Effect of pirfenidone on wound healing in lung transplant patients
Abstract Background The drug pirfenidone has been shown to slow the progression and decrease mortality of idiopathic pulmonary fibrosis (IPF). Its exact mechanism is unknown, but it likely inhibits pro-fibrotic cytokine transforming growth factor beta, a known contributor to wound healing. We evalua...
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Format: | Article |
Language: | English |
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PAGEPress Publications
2018-06-01
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Series: | Multidisciplinary Respiratory Medicine |
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Online Access: | http://link.springer.com/article/10.1186/s40248-018-0129-4 |
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author | Amber Mortensen Lauren Cherrier Rajat Walia |
author_facet | Amber Mortensen Lauren Cherrier Rajat Walia |
author_sort | Amber Mortensen |
collection | DOAJ |
description | Abstract Background The drug pirfenidone has been shown to slow the progression and decrease mortality of idiopathic pulmonary fibrosis (IPF). Its exact mechanism is unknown, but it likely inhibits pro-fibrotic cytokine transforming growth factor beta, a known contributor to wound healing. We evaluated whether patients taking pirfenidone until lung transplantation had increased risk of impaired wound healing post-transplant. This information could determine whether pirfenidone should be discontinued prior to listing to allow for a wash-out period. Methods We retrospectively reviewed patients who underwent lung transplantation for pulmonary fibrosis at Norton Thoracic Institute in Phoenix, Arizona, from January 2014 to December 2015. Results We describe 18 patients who took pirfenidone up to a month before transplant. Aside from one patient who experienced sternal dehiscence due to a surgical issue, all remaining patients did well with no evidence of airway dehiscence. Each of these 17 patients had been on pirfenidone for at least 30 days; nine patients had been on pirfenidone for over 90 days. Baseline characteristics including age, sex, body mass index, renal function, liver function, glucose level, pre-transplant corticosteroid use, and post-transplant immunosuppressant therapy were similar. Conclusions In our experience, pirfenidone may be safely continued until lung transplantation. Only one patient in our series experienced impaired wound healing related to a surgical issue, even when pirfenidone was continued until lung transplantation. We found no evidence of impaired wound healing or airway complications after lung transplantation in patients who were treated with pirfenidone before lung transplantation. |
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format | Article |
id | doaj.art-2858bfdc962e4f6cb5405125766614e8 |
institution | Directory Open Access Journal |
issn | 2049-6958 |
language | English |
last_indexed | 2024-03-07T17:08:35Z |
publishDate | 2018-06-01 |
publisher | PAGEPress Publications |
record_format | Article |
series | Multidisciplinary Respiratory Medicine |
spelling | doaj.art-2858bfdc962e4f6cb5405125766614e82024-03-03T02:04:52ZengPAGEPress PublicationsMultidisciplinary Respiratory Medicine2049-69582018-06-011311510.1186/s40248-018-0129-4Effect of pirfenidone on wound healing in lung transplant patientsAmber Mortensen0Lauren Cherrier1Rajat Walia2Department of Pharmacy, St. Joseph’s Hospital and Medical CenterDepartment of Pharmacy, St. Joseph’s Hospital and Medical CenterDivision of Pulmonology, Norton Thoracic Institute, St. Joseph’s Hospital and Medical CenterAbstract Background The drug pirfenidone has been shown to slow the progression and decrease mortality of idiopathic pulmonary fibrosis (IPF). Its exact mechanism is unknown, but it likely inhibits pro-fibrotic cytokine transforming growth factor beta, a known contributor to wound healing. We evaluated whether patients taking pirfenidone until lung transplantation had increased risk of impaired wound healing post-transplant. This information could determine whether pirfenidone should be discontinued prior to listing to allow for a wash-out period. Methods We retrospectively reviewed patients who underwent lung transplantation for pulmonary fibrosis at Norton Thoracic Institute in Phoenix, Arizona, from January 2014 to December 2015. Results We describe 18 patients who took pirfenidone up to a month before transplant. Aside from one patient who experienced sternal dehiscence due to a surgical issue, all remaining patients did well with no evidence of airway dehiscence. Each of these 17 patients had been on pirfenidone for at least 30 days; nine patients had been on pirfenidone for over 90 days. Baseline characteristics including age, sex, body mass index, renal function, liver function, glucose level, pre-transplant corticosteroid use, and post-transplant immunosuppressant therapy were similar. Conclusions In our experience, pirfenidone may be safely continued until lung transplantation. Only one patient in our series experienced impaired wound healing related to a surgical issue, even when pirfenidone was continued until lung transplantation. We found no evidence of impaired wound healing or airway complications after lung transplantation in patients who were treated with pirfenidone before lung transplantation.http://link.springer.com/article/10.1186/s40248-018-0129-4Idiopathic pulmonary fibrosis/drug therapyIdiopathic pulmonary fibrosis/surgeryLung transplantationPirfenidoneSurgical wound dehiscenceWound healing |
spellingShingle | Amber Mortensen Lauren Cherrier Rajat Walia Effect of pirfenidone on wound healing in lung transplant patients Multidisciplinary Respiratory Medicine Idiopathic pulmonary fibrosis/drug therapy Idiopathic pulmonary fibrosis/surgery Lung transplantation Pirfenidone Surgical wound dehiscence Wound healing |
title | Effect of pirfenidone on wound healing in lung transplant patients |
title_full | Effect of pirfenidone on wound healing in lung transplant patients |
title_fullStr | Effect of pirfenidone on wound healing in lung transplant patients |
title_full_unstemmed | Effect of pirfenidone on wound healing in lung transplant patients |
title_short | Effect of pirfenidone on wound healing in lung transplant patients |
title_sort | effect of pirfenidone on wound healing in lung transplant patients |
topic | Idiopathic pulmonary fibrosis/drug therapy Idiopathic pulmonary fibrosis/surgery Lung transplantation Pirfenidone Surgical wound dehiscence Wound healing |
url | http://link.springer.com/article/10.1186/s40248-018-0129-4 |
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