OP0169 LONG-TERM SURVIVAL IN LUNG TRANSPLANTATION FOR INTERSTITIAL LUNG DISEASE ASSOCIATED WITH CONECTIVE TISSUE DISEASES. STUDY OF 26 CASES OF A SINGLE CENTER
Authors: D. Prieto-Peña, Monica Calderón-Goercke, Amaya Martínez-Meñaca, Victor Manuel Mora-Cuesta, Sonia Fernández-Rozas, David Iturbe-Fernández, Jose Manuel Cifrián-Martínez, Miguel A González-Gay, Ricardo Blanco
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Interstitial lung disease (ILD) is one of the most serious complications associated with connective tissue diseases (CTD). Patients with ILD have increased mortality and limited treatment options. Lung transplant has been recognized as an option for patients with end-stage CTD-ILD. However, rheumatic diseases are still sometimes considered a contraindication for lung transplant because of concerns for worse outcomes. <h3>Objectives</h3> Our aims were to: <b>a)</b> assess long-term post-transplant survival in patients with CTD-ILD and <b>b)</b> compare post post-transplant survival of patients with CTD-ILD with patients with idiopathic pulmonary fibrosis (IPF). <h3>Methods</h3> Single center study in a referral center for lung transplant of all patients who underwent lung transplantation for CTD-ILD between 1998 and 2017. This cohort was compared with patients with IPF (group-matched for age, transplant year and basiliximab induction). Cumulative survival rates after transplantation were estimated by the Kaplan-Meier method and compared between groups using the log-rank test. <h3>Results</h3> We studied 26 patients with CTD-ILD matched to 26 patients with IPF. The underlying diseases of patients with CTD-ILD were: Rheumatoid arthritis (n=9), Scleroderma (n=6), Sjögren syndrome (n= 4), ANCA-vasculitis (n=3), Anti synthetase syndrome (n=2), Dermatomyositis (n=1), Systemic lupus erythematosus (n=1). The comparative study of baseline characteristics between both groups is shown in the TABLE. All of RA patients undergoing transplantation in our study had the histologic subtype of usual interstitial pneumonia (UIP) whereas non-specific interstitial pneumonia (NSIP) was the most common histologic subtype of ILD associated with the rest of CTD. Cumulative survival rates at 5 year post-transplant did no differ significantly between CTD-ILD and IFP [42.4% vs 65.8% (p=0.075)] (FIGURE 1). <h3>Conclusion</h3> Our retrospective analysis showed a trend to lower long-term post-transplant survival than in those with IPF, however no statistical differences were found in cumulative survival rates at 5-years post-transplant. These data support that lung transplantation should be considered in patients with end-stage CTD-ILD. <h3>Disclosure of Interests</h3> D. Prieto-Peña: None declared, Monica Calderón-Goercke: None declared, Amaya Martínez-Meñaca: None declared, Victor Manuel Mora-Cuesta: None declared, Sonia Fernández-Rozas: None declared, David Iturbe-Fernández: None declared, Jose Manuel Cifrián-Martínez: None declared, Miguel A González-Gay Grant/research support from: Prof. MA Gonzalez-Gay received grants/research supports from Abbvie, MSD, Jansen and Roche., Speakers bureau: Consultation fees/participation in company sponsored speaker's bureau from Pfizer, Lilly, Sobi, Celgene, Novartis, Roche and Sanofi., Ricardo Blanco Grant/research support from: Abbvie, MSD, and Roche, Consultant for: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen, Speakers bureau: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen