1. Lung Transplant Improves Survival and Quality of Life Regardless of Telomere Dysfunction
- Author
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Lurdes Planas-Cerezales, Elena G. Arias-Salgado, Cristina Berastegui, Ana Montes-Worboys, Rafaela González-Montelongo, José. M. Lorenzo-Salazar, Vanesa Vicens-Zygmunt, Marta Garcia-Moyano, Jordi Dorca, Carlos Flores, Rosario Perona, Antonio Román, María Molina-Molina, Institut Català de la Salut, [Planas-Cerezales L, Montes-Worboys A] ILD Multidisciplinary Unit, Hospital Universitari Bellvitge, IDIBELL, Universitat de Barcelona, Hospitalet de Llobregat, Spain. [Arias-Salgado EG] Biomedical Research Institute CSIC/UAM, IdIPAZ, Madrid, Spain. Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Madrid, Spain. [Berastegui C, Román A] Servei de Pneumologia, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Vall d'Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. [González-Montelongo R, Lorenzo-Salazar JM] Genomics Division, Instituto Tecnológico y de Energías Renovables, Santa Cruz de Tenerife, Spain, and Vall d'Hebron Barcelona Hospital Campus
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0301 basic medicine ,Telomerase ,Medicine (General) ,Respiratory Tract Diseases::Lung Diseases::Lung Diseases, Interstitial [DISEASES] ,medicine.medical_treatment ,law.invention ,0302 clinical medicine ,telomere shortening ,law ,telomere disorders ,Pulmonary fibrosis ,Medicine ,genetics ,Surgical Procedures, Operative::Surgical Procedures, Operative::Transplantation::Organ Transplantation::Lung Transplantation [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,Original Research ,interstitial lung disease ,Otros calificadores::Otros calificadores::/genética [Otros calificadores] ,Interstitial lung disease ,General Medicine ,Intensive care unit ,medicine.anatomical_structure ,medicine.medical_specialty ,03 medical and health sciences ,R5-920 ,Internal medicine ,Transplantation of organs, tissues, etc ,Other subheadings::Other subheadings::/genetics [Other subheadings] ,lung transplantation ,Lung transplantation ,Fibrosi pulmonar - Aspectes genètics ,Lung ,pulmonary fibrosis ,business.industry ,Extracorporeal circulation ,diagnóstico::pronóstico::resultado del tratamiento [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,Pulmó ,Diagnosis::Prognosis::Treatment Outcome [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,medicine.disease ,Transplantation ,Trasplantament d'òrgans ,Pulmons - Trasplantació ,030104 developmental biology ,Anomalies cromosòmiques ,030228 respiratory system ,enfermedades respiratorias::enfermedades pulmonares::enfermedades pulmonares intersticiales [ENFERMEDADES] ,Chromosome abnormalities ,Avaluació de resultats (Assistència sanitària) ,intervenciones quirúrgicas::intervenciones quirúrgicas::trasplante::trasplante de órganos::trasplante de pulmón [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,Lungs ,business - Abstract
Trasplante de pulmón; Fibrosis pulmonar; Trastornos de los telómeros Trasplantament pulmonar; Fibrosi pulmonar; Trastorns dels telòmers Lung transplantation; Pulmonary fibrosis; Telomere disorders Introduction: Fibrotic interstitial lung diseases (ILDs) are the first indication for lung transplantation (LT). Telomere dysfunction has been associated with poor post-transplant outcomes. The aim of the study was to evaluate the morbi-mortality and quality of life in fibrotic ILDs after lung transplant depending on telomere biology. Methods: Fibrotic ILD patients that underwent lung transplant were allocated to two arms; with or without telomere dysfunction at diagnosis based on the telomere length and telomerase related gene mutations revealed by whole-exome sequencing. Post-transplant evaluation included: (1) short and long-term mortality and complications and (2) quality of life. Results: Fifty-five percent of patients that underwent LT carried rare coding mutations in telomerase-related genes. Patients with telomere shortening more frequently needed extracorporeal circulation and presented a higher rate of early post-transplant hematological complications, longer stay in the intensive care unit (ICU), and a higher number of long-term hospital admissions. However, post-transplant 1-year survival was higher than 80% regardless of telomere dysfunction, with improvement in the quality of life and oxygen therapy withdrawal. Conclusions: Post-transplant morbidity is higher in patients with telomere dysfunction and differs according to elapsed time from transplantation. However, lung transplant improves survival and quality of life and the associated complications are manageable. This study was funded by Instituto de Salud Carlos III through project PI18/00367 (Co-funded by European Regional Development Fund, ERDF, a way to build Europe), Spanish Society of Respiratory (SEPAR), Barcelona Respiratory Network (BRN), and Fundació Ramón Pla Armengol. RP laboratory was funded by grants PI20-00335 (Fondo de Investigaciones Sanitarias, Instituto de Salud Carlos III, Spain supported by FEDER funds). MM-M was funded by grants PI18/00367 (Fondo de Investigaciones Sanitarias, ISCIII, Spain, supported by FEDER funds), AC19/00006 (Projects of International Programs, ISCIII, Spain, supported by FEDER funds), Cohorte FPI CIBERES-ISCIII, Barcelona Respiratory Network-Fundation Ramon Pla Armengol, Spanish Society of Respiratory (SEPAR), and Catalan Society of Respiratory (SOCAP-FUCAP). CF was funded by Ministerio de Ciencia e Innovación (grant RTC-2017-6471-1; AEI/FEDER, UE), and by Cabildo Insular de Tenerife (CGIEU0000219140).
- Published
- 2021