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The impact of long-term air pollution and traffic on outcome after lung transplantation in Europe

David Ruttens, Stijn Verleden, Esmee Bijnens, Ellen Winckelmans, Jens Gottlieb, Gregor Warnecke, Federica Meloni, Monica Morosini, Davide Piloni, Wim Van der Bij, Erik Verschuuren, Gerhard Weinreich, Markus Kamler, Urte Sommerwerck, Antonio Roman, Susana Gomez-Olles, Cristina Berastegui, Christian Benden, Are Holm, Martin Iversen, Hans-Henrik Schultz, Bart Luijk, Erik-Jan Oudijk, Diane Van Kessel, Johanna Kwakkel-van-Erp, Peter Jaksch, Walter Klepetko, Nikolaus Kneidinger, Claus Neurohr, Paul Corris, Andy Fisher, Gerard Meachery, Jim Lordan, Elly Vandermeulen, Hannelore Bellon, Barbara Hoffmann, Kees De Hoogh, Danielle Vienneau, Gerard Hoek, Benoit Nemery, Geert Verleden, Robin Vos, Tim Nawrot, Bart Vanaudenaerde
European Respiratory Journal 2015 46: OA3270; DOI: 10.1183/13993003.congress-2015.OA3270
David Ruttens
1KUleuven, KUleuven, Leuven, Belgium
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Stijn Verleden
1KUleuven, KUleuven, Leuven, Belgium
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Esmee Bijnens
2KUleuven, KUleuven, Hasselt, Belgium
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Ellen Winckelmans
2KUleuven, KUleuven, Hasselt, Belgium
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Jens Gottlieb
3Hannover Medical School, Hannover Medical School, Hannover, Germany
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Gregor Warnecke
3Hannover Medical School, Hannover Medical School, Hannover, Germany
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Federica Meloni
4Universita degli Studi di Pavia, Universita Degli Studi di Pavia, Pavia, Italy
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Monica Morosini
4Universita degli Studi di Pavia, Universita Degli Studi di Pavia, Pavia, Italy
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Davide Piloni
4Universita degli Studi di Pavia, Universita Degli Studi di Pavia, Pavia, Italy
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Wim Van der Bij
5Rijksuniversiteit Groningen, Rijksuniversiteit Groningen, Groningen, Netherlands
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Erik Verschuuren
5Rijksuniversiteit Groningen, Rijksuniversiteit Groningen, Groningen, Netherlands
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Gerhard Weinreich
6Department of Pneumology, Ruhrlandklinik, Department of Pneumology, Ruhrlandklinik, Essen, Germany
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Markus Kamler
6Department of Pneumology, Ruhrlandklinik, Department of Pneumology, Ruhrlandklinik, Essen, Germany
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Urte Sommerwerck
6Department of Pneumology, Ruhrlandklinik, Department of Pneumology, Ruhrlandklinik, Essen, Germany
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Antonio Roman
7University Hospital Vall d'Hebron, University Hospital Vall d'Hebron, Barcelona, Spain
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Susana Gomez-Olles
7University Hospital Vall d'Hebron, University Hospital Vall d'Hebron, Barcelona, Spain
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Cristina Berastegui
7University Hospital Vall d'Hebron, University Hospital Vall d'Hebron, Barcelona, Spain
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Christian Benden
8University Hospital Zurich, University Hospital Zurich, Zurich, Switzerland
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Are Holm
9University of Oslo, University of Oslo, Oslo, Norway
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Martin Iversen
10Copenhagen University Hospital RigsHospitalet, Copenhagen University Hospital RigsHospitalet, Copenhagen, Denmark
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Hans-Henrik Schultz
10Copenhagen University Hospital RigsHospitalet, Copenhagen University Hospital RigsHospitalet, Copenhagen, Denmark
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Bart Luijk
11University Medical Centre Utrecht/ St. Antonius Hospital Nieuwegein, University Medical Centre Utrecht/ St. Antonius Hospital Nieuwegein, Utrecht, Netherlands
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Erik-Jan Oudijk
11University Medical Centre Utrecht/ St. Antonius Hospital Nieuwegein, University Medical Centre Utrecht/ St. Antonius Hospital Nieuwegein, Utrecht, Netherlands
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Diane Van Kessel
11University Medical Centre Utrecht/ St. Antonius Hospital Nieuwegein, University Medical Centre Utrecht/ St. Antonius Hospital Nieuwegein, Utrecht, Netherlands
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Johanna Kwakkel-van-Erp
11University Medical Centre Utrecht/ St. Antonius Hospital Nieuwegein, University Medical Centre Utrecht/ St. Antonius Hospital Nieuwegein, Utrecht, Netherlands
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Peter Jaksch
12University of Vienna, University of Vienna, Vienna, Austria
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Walter Klepetko
12University of Vienna, University of Vienna, Vienna, Austria
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Nikolaus Kneidinger
13Klinikum Großhadern der LMU, Klinikum Grosshadern der LMU, Munich, Germany
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Claus Neurohr
13Klinikum Großhadern der LMU, Klinikum Grosshadern der LMU, Munich, Germany
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Paul Corris
14Newcastle University, Newcastle University, Newcaslte, United Kingdom
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Andy Fisher
14Newcastle University, Newcastle University, Newcaslte, United Kingdom
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Gerard Meachery
14Newcastle University, Newcastle University, Newcaslte, United Kingdom
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Jim Lordan
14Newcastle University, Newcastle University, Newcaslte, United Kingdom
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Elly Vandermeulen
1KUleuven, KUleuven, Leuven, Belgium
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Hannelore Bellon
1KUleuven, KUleuven, Leuven, Belgium
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Barbara Hoffmann
15IUF Leibniz Research Institute for Environmental Medicine and Medical Faculty, University of Duesseldorf, IUF Leibniz Research Institute for Environmental Medicine and Medical Faculty, University of Duesseldorf, Duesseldorf, Germany
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Kees De Hoogh
16Swiss Tropical and Public Health Institute, Basel, Swiss Tropical and Public Health Institute, Basel, Switzerland, Basel, Switzerland
17University of Basel, University of Basel, Basel, Switzerland
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Danielle Vienneau
16Swiss Tropical and Public Health Institute, Basel, Swiss Tropical and Public Health Institute, Basel, Switzerland, Basel, Switzerland
17University of Basel, University of Basel, Basel, Switzerland
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Gerard Hoek
11University Medical Centre Utrecht/ St. Antonius Hospital Nieuwegein, University Medical Centre Utrecht/ St. Antonius Hospital Nieuwegein, Utrecht, Netherlands
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Benoit Nemery
1KUleuven, KUleuven, Leuven, Belgium
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Geert Verleden
1KUleuven, KUleuven, Leuven, Belgium
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Robin Vos
1KUleuven, KUleuven, Leuven, Belgium
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Tim Nawrot
2KUleuven, KUleuven, Hasselt, Belgium
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Bart Vanaudenaerde
1KUleuven, KUleuven, Leuven, Belgium
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Abstract

It has been suggested that air pollution influences survival after lung transplantation (LTx).We investigated the association of long-term exposure to fine particles and traffic with mortality and chronic lung allograft dysfunction (CLAD).In 13 European LTx centers, patient characteristics were retrospectively collected. Patients transplanted <1990, early death (<90 days) and living>700 km from LTx center were excluded, resulting in 5,707 LTx patients. We estimated long-term particulate matter (PM10) exposure at home addresses with temporally adjusted land-use regression models and total road length within buffers zones around the home and using Cox regression. We associated this with incidence of CLAD and mortality, separately for patients taking macrolides or not. During follow-up (median 4.2 y), 2,767 patients developed CLAD and 2,718 died. In patients not taking AZI (n=3,551) air-pollution was associated with mortality and CLAD independent of covariates.The risk for dying increased by 22.0% for patients living in an area above the WHO air pollution standards (20 µg/m³) compared with residence <20 µg/m³. The density of roads within a 50-to-500m buffer zone around the home address was also associated with mortality and CLAD.

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No associations were observed in the macrolide-group (n=2,156).Air pollution is associated with worse prognosis after LTx and macrolides may prevent air pollution induced mortality.

  • Air pollution
  • Public health
  • Transplantation
  • Copyright ©ERS 2015
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The impact of long-term air pollution and traffic on outcome after lung transplantation in Europe
David Ruttens, Stijn Verleden, Esmee Bijnens, Ellen Winckelmans, Jens Gottlieb, Gregor Warnecke, Federica Meloni, Monica Morosini, Davide Piloni, Wim Van der Bij, Erik Verschuuren, Gerhard Weinreich, Markus Kamler, Urte Sommerwerck, Antonio Roman, Susana Gomez-Olles, Cristina Berastegui, Christian Benden, Are Holm, Martin Iversen, Hans-Henrik Schultz, Bart Luijk, Erik-Jan Oudijk, Diane Van Kessel, Johanna Kwakkel-van-Erp, Peter Jaksch, Walter Klepetko, Nikolaus Kneidinger, Claus Neurohr, Paul Corris, Andy Fisher, Gerard Meachery, Jim Lordan, Elly Vandermeulen, Hannelore Bellon, Barbara Hoffmann, Kees De Hoogh, Danielle Vienneau, Gerard Hoek, Benoit Nemery, Geert Verleden, Robin Vos, Tim Nawrot, Bart Vanaudenaerde
European Respiratory Journal Sep 2015, 46 (suppl 59) OA3270; DOI: 10.1183/13993003.congress-2015.OA3270

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The impact of long-term air pollution and traffic on outcome after lung transplantation in Europe
David Ruttens, Stijn Verleden, Esmee Bijnens, Ellen Winckelmans, Jens Gottlieb, Gregor Warnecke, Federica Meloni, Monica Morosini, Davide Piloni, Wim Van der Bij, Erik Verschuuren, Gerhard Weinreich, Markus Kamler, Urte Sommerwerck, Antonio Roman, Susana Gomez-Olles, Cristina Berastegui, Christian Benden, Are Holm, Martin Iversen, Hans-Henrik Schultz, Bart Luijk, Erik-Jan Oudijk, Diane Van Kessel, Johanna Kwakkel-van-Erp, Peter Jaksch, Walter Klepetko, Nikolaus Kneidinger, Claus Neurohr, Paul Corris, Andy Fisher, Gerard Meachery, Jim Lordan, Elly Vandermeulen, Hannelore Bellon, Barbara Hoffmann, Kees De Hoogh, Danielle Vienneau, Gerard Hoek, Benoit Nemery, Geert Verleden, Robin Vos, Tim Nawrot, Bart Vanaudenaerde
European Respiratory Journal Sep 2015, 46 (suppl 59) OA3270; DOI: 10.1183/13993003.congress-2015.OA3270
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More in this TOC Section

  • Oto score and medium-term outcomes in lung transplantation
  • Differences in the lipidomic profile of bronchial washing (BW) and bronchoalveolar lavage (BAL) in lung transplanted patients
  • Diffusion capacity as a predictor of prognosis after onset of CLAD
Show more 8.2 Transplantation

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