Abstract
Background
The early experience of lung transplantation was plagued with airway anastomotic complications.
The use of corticosteroids in the pre-transplant period has been implicated as a major
contributing factor in bronchial dehiscence, and many patients have been denied transplantation
on the basis of corticosteroid use. We conducted the current study to assess the risks
associated with pre-transplant corticosteroid use.
Methods
We analyzed records of 73 single- and bilateral-single lung transplant recipients
who had chronic obstructive pulmonary disease or α1-antitrypsin deficiency as their underlying disease from 1986 to 1996. Twenty-six
patients (steroid group) received daily corticosteroid therapy (prednisone, 1.5 to
40 mg/day) up to the time of transplantation, whereas 47 patients did not receive
chronic corticosteroids and had no corticosteroid therapy within 3 months of transplantation
(non-steroid group).
Results
The demographic profiles of the 2 groups were comparable. We noted no statistical
significances in length of hospital stay, duration of intensive care, and post-operative
pulmonary function. The rates of cytomegalovirus infection, acute rejection, bronchiolitis
obliterans syndrome, and survival were also similar. The non-steroid group seemed
to have a higher rate of bronchial stenosis at 3 years (29% vs 6%, p = 0.03). Bronchial dehiscence did not occur in either study group.
Conclusions
Pre-transplant use of corticosteroids does not adversely affect outcome following
lung transplantation.
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Article info
Publication history
Accepted:
October 26,
2000
Received:
October 25,
1999
Identification
Copyright
© 2001 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.
