Abstract
Background: Silicosis is a rare indication for lung transplantion (LT). The number of patients with silicosis in Israel is increasing due to improper processing of a new quarts stone Caesarstone.
Methods and materials: We retrospectively reviewed the files of patients that were transplanted in Rabin Medical center (RMC) and compared the data to that of the ISHLT.
Results: According to the ISHLT registry out of 24,090 transplants 50 patients were transplanted for Silicosis between 1994-may 2009.
Out of 336 lung transplantations in RMC between 1997- may 2010 8 patients underwent LT for silicosis. There were more patients transplanted for silicosis in RMC compared to the ISHLT (p<0.01).
All of our patients were men, their average age being 50.5. Four underwent left LT 3 right LT and 1 bilateral sequential LT. Before transplant their average FEV1 and DLCO were 298.9 and 28.58, one patient was treated with ECMO. In all the patients the native lung extraction was difficult because of severe pleural adhesions.
Three patients died, due to technical failure, recurrent pneumothorax, and recurrent infections. Three patients had intra-operative bleeding, one of them needed a second operative procedure.
Post operative complications also included severe infections in 3 patients, severe primary graft dysfunction in 2 patients, injury to the phrenic nerve and diaphragm paralysis in 2 patients. According to the ISHLT 6 of 36 patients needed additional surgical procedure, and 20 out of 39 were treated for infection.
Conclusions: Compared to the ISHLT registry, in Israel there are more transplantations for silicosis. LT in patients with silicosis is technically difficult with higher morbidity and mortality.
- © 2011 ERS