Photo Credit: iStock.com/ArtemisDiana

The following is a summary of “Outcomes of lung transplantation for end stage lung disease with connective tissue disease: a systematic review and meta-analysis,” published in the May 2025 issue of BMC Pulmonary Medicine by Liu et al. 

Lung transplantation had been the key intervention for end-stage lung disease, though its outcomes in individuals with connective tissue disease (CTD) and advanced pulmonary complications remained uncertain.  

Researchers conducted a retrospective study to compare survival rates and adverse event incidences between individuals with and without CTD who underwent lung transplantation for end-stage lung disease.  

They searched PubMed, Embase, Web of Science, Cochrane, Wanfang, VIP, CNKI, and CBM databases from inception to October 18, 2023, to identify eligible studies. Meta-analyses were conducted using Stata version 14.0 with a 95% CI. A fixed- or random-effects model was applied based on heterogeneity of results. The systematic review was registered in PROSPERO (CRD42023483687).  

The results showed that 12 studies were included, comprising 369 individuals with CTD and 2,165 without, all of whom underwent lung transplantation. Survival rates at 1 month (OR = 2.20, 95% CI: 0.75–6.47, P = 0.485), 6 months (OR = 0.61, 95% CI: 0.33–1.14, P = 0.099), 1 year (OR = 1.05, 95% CI: 0.66–1.66, P = 0.982), 2 years (OR = 0.50, 95% CI: 0.23–1.06, P = 0.096), 3 years (OR = 1.11, 95% CI: 0.70–1.78, P = 0.703), and 5 years (OR = 2.08, 95% CI: 1.11–3.91, P = 0.027) did not significantly differ except at 5 years. The incidence of grade 3 primary graft dysfunction (PGD) (OR = 1.33, 95% CI: 0.68–2.60, P = 0.184), rejection events (OR = 1.19, 95% CI: 0.61–2.32, P = 0.607), and intensive care unit (ICU) length of stay (SMD = 0.54, 95% CI: -0.26 to 1.34, P = 0.187) were similar between groups. Individuals with CTD had a higher risk of PGD (OR = 2.91, 95% CI: 1.43–5.95, P = 0.003), prolonged hospital stay after transplant (SMD = 0.52, 95% CI: 0.09–0.96, P = 0.009), and delayed extubation time (SMD = 0.68, 95% CI: 0.12–1.25, P = 0.023).  

Investigators concluded that survival and grade 3 PGD rates in patients with CTD after lung transplantation were comparable to others, supporting lung transplantation as a viable treatment while emphasizing the need to improve perioperative care to reduce post-transplant hospitalization. 

Source: bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-025-03640-x