American College of Chest Physicians, Oct. 18-21

The 86th Annual Meeting of the American College of Chest Physicians

The annual meeting of the American College of Chest Physicians was held virtually this year from Oct. 18 to 21 and attracted participants from around the world, including specialists and health care professionals in the fields of pulmonology, critical care, and sleep medicine. The conference featured presentations focusing on clinical updates in thoracic medicine.

In one study, Sung Choi, M.D., of the Rutgers New Jersey Medical School in Newark, and colleagues found that lung transplantation recipients’ smoking history impacts posttransplantation mortality rates in a dose-dependent manner.

Using the United Network for Organ Sharing Standard Transplant Analysis and Research database, the authors identified individuals older than 18 years of age who received either a single or double lung transplant between 1987 and 2017. The recipients were categorized by smoking history (no smoking history, less than 10 pack-years, 10 to 20 pack-years, and greater than 20 pack-years), and adjustments were made for various recipient and donor variables. The researchers found that recipients with a longer/more smoking history fared worse one year after transplantation compared with those with a shorter/less smoking history. In addition, recipients who were reported to have had 10 to 20 pack-years of smoking history had a 25 percent increase in the one-year posttransplantation mortality rate compared with those with no smoking history. Meanwhile, the recipients with 20 pack-years of smoking history had a 70 percent increase in the posttransplantation mortality rate compared with those with no smoking history.

“Interestingly, there was no statistically significant difference between patients with less than 10 pack-years of smoking history compared to those with no smoking history,” Choi said. “Current guidelines for lung transplantation (International Society for Heart and Lung Transplantation) suggest active tobacco smoking history as an absolute contraindication, but it does not make further recommendations regarding patients’ overall smoking history. As a clinician, one should consider patients’ extensive smoking history when evaluating for potential lung transplantation.”

Abstract

In a subgroup analysis of the Efficacy and Safety of Nintedanib in Patients With Progressive Fibrosing Interstitial Lung Disease (INBUILD) study, Shane Shapera, M.D., of the Toronto General Hospital Research Institute, and colleagues found that a subset of individuals with progressive fibrosing interstitial lung disease (PF-ILD) in the United States and Canada enrolled in INBUILD had similar outcomes to the overall population enrolled in INBUILD in other parts of the world.