Background: Following recent approval of pirfenidone and nintedanib for idiopathic pulmonary fibrosis (IPF),\nquestions arise about the use of these antifibrotics in patients awaiting lung transplantation (LTx).\nMethods: Safety and efficacy of antifibrotic drugs in IPF patients undergoing LTx were investigated in a single-centre\nretrospective cohort analysis.\nResults: A total of nine patients, receiving antifibrotic therapy for 419 Ã?± 315 days until subsequent LTx, were included. No\nmajor side effects were noted. Significant weight loss occurred during antifibrotic treatment (p = 0.0062). FVC tended to\nstabilize after 12 weeks of treatment in most patients. A moderate decline in FVC, TLC and DLCO was noted during the\nwhole pretransplant time period of antifibrotic therapy. Functional exercise capacity and lung allocation score remained\nunchanged. No post-operative thoracic wound healing problems, nor severe early anastomotic airway complications\nwere attributable to prior antifibrotic treatment. None of the patients developed chronic lung allograft dysfunction after a\nmedian follow-up of 19.8 (11.2ââ?¬â??26.5) months; and post-transplant survival was 100% after 1 year and 80% after 2 years.\nConclusions: Antifibrotic drugs can probably be safely administered in IPF patients, possibly attenuating disease\nprogression over time, while awaiting LTx.
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