Clinical efficacy of lung transplantation for lung chronic graft-versus-host disease after hematopoietic stem cell transplantation

Ling Guoyao; Lian Qiaoyan; Li Shiyin; Wang Xiaohua; Wang Lulin; Liao Hailin; Ju Chunrong

doi:10.3969/j.issn.1674-7445.2023258

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Ling Guoyao, Lian Qiaoyan, Li Shiyin, et al. Clinical efficacy of lung transplantation for lung chronic graft-versus-host disease after hematopoietic stem cell transplantation[J]. ORGAN TRANSPLANTATION. doi: 10.3969/j.issn.1674-7445.2023258

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Clinical efficacy of lung transplantation for lung chronic graft-versus-host disease after hematopoietic stem cell transplantation

doi: 10.3969/j.issn.1674-7445.2023258

1.
The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Respiratory Health Research Institute, Guangzhou 510012, China

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Corresponding author: Ju Chunrong, Email: juchunrong@126.com
Received Date: 2023-12-28
Available Online: 2024-03-25

Abstract

Abstract

Objective To evaluate clinical efficacy of lung transplantation for lung chronic graft-versus-host disease (cGVHD) after hematopoietic stem cell transplantation (HSCT). Methods Clinical data of 12 patients undergoing lung transplantation for lung cGVHD were retrospectively analyzed. Preoperative clinical manifestations and involved organs of patients were analyzed. The lung function before and after lung transplantation was compared, and the survival of patients after lung transplantation was analyzed. Results 11 patients underwent HSCT due to primary hematological malignancies, including 9 cases of leukemia, 1 case of myelodysplastic syndrome, 1 case of lymphoma. And 1 case underwent HSCT for systemic lupus erythematosus. Among 12 cGVHD patients, skin involvement was found in 8 cases, oral cavity involvement in 5 cases, gastrointestinal tract involvement in 4 cases and liver involvement in 3 cases. All 12 patients developed severe respiratory failure caused by cGVHD before lung transplantation, including 9 cases of typeⅡ respiratory failure and 3 cases of type Ⅰ respiratory failure. Two patients underwent right lung transplantation, 2 cases of left lung transplantation and 8 cases of bilateral lung transplantation. The interval from HSCT to lung transplantation was 75 (19-187) months. Upon the date of submission, postoperative follow-up time was 18 (7-74) months. Ten patients survived, 1 died from severe hepatitis at postoperative 22 months, and 1 died from gastrointestinal bleeding at postoperative 6 months. No recurrence of primary diseases was reported in surviving patients. Conclusions Lung transplantation is an efficacious treatment for lung cGVHD after HSCT, which may prolong the survival time and improve the quality of life of the recipients.
- Lung transplantation,
- Hematopoietic stem cell transplantation,
- Chronic graft-versus-host disease,
- Bronchiolitis obliterans syndrome,
- Interstitial lung disease,
- Respiratory failure,
- Leukemia,
- Pulmonary function

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References

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Clinical efficacy of lung transplantation for lung chronic graft-versus-host disease after hematopoietic stem cell transplantation

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Clinical efficacy of lung transplantation for lung chronic graft-versus-host disease after hematopoietic stem cell transplantation

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