Clinical efficacy of lung transplantation for combined pulmonary fibrosis and emphysema syndrome

Background The clinical efficacy of lung transplantation for the treatment of CPFE remains unclear. Methods Clinical data of patients with CPFE who underwent lung transplantation at the Affiliated Wuxi People's Hospital of Nanjing Medical University between January 2018 and December 2021 were retrospectively reviewed. They were divided into the SLT and BLT groups. Results Fifty-seven patients with CPFE, including 33 in the SLT group and 24 in the BLT group, were included. Patients in the BLT group were younger and had a longer surgery duration and extracorporeal membrane oxygenation support time, more blood loss and transfusion requirements, and lower pulmonary artery pressure postoperatively. The carbon monoxide diffusion capacity (DLCO) was significantly better after BLT than after SLT (P = 0.0026). The risk of short- and medium-term mortality after BLT was 21.4 % of that after SLT, though the survival rate was not significantly different between the groups. Conclusion After good and effective perioperative management, lung transplantation is feasible for patients with CPFE, which effectively improves the lung function, oxygenation index and pulmonary artery pressure, and prolongs survival. Short - and medium-term survival rates were similar between SLT group and BLT group, but BLT resulted in a better improvement of DLCO and a lower risk of death. Patients aged 65 years or older have worse survival rates after lung transplantation.