title: Lung and heart-lung transplantation for systemic sclerosis patients. A monocentric experience of 13 patients, review of the literature and position paper of a multidisciplinary Working Group.
abstract: Systemic sclerosis per se should not be considered as an a priori contraindication for a pre-transplantation assessment in patients with advanced interstitial lung disease and/or pulmonary hypertension. For lung or heart-lung transplantation, a multidisciplinary approach, adapting the pre-transplant assessment to systemic sclerosis and optimizing systemic sclerosis patient management before, during and after surgery should improved the short- and long-term prognosis. Indications and contraindications for transplantation have to be adapted to the specificities of systemic sclerosis. A special focus on the digestive tract involvement and its thorough evaluation are mandatory before transplantation in systemic sclerosis. As the esophagus is almost always involved, isolated gastro-oesophageal reflux disease, pH metry and/or manometry abnormalities should not be a systematic per se contraindication for pre-transplantation assessment. Corticosteroids may be harmful in systemic sclerosis as they are associated with acute renal crisis. A low dose corticosteroids protocol for immunosuppression is therefore advisable in systemic sclerosis.
authors.affiliation: Université Lille Nord de France, faculté de médecine, 59000 Lille, France; CHRU de Lille, hôpital Claude-Huriez, service de médecine interne, centre national de référence de la sclérodermie systémique, 59037 Lille cedex, France; EA2686, 59045 Lille, France. Electronic address: david.launay@chru-lille.fr.
authors.forename: David
authors.initials: D
authors.lastname: Launay
authors.affiliation: Université Paris-Sud, faculté de médecine, 94270 Le Kremlin-Bicêtre, France; AP-HP, hôpital Bicêtre, service de pneumologie, DHU Thorax Innovation, 94275 Le Kremlin-Bicêtre, France; Inserm U999, Centre chirurgical Marie-Lannelongue, LabEx LERMIT, 92350 Le Plessis-Robinson, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Savale
authors.affiliation: AP-HP, université Paris-Descartes, hôpital Cochin, service de médecine interne, Centre national de référence des vascularites nécrosantes et de la sclérodermie systémique, 75014 Paris, France.
authors.forename: Alice
authors.initials: A
authors.lastname: Berezne
authors.affiliation: Université Paris-Sud, faculté de médecine, 94270 Le Kremlin-Bicêtre, France; Inserm U999, Centre chirurgical Marie-Lannelongue, LabEx LERMIT, 92350 Le Plessis-Robinson, France; Centre chirurgical Marie-Lannelongue, service de chirurgie thoracique, vasculaire et de transplantation cardiopulmonaire, 92350 Le Plessis-Robinson, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Le Pavec
authors.affiliation: Université Lille Nord de France, faculté de médecine, 59000 Lille, France; CHRU de Lille, hôpital Claude-Huriez, service de médecine interne, centre national de référence de la sclérodermie systémique, 59037 Lille cedex, France; EA2686, 59045 Lille, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Hachulla
authors.affiliation: AP-HP, université Paris-Descartes, hôpital Cochin, service de médecine interne, Centre national de référence des vascularites nécrosantes et de la sclérodermie systémique, 75014 Paris, France.
authors.forename: Luc
authors.initials: L
authors.lastname: Mouthon
authors.affiliation: Université Paris-Sud, faculté de médecine, 94270 Le Kremlin-Bicêtre, France; AP-HP, hôpital Bicêtre, service de pneumologie, DHU Thorax Innovation, 94275 Le Kremlin-Bicêtre, France; Inserm U999, Centre chirurgical Marie-Lannelongue, LabEx LERMIT, 92350 Le Plessis-Robinson, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Sitbon
authors.affiliation: AP-HP, hôpital Bicêtre, service de chirurgie générale et digestive, 94275 Le Kremlin-Bicêtre, France.
authors.forename: Benoit
authors.initials: B
authors.lastname: Lambert
authors.affiliation: AP-HP, université Paris-Descartes, hôpital Cochin, service de gastroentérologie, 75014 Paris, France.
authors.forename: Marianne
authors.initials: M
authors.lastname: Gaudric
authors.affiliation: Université Paris-Sud, faculté de médecine, 94270 Le Kremlin-Bicêtre, France; AP-HP, hôpital Bicêtre, service de pneumologie, DHU Thorax Innovation, 94275 Le Kremlin-Bicêtre, France; Inserm U999, Centre chirurgical Marie-Lannelongue, LabEx LERMIT, 92350 Le Plessis-Robinson, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Jais
authors.affiliation: Centre chirurgical Marie-Lannelongue, service de réanimation adulte, 92350 Le Plessis-Robinson, France.
authors.forename: Francois
authors.initials: F
authors.lastname: Stephan
authors.affiliation: Université Lille Nord de France, faculté de médecine, 59000 Lille, France; CHRU de Lille, hôpital Claude-Huriez, service de médecine interne, centre national de référence de la sclérodermie systémique, 59037 Lille cedex, France.
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Hatron
authors.affiliation: Université Lille Nord de France, faculté de médecine, 59000 Lille, France; CHRU de Lille, hôpital cardiologique, service de cardiologie, 59034 Lille cedex, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Lamblin
authors.affiliation: AP-HP, université Paris-Descartes, hôpital Cochin, service de radiologie, 75014 Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Vignaux
authors.affiliation: Université Claude-Bernard Lyon 1, hôpital Louis-Pradel, service de pneumologie, Centre de référence national des maladies pulmonaires rares, 69000 Lyon, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Cottin
authors.affiliation: AP-HP, hôpital Saint-Louis, service de médecine interne et pathologie vasculaire, 75010 Paris, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Farge
authors.affiliation: Université Lille Nord de France, faculté de médecine, 59000 Lille, France; CHRU de Lille, hôpital Calmette, service de pneumologie et immunoallergologie, clinique des maladies respiratoires, Centre de compétence maladies pulmonaires rares, 59000 Lille, France.
authors.forename: Benoît
authors.initials: B
authors.lastname: Wallaert
authors.affiliation: AP-HP, université Paris-Descartes, hôpital Cochin, service de médecine interne, Centre national de référence des vascularites nécrosantes et de la sclérodermie systémique, 75014 Paris, France.
authors.forename: Loic
authors.initials: L
authors.lastname: Guillevin
authors.affiliation: Université Paris-Sud, faculté de médecine, 94270 Le Kremlin-Bicêtre, France; AP-HP, hôpital Bicêtre, service de pneumologie, DHU Thorax Innovation, 94275 Le Kremlin-Bicêtre, France; Inserm U999, Centre chirurgical Marie-Lannelongue, LabEx LERMIT, 92350 Le Plessis-Robinson, France.
authors.forename: Gerald
authors.initials: G
authors.lastname: Simonneau
authors.affiliation: Université Paris-Sud, faculté de médecine, 94270 Le Kremlin-Bicêtre, France; Inserm U999, Centre chirurgical Marie-Lannelongue, LabEx LERMIT, 92350 Le Plessis-Robinson, France; Centre chirurgical Marie-Lannelongue, service de chirurgie thoracique, vasculaire et de transplantation cardiopulmonaire, 92350 Le Plessis-Robinson, France.
authors.forename: Olaf
authors.initials: O
authors.lastname: Mercier
authors.affiliation: Université Paris-Sud, faculté de médecine, 94270 Le Kremlin-Bicêtre, France; Inserm U999, Centre chirurgical Marie-Lannelongue, LabEx LERMIT, 92350 Le Plessis-Robinson, France; Centre chirurgical Marie-Lannelongue, service de chirurgie thoracique, vasculaire et de transplantation cardiopulmonaire, 92350 Le Plessis-Robinson, France.
authors.forename: Elie
authors.initials: E
authors.lastname: Fadel
authors.affiliation: Université Paris-Sud, faculté de médecine, 94270 Le Kremlin-Bicêtre, France; Inserm U999, Centre chirurgical Marie-Lannelongue, LabEx LERMIT, 92350 Le Plessis-Robinson, France; Centre chirurgical Marie-Lannelongue, service de chirurgie thoracique, vasculaire et de transplantation cardiopulmonaire, 92350 Le Plessis-Robinson, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Dartevelle
authors.affiliation: Université Paris-Sud, faculté de médecine, 94270 Le Kremlin-Bicêtre, France; AP-HP, hôpital Bicêtre, service de pneumologie, DHU Thorax Innovation, 94275 Le Kremlin-Bicêtre, France; Inserm U999, Centre chirurgical Marie-Lannelongue, LabEx LERMIT, 92350 Le Plessis-Robinson, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Humbert
authors.affiliation: Université Paris-Sud, faculté de médecine, 94270 Le Kremlin-Bicêtre, France; Inserm U999, Centre chirurgical Marie-Lannelongue, LabEx LERMIT, 92350 Le Plessis-Robinson, France; Centre chirurgical Marie-Lannelongue, service de chirurgie thoracique, vasculaire et de transplantation cardiopulmonaire, 92350 Le Plessis-Robinson, France. Electronic address: s.mussot@ccml.fr.
authors.forename: Sacha
authors.initials: S
authors.lastname: Mussot
mesh_terms: D006331:Heart Diseases / Q000209:etiology / Q000601:surgery; D016041:Heart-Lung Transplantation; D006801:Humans; D008171:Lung Diseases / Q000209:etiology / Q000601:surgery; D008875:Middle Aged; D012189:Retrospective Studies; D012595:Scleroderma, Systemic / Q000150:complications / Q000601:surgery*