Tu1108 Pre-Transplant Proton Pump Inhibitor Is Not Associated With Improved Survival of Lung Allografts

Abstract

Background Gastroesophageal reflux disease (GERD) has been identified as a possible contributor of aspiration after lung transplantation that leads to graft failure and increased mortality. This study was designed to investigate whether the usage of proton pump inhibitor (PPI) pre-transplant is associated with decreased posttransplant mortality and/or retransplant. Methods A total of 324 consecutive patients who underwent lung transplant from January 2009 to June 2012 were retrospectively reviewed. Demographic information and baseline clinical characteristics of lung transplant recipients were collected. Clinical variables were compared between patients with and without clinical events determined as all-cause mortality and/or re-transplant. Usage of PPI were analyzed between recipients with clinical events (n= 78) and those without events (n= 246). Perioperative events were defined as events that occurred within 30 days after transplant. Results The cohort comprised of 58.3% male (189 of 324) with mean age (SD) of 58(13). Majority of patients had double lung transplant (62.8%; 203 of 324). Mean (SD) follow up interval was 2.0 (1.2) year. Idiopathic pulmonary fibrosis was the leading primary lung pathology (46.9%), followed by COPD (23.1%) and cystic fibrosis (6.5%). Prevalence of GERD prior to transplant was 42% (137 of 324). Clinical events occurred in 25% (78 of 324) of the cohort (66 death and 12 retransplants). Of those, 29.5% (23 of 78) were perioperative. There was no statistically significant difference in percentage use of PPI between patients with and without events (54.7% VS 53.0% respectively; p 0.927). Subgroup analysis in patients with diagnosis of GERD pre-transplant also demonstrated no significant difference in PPI use in the two groups (78.8% VS 83.7%; p 0.522). Kaplan Meier survival analysis revealed no significant difference in both mortality (p 0.874) and overall graft survival (p 0.806) as shown in Figure 1. Conclusion Use of proton pump inhibitors prior to transplantation is not associated with increased allografts survival in lung transplant recipients. Baseline characteristics and study variables categorized by clinical events.