Survival benefit of lung transplantation for patients with idiopathic pulmonary fibrosis

J Thorac Cardiovasc Surg. 2003 Aug;126(2):469-75. doi: 10.1016/s0022-5223(03)00600-7.


Objective: Although lung transplantation is viewed as an acceptable option for patients with end-stage idiopathic pulmonary fibrosis, the survival benefit of this approach is still debated. This study examined whether there was a survival benefit of lung transplantation in a cohort of patients referred to our transplant center with a diagnosis of idiopathic pulmonary fibrosis according to American Thoracic Society criteria.

Methods: Forty-six patients accepted for lung transplantation during a 12-year period with a diagnosis of idiopathic pulmonary fibrosis form the basis of this study. Survival benefit offered by lung transplantation was assessed using Cox proportional-hazards modeling, with patients on a waiting list as the control group.

Results: Twenty-eight patients underwent lung transplantation (27 single and 1 double), 16 patients died while waiting, and 2 patients remained on the active waiting list. Diagnosis of idiopathic pulmonary fibrosis was made on histologic examination of the explanted lung or lung biopsy before lung transplantation. There was a pattern of usual interstitial pneumonia in 31 cases (67%). The 15 remaining patients fulfilled all American Thoracic Society criteria for idiopathic pulmonary fibrosis. The median waiting time for organs was 51 days. Survival after lung transplantation was 79.4% at 1 year, 63.5% at 2 years, and 39% at 5 years. The multivariable analysis showed that lung transplantation reduced the risk of death by 75% (95% confidence interval, 8%-86%; P =.03) after adjustment on potential confounding variables.

Conclusions: Lung transplantation is effective in improving the survival of selected patients affected by idiopathic pulmonary fibrosis.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Biopsy
  • Cohort Studies
  • Exercise Tolerance / physiology
  • Female
  • Follow-Up Studies
  • France
  • Humans
  • Lung / pathology
  • Lung / physiopathology
  • Lung Transplantation / mortality*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Pulmonary Fibrosis / etiology*
  • Pulmonary Fibrosis / mortality
  • Pulmonary Fibrosis / surgery*
  • Severity of Illness Index
  • Statistics as Topic
  • Survival Analysis
  • Time Factors
  • Total Lung Capacity / physiology
  • Treatment Outcome
  • Waiting Lists