Pirfenidone in restrictive allograft syndrome after lung transplantation: A case series

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
R VosG M Verleden

Abstract

Pirfenidone may attenuate the decline of pulmonary function in restrictive allograft syndrome (RAS) after lung transplantation. We retrospectively assessed all lung transplant recipients with RAS who were treated with pirfenidone for at least 3 months (n = 11) in our lung transplant center and report on their long-term outcomes following initiation of pirfenidone. Main outcome parameters included evolution of pulmonary function and overall survival. Pirfenidone appears to attenuate the decline in forced vital capacity and forced expiratory volume in 1 second. Notably, 3 patients were bridged to redo-transplantation with pirfenidone for 11 (5-12) months and are currently alive, while 3 other patients demonstrate long-term stabilization of pulmonary function after 26.6 (range 18.4-46.6) months of treatment. Median overall 3-year survival after RAS diagnosis was 54.5%. Subjective intolerance, mainly anorexia and nausea, necessitating pirfenidone dose de-escalation in 55% of patients, as well as calcineurin dose increase requirements with about 20% are important complications during pirfenidone treatment after lung transplantation. Our findings provide further evidence that pirfenidone appears to be safe and may attenuate the rate ...Continue Reading

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Citations

Apr 3, 2019·Current Opinion in Organ Transplantation·Stijn E VerledenGeert M Verleden
Nov 23, 2019·Fundamental & Clinical Pharmacology·Hélène PluchartPierrick Bedouch
Jul 24, 2020·Current Opinion in Pulmonary Medicine·Laurens J De SadeleerGeert M Verleden
Aug 16, 2019·Bone Marrow Transplantation·Louise BondeelleAnne Bergeron
May 16, 2019·Current Opinion in Organ Transplantation·Stijn E VerledenGeert M Verleden
Mar 18, 2021·Pediatric Transplantation·Timothy KloudaLevent Midyat
May 22, 2020·La Presse médicale·Jérôme Le PavecElie Fadel
May 25, 2021·Seminars in Respiratory and Critical Care Medicine·Olawale AmubieyaS Samuel Weigt
Aug 21, 2021·European Respiratory Review : an Official Journal of the European Respiratory Society·Saskia BosRobin Vos

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