Long-Term Survival After Lung Transplantation in Patients with Silicosis and Other Occupational Lung Disease.
BACKGROUND
Survival after lung transplantation (LTx) for patients with occupational lung disease (OLD) is not well studied.


METHODS
The United Network for Organ Sharing (UNOS) database was queried from 2005 to 2013 to assess survival after LTx in patients with silicosis and non-silicotic OLD compared to non-OLD patients.


RESULTS
Of 7273 adult LTx recipients, 7227 (24 with silicosis and 29 with non-silicotic OLD) were included in our univariate and Kaplan-Meier function analysis and 6370 for multivariate Cox models. Univariate Cox models did not identify survival differences in silicosis (HR 0.717; 95 % CI 0.358-1.435; p = 0.347) and non-silicotic OLDs (HR 0.934; 95 % CI 0.486-1.798; p = 0.839). Kaplan-Meier function analysis did not identify a survival disadvantage for either silicosis or non-silicotic OLD (log-rank test: χ (2) 0.93, p = 0.627). Patients with non-silicotic OLD were at risk for worse survival for the first 2.5 years post-transplant; however, at the conclusion of the study, this group had the highest survival rate. Multivariate Cox models confirmed no increased risk for mortality for silicosis (HR 1.264; 95 % CI 0.631-2.534; p = 0.509) and non-silicotic OLD (HR 1.114; 95 % CI 0.578-2.147; p = 0.747).


CONCLUSIONS
Long-term survival for adult patients with silicosis and non-silicotic OLD after LTx is not significantly different compared to the general lung transplant population.
Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA. hayes.705@osu.edu.|Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA. hayes.705@osu.edu.|Section of Pulmonary Medicine, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA. hayes.705@osu.edu.
Don
D
Hayes
Section of Pulmonary Medicine, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA.
Kaitlyn T
KT
Hayes
Section of Pulmonary Medicine, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA.
Hunter C
HC
Hayes
Department of Anesthesiology, The Ohio State University College of Medicine, Columbus, OH, USA.|Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
Joseph D
JD
Tobias
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D000368:Aged; D005080:Exercise Test; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D053208:Kaplan-Meier Estimate; D008171:Lung Diseases / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009784:Occupational Diseases / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012829:Silicosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D015996:Survival Rate; D014019:Tissue Donors / Q000706:statistics & numerical data; D014481:United States; D014797:Vital Capacity
Lung transplantation; Occupational lung disease; Silicosis; Survival