 and September 14, 2012. We examined associations between diagnosis and 1‐year survival after lung transplantation using stratified Cox models adjusted for recipient, donor, and procedure factors.
Results
Adults with SSc undergoing lung transplantation in the US had a multivariable‐adjusted 48% relative increase in the 1‐year mortality rate compared to those with non–SSc‐related ILD (hazard ratio 1.48 [95% confidence interval 1.01–2.17]). However, we did not detect a difference in the risk of death at 1 year between those with SSc and those with non–SSc‐related PAH (hazard ratio 0.85 [95% confidence interval 0.50–1.44]).
Conclusion
A diagnosis of SSc may confer an increased risk of death 1 year following lung transplantation compared to a diagnosis of ILD, but this risk is similar to that of PAH, a widely accepted indication for lung transplantation. Future work should identify modifiable risk factors that can improve transplant outcomes in this population.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>25581250</pmid><doi>10.1002/art.39021</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2326-5191 |
| ispartof | Arthritis & rheumatology (Hoboken, N.J.), 2015-05, Vol.67 (5), p.1314-1322 |
| issn | 2326-5191 2326-5205 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1676596275 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; Alma/SFX Local Collection |
| subjects | Adult Cohort Studies Confidence intervals Cystic fibrosis Female Humans Hypertension, Pulmonary - mortality Hypertension, Pulmonary - surgery Lung Diseases, Interstitial - mortality Lung Diseases, Interstitial - surgery Lung Transplantation Male Middle Aged Mortality Prognosis Proportional Hazards Models Retrospective Studies Scleroderma, Systemic - mortality Scleroderma, Systemic - surgery Survival Rate Transplants & implants |
| title | Survival of Adults With Systemic Sclerosis Following Lung Transplantation: A Nationwide Cohort Study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-23T15%3A15%3A21IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Survival%20of%20Adults%20With%20Systemic%20Sclerosis%20Following%20Lung%20Transplantation:%20A%20Nationwide%20Cohort%20Study&rft.jtitle=Arthritis%20&%20rheumatology%20(Hoboken,%20N.J.)&rft.au=Bernstein,%20Elana%20J.&rft.date=2015-05&rft.volume=67&rft.issue=5&rft.spage=1314&rft.epage=1322&rft.pages=1314-1322&rft.issn=2326-5191&rft.eissn=2326-5205&rft_id=info:doi/10.1002/art.39021&rft_dat=%3Cproquest_cross%3E1676596275%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1675905673&rft_id=info:pmid/25581250&rfr_iscdi=true |