Statin use is associated with improved function and survival of lung allografts.
3-Hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) are widely used antilipidemic agents that are also immunomodulatory. We evaluated possible effects of these agents after lung transplantation by comparing outcomes of 39 allograft recipients, who were prescribed statins for hyperlipidemia, with those of 161 contemporaneous control recipients who did not receive these drugs. Acute rejection (>or= Grade II) was less frequently found in the statin group (15.1 versus 25.6% of biopsies, p < 0.01). None of 15 recipients started on statins during postoperative Year 1 developed obliterative bronchiolitis, whereas the cumulative incidence of this complication among control subjects was 37% (p < 0.01). Total cellularity, as well as proportions of inflammatory neutrophils and lymphocytes, were significantly lower in bronchoalveolar lavages of statin recipients. Among double lung recipients, those taking statins had significantly better spirometry: FVC (80 +/- 2 versus 70 +/- 1%) and FEV1 (87 +/- 2 versus 70 +/- 1%), as percentages of predicted values, and absolute FEV1/FVC (83.4 +/- 1.2 versus 78.6 +/- 0.5) (all p < 0.01). The 6-year survival of recipients taking statins (91%) was much greater than that of control subjects (54%) (p < 0.01). These data suggest statin use may have substantial clinical benefits after pulmonary transplantation.
Johnson
Bruce A
BA
Department of Medicine, University of Pittsburgh, 628 NW MUH, 3459 Fifth Ave., Pittsburgh, PA 15213, USA.
Iacono
Aldo T
AT
Zeevi
Adriana
A
McCurry
Kenneth R
KR
Duncan
Steven R
SR
D000208:Acute Disease; D001706:Biopsy; D001989:Bronchiolitis Obliterans / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology; D002423:Cause of Death; D005260:Female; D005541:Forced Expiratory Volume; D006084:Graft Rejection / Q000453:epidemiology / Q000276:immunology / Q000473:pathology / Q000517:prevention & control*; D006085:Graft Survival / Q000187:drug effects* / Q000276:immunology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000276:immunology / Q000627:therapeutic use*; D006949:Hyperlipidemias / Q000150:complications / Q000188:drug therapy*; D015994:Incidence; D007958:Leukocyte Count; D016040:Lung Transplantation / Q000009:adverse effects / Q000276:immunology / Q000401:mortality; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D012307:Risk Factors; D012720:Severity of Illness Index; D013147:Spirometry; D016019:Survival Analysis; D016896:Treatment Outcome; D014797:Vital Capacity
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors