title: Safety and efficacy of bridging to lung transplantation with antifibrotic drugs in idiopathic pulmonary fibrosis: a case series.
abstract: Following recent approval of pirfenidone and nintedanib for idiopathic pulmonary fibrosis (IPF), questions arise about the use of these antifibrotics in patients awaiting lung transplantation (LTx).
  
  
  
  Safety and efficacy of antifibrotic drugs in IPF patients undergoing LTx were investigated in a single-centre retrospective cohort analysis.
  
  
  
  A total of nine patients, receiving antifibrotic therapy for 419 ± 315 days until subsequent LTx, were included. No major side effects were noted. Significant weight loss occurred during antifibrotic treatment (p = 0.0062). FVC tended to stabilize after 12 weeks of treatment in most patients. A moderate decline in FVC, TLC and DLCO was noted during the whole pretransplant time period of antifibrotic therapy. Functional exercise capacity and lung allocation score remained unchanged. No post-operative thoracic wound healing problems, nor severe early anastomotic airway complications were attributable to prior antifibrotic treatment. None of the patients developed chronic lung allograft dysfunction after a median follow-up of 19.8 (11.2-26.5) months; and post-transplant survival was 100% after 1 year and 80% after 2 years.
  
  
  
  Antifibrotic drugs can probably be safely administered in IPF patients, possibly attenuating disease progression over time, while awaiting LTx.
authors.affiliation: Department of Respiratory Diseases, Interstitial Lung Disease and Lung Transplant Unit, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Delanote
authors.affiliation: Department of Respiratory Diseases, Interstitial Lung Disease and Lung Transplant Unit, University Hospitals Leuven, Leuven, Belgium.|KULeuven, Department of Clinical and Experimental Medicine, Division of Respiratory Diseases, Laboratory of Respiratory Diseases, Lung Transplantation Unit, KU Leuven, Herestraat 49, B-3000, Leuven, Belgium.
authors.forename: Wim A
authors.initials: WA
authors.lastname: Wuyts
authors.affiliation: Department of Respiratory Diseases, Interstitial Lung Disease and Lung Transplant Unit, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Jonas
authors.initials: J
authors.lastname: Yserbyt
authors.affiliation: KULeuven, Department of Histopathology, Leuven, Belgium.
authors.forename: Eric K
authors.initials: EK
authors.lastname: Verbeken
authors.affiliation: Department of Respiratory Diseases, Interstitial Lung Disease and Lung Transplant Unit, University Hospitals Leuven, Leuven, Belgium.|KULeuven, Department of Clinical and Experimental Medicine, Division of Respiratory Diseases, Laboratory of Respiratory Diseases, Lung Transplantation Unit, KU Leuven, Herestraat 49, B-3000, Leuven, Belgium.
authors.forename: Geert M
authors.initials: GM
authors.lastname: Verleden
authors.affiliation: Department of Respiratory Diseases, Interstitial Lung Disease and Lung Transplant Unit, University Hospitals Leuven, Leuven, Belgium. robin.vos@uzleuven.be.|KULeuven, Department of Clinical and Experimental Medicine, Division of Respiratory Diseases, Laboratory of Respiratory Diseases, Lung Transplantation Unit, KU Leuven, Herestraat 49, B-3000, Leuven, Belgium. robin.vos@uzleuven.be.
authors.forename: Robin
authors.identifier: 0000-0002-3468-9251
authors.initials: R
authors.lastname: Vos
mesh_terms: D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use*; D001530:Belgium; D018450:Disease Progression; D005260:Female; D006085:Graft Survival; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000628:therapy*; D007211:Indoles / Q000009:adverse effects / Q000627:therapeutic use*; D008168:Lung / Q000503:physiopathology; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011728:Pyridones / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D014797:Vital Capacity
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D007211:Indoles; D011728:Pyridones; C093844:pirfenidone; C530716:nintedanib
keywords: Antifibrotics; IPF; Lung transplantation; Nintedanib; Pirfenidone; Safety