Letter to the Editor
End-stage silicosis and lung transplantation: A way forward
Silicose em estádio terminal e transplante pulmonar: Um caminho a seguir
M.T. Redondo
, M. Vaz, C. Damas
Corresponding author
Department of Pneumology, Centro Hospitalar de São João, Porto, Portugal
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Redondo, M. Vaz, C. Damas" "autores" => array:3 [ 0 => array:4 [ "nombre" => "M.T." "apellidos" => "Redondo" "email" => array:1 [ 0 => "margarida.tredondo@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Vaz" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Damas" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Department of Pneumology, Centro Hospitalar de São João, Porto, Portugal" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Silicose em estádio terminal e transplante pulmonar: Um caminho a seguir" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Lung transplantation is an available and accepted therapy for the management of a wide range of severe lung disorders.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Silicosis is a progressive, fibrotic, occupational lung disease. End-stage silicosis is one of the accepted indications for lung transplantation, although there is little published data on this topic.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The aim of our study was to investigate the selection of recipients and follow-up of lung transplantation for silicosis.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Data from all lung transplant patients with silicosis followed at Centro Hospitalar São João between 2008 and 2013, were retrospectively analyzed.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Six males with a mean age of 55.5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>6.9 years underwent lung transplantation for silicosis. Of the 6 patients, 3 subjects worked in water exploration wells, 1 was a sandblasting worker, 1 slate mine worker and 1 quarry worker. At the time of referral for lung transplant, functional lung characteristics were as follows: FVC 50.20<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>10.8% predicted and FEV1 40.48<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>7.9% predicted. The mean pulmonary artery pressure was 61<span class="elsevierStyleHsp" style=""></span>mm Hg estimated by echocardiography. Mean time between the first observation and lung transplant was 18.5 months. All patients underwent single lung transplantation, 4 patients underwent left lung transplantation. There was no perioperative mortality, although two patients developed primary graft dysfunction after transplant. During follow-up, two recipients had cytomegalovirus infection. All recipients are alive with a mean follow-up time of 32.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>17.2 months, with a good quality of life (measured by the Portuguese version of the Medical Outcomes Study, Short Form-36,<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> presented as the median of the subscales: physical-function 54.0<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>39.1, general health 52.4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>25.7, vitality 54.0<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>19.5, social functioning 70.0<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>31.4, mental health 56.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>19.9) and improved lung function (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Despite the global efforts of prevention, silicosis remains a worldwide occupational lung disease. There is no proven specific therapy for silicosis<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> and this disease can be a lethal with poor prognosis. Our study demonstrated that selected patients with end-stage silicosis can benefit from lung transplantation. This study can also contribute to the current knowledge about this specific and rare indication for lung transplantation.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interest</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflict of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Before transplantation \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">After transplantation \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">FVC, % predicted \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">50.20<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>10.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">60.80<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>11.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">FEV1, % predicted \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">40.48<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>7.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">73.95<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>16.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">FEV1/FVC ratio \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">63.47<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>17.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">66.38<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>11.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab888010.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Lung functional parameters of patients before and after lung transplant.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "International guidelines for the selection of lung transplant candidates: 2006 update – a consensus report from the pulmonary scientific council of the international society for heart and lung transplantation" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.B. Orens" 1 => "M. Estenne" 2 => "S. Arcosy" 3 => "J.V. Conte" 4 => "P. Corris" 5 => "J.J. Egan" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Heart Lung Transpl" "fecha" => "2006" "volumen" => "25" "paginaInicial" => "745" "paginaFinal" => "755" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Silicosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C.C. Leung" 1 => "I.T. Yu" 2 => "W. Chen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0140-6736(12)60235-9" "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "2012" "volumen" => "379" "paginaInicial" => "2008" "paginaFinal" => "2018" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22534002" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Development of the Portuguese version of MOS SF-36: Part I. Cultural and linguistic adaptation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "P.L. Ferreira" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Acta Med Port" "fecha" => "2000" "volumen" => "13" "numero" => "1–2" "paginaInicial" => "55" "paginaFinal" => "66" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11059056" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/08732159/0000002000000006/v2_201509071019/S0873215914001299/v2_201509071019/en/main.assets" "Apartado" => array:4 [ "identificador" => "19161" "tipo" => "SECCION" "pt" => array:2 [ "titulo" => "Cartas ao editor" "idiomaDefecto" => true ] "idiomaDefecto" => "pt" ] "PDF" => "https://static.elsevier.es/multimedia/08732159/0000002000000006/v2_201509071019/S0873215914001299/v2_201509071019/en/main.pdf?idApp=UINPBA00004E&text.app=https://journalpulmonology.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215914001299?idApp=UINPBA00004E" ]
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