Pirfenidone exerts beneficial effects in patients with IPF undergoing single lung transplantation

Pirfenidonedemonstrated pleiotropic antiinflammatory effects in various experimental and clinical settings. The aim of this study was to assess the impact of previous treatment with pirfenidoneon short-term outcomes after single lung transplantation (SLTx). Therefore, patients with idiopathic pulmonary fibrosis(IPF) who were undergoing SLTx were screened retrospectively for previous use of pirfenidoneand compared to respective controls. Baseline parameters and short-term outcomes were recorded and analyzed. In total, 17 patients with pirfenidonewere compared with 26 patients without antifibrotic treatment. Baseline characteristics and severity of disease did not differ between groups. Use of pirfenidonedid not increase blood loss, wound-healing, or anastomotic complications. Severity of primary graft dysfunction at 72~hours was less (0.3~±~0.6 vs 1.4~±~1.3, P~=~.002), and length of mechanical ventilation (37.5~±~34.8 vs 118.5~±~151.0~hours, P~=~.016) and intensive care unit (ICU) stay (6.6~±~7.1 vs 15.6~±~20.3, P~=~.089) were shorter in patients with pirfenidonetreatment. An independent beneficial effect of pirfenidonewas confirmed by regression analysis while controlling for confounding variables (P~=~.016). Finally, incidence of acute cellular rejections within the first 30~days after SLTx was lower in patients with previous pirfenidonetreatment (0.0% vs 19.2%; P~=~.040). Our data suggest a beneficial role of previous use of pirfenidonein patients with IPF who were undergoing SLTx.