Outcomes following lung transplantation for interstitial lung diseases in New Zealand: a retrospective review.

Abstract

Background: Interstitial lung diseases (ILDs) are a heterogeneous group of diseases that have limited treatment options and can lead to progressive respiratory failures. Lung transplantation offers a therapeutic option for selected patients. There are no New Zealand data published regarding outcomes of those who received lung transplantation for ILDs.

Aims: We assessed survival outcomes after lung transplantation for ILDs in New Zealand, comparing bilateral versus single-lung transplants and size-matched versus mismatched lungs.

Methods: A retrospective, single-centre study included ILD patients who underwent lung transplantation from December 2006 to March 2023. Baseline characteristics, survival and post-transplant complications were analysed. Size matching was based on predicted total lung capacity ratios.

Results: Fourty-four patients underwent lung transplantation for ILDs during this period, with a median recipient age of 54 years old. Median survival was 6.2 years; 30-day and 1-, 3-, 5- and 7-year survival rates were 84%, 80%, 66%, 58% and 49% respectively. Survival did not differ between bilateral and single lung transplants (P = 0.42) or between size matched and mismatched transplants (P = 0.58). Single lung transplants had shorter intensive care unit (ICU) stays and less intra-operative cardiopulmonary bypass use.

Conclusion: Lung transplantation for ILDs in New Zealand achieves survival outcomes comparable to international centres. No significant survival differences were found between bilateral and single-lung transplants or between sizes matched and mismatched lungs. Single-lung transplantation may offer advantages such as shorter ICU stays and reduced cardiopulmonary bypass use. Careful patient selection, especially in older patients, may improve outcomes.