Informace o publikaci

Lung Transplantation in Idiopathic Pulmonary Fibrosis Patients in the European MultiPartner IPF Registry: Challenges for Health Equity

Autoři	TOTH Nora M KRAMER Mordechai R STERCLOVA Martina MULLER Veronika LEWANDOWSKA Katarzyna B MOGULKOC Nesrin HAJKOVA Marta STUDNICKA Michael TEKAVEC-TRKANJEC Jasna DIMIC-JANJIC Sanja PENEV Anton ARSOVSKI Zoran GREGOR Jakub OVESNÁ Petra KOZIAR VASAKOVA Martina
Rok publikování	2025
Druh	Článek v odborném periodiku
Časopis / Zdroj	Biomedicines
Fakulta / Pracoviště MU	Lékařská fakulta
Citace
www	https://www.mdpi.com/2227-9059/13/11/2684
Doi	https://doi.org/10.3390/biomedicines13112684
Klíčová slova	idiopathic pulmonary fibrosis; lung transplantation; healthcare access; geographic disparities; transplant referral
Popis	Background: Despite advancements in pharmacological therapy, lung transplantation (LuTX) remains the only life-prolonging treatment in end-stage idiopathic pulmonary fibrosis (IPF). However, real-world referral patterns in Central and Eastern European (CEE) countries remain poorly characterized. We aimed to comprehensively review factors influencing referral and identify systemic barriers to LuTX access. Methods: Baseline characteristics of IPF patients potentially eligible for LuTX, enrolled in the European MultiPartner IPF Registry between 2012 and 2022 (n = 1256), were retrospectively analyzed. LuTX (n = 94) and potentially eligible but not transplanted (n = 1162) subgroups were compared. National experts also completed a questionnaire assessing transplant referral and listing practices across different healthcare systems. Results: Only 7.5% of potentially eligible subjects were transplanted, revealing substantial geographic disparities, with Israel having the highest rates (43.1%), followed by Austria (9.5%), Hungary (7.8%), and the Czech Republic (4.6%). LuTX patients were younger (60.2 +/- 7.4 vs. 62.6 +/- 6.2 years, p < 0.001), had worse lung function (FVC 60 +/- 15 vs. 74 +/- 21% predicted; p < 0.001, TLCO 41 +/- 15 vs. 49 +/- 19% predicted; p < 0.001), and were more likely to receive antifibrotic and oxygen therapies. The most frequent reasons for exclusion from referral/listing were age > 70 years and concomitant heart/renal failure. Conclusions: This first comprehensive CEE analysis demonstrates low IPF transplant rates with high inter-country variability. Patients presenting early with functionally advanced disease are more likely transplanted, while advanced age remains the primary exclusion factor, highlighting critical access gaps potentially contributing to regional outcome differences.