Department of Internal Medicine V, Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research (DZL), University of Munich, LMU, Munich, Germany.
Transplant Center, University of Munich, Munich, Germany.
Am J Transplant. 2019 Aug;19(8):2358-2365. doi: 10.1111/ajt.15378. Epub 2019 Apr 29.
Pirfenidone demonstrated pleiotropic antiinflammatory effects in various experimental and clinical settings. The aim of this study was to assess the impact of previous treatment with pirfenidone on short-term outcomes after single lung transplantation (SLTx). Therefore, patients with idiopathic pulmonary fibrosis (IPF) who were undergoing SLTx were screened retrospectively for previous use of pirfenidone and compared to respective controls. Baseline parameters and short-term outcomes were recorded and analyzed. In total, 17 patients with pirfenidone were compared with 26 patients without antifibrotic treatment. Baseline characteristics and severity of disease did not differ between groups. Use of pirfenidone did not increase blood loss, wound-healing, or anastomotic complications. Severity of primary graft dysfunction at 72 hours was less (0.3 ± 0.6 vs 1.4 ± 1.3, P = .002), and length of mechanical ventilation (37.5 ± 34.8 vs 118.5 ± 151.0 hours, P = .016) and intensive care unit (ICU) stay (6.6 ± 7.1 vs 15.6 ± 20.3, P = .089) were shorter in patients with pirfenidone treatment. An independent beneficial effect of pirfenidone was confirmed by regression analysis while controlling for confounding variables (P = .016). Finally, incidence of acute cellular rejections within the first 30 days after SLTx was lower in patients with previous pirfenidone treatment (0.0% vs 19.2%; P = .040). Our data suggest a beneficial role of previous use of pirfenidone in patients with IPF who were undergoing SLTx.
吡非尼酮在各种实验和临床环境中表现出多种抗炎作用。本研究旨在评估特发性肺纤维化（IPF）患者在接受单肺移植（SLTx）之前接受吡非尼酮治疗对短期结局的影响。因此，回顾性筛选了接受 SLTx 的 IPF 患者，以评估他们之前是否使用过吡非尼酮，并与相应的对照组进行比较。记录并分析了基线参数和短期结局。总共比较了 17 名使用吡非尼酮的患者和 26 名未接受抗纤维化治疗的患者。两组的基线特征和疾病严重程度无差异。吡非尼酮的使用并未增加出血、伤口愈合或吻合口并发症的发生。72 小时原发性移植物功能障碍的严重程度较轻（0.3±0.6 与 1.4±1.3，P=0.002），机械通气时间（37.5±34.8 与 118.5±151.0 小时，P=0.016）和重症监护病房（ICU）住院时间（6.6±7.1 与 15.6±20.3 小时，P=0.089）也更短。通过回归分析控制混杂因素后，确认了吡非尼酮的独立有益作用（P=0.016）。最后，SLTx 后 30 天内急性细胞排斥反应的发生率在先前接受吡非尼酮治疗的患者中较低（0.0%与 19.2%；P=0.040）。我们的数据表明，在接受 SLTx 的 IPF 患者中，先前使用吡非尼酮具有有益作用。
