Lung-Liver Transplantation Has a Protective Effect on Long-Term Survival in Cystic Fibrosis and Interstitial Pulmonary Fibrosis

Purpose Lung-liver transplantation (LLTx) is a rare but life-saving treatment option. Survival of patients with end-stage lung and liver disease undergoing LLTx is not well studied. This study aims to compare outcomes of LLTx to lung transplantation alone (LTx). Methods The UNOS registry was queried for patients listed for bilateral LTx or LLTx from 1/1987 - 9/2020. Using propensity score matching (PSM), LLTx and LTx patients diagnosed with Cystic Fibrosis (CF) or Interstitial pulmonary fibrosis (IPF) were matched on a 2:1 ratio using Lung Allocation Score, sex, bilirubin, glomerular filtration rate (GFR) and forced expiratory volume at transplant. Results LLTx was performed in 131 patients. Median age was 30 yrs [range: 3-67] for LLTx and 54 yrs [0-79] for LTx patients (n=26,727; p Conclusion LLTx shows comparable survival outcomes to LTx in CF and IPF patients. LLTx is associated with lower incidence of BOS and consequently offers better long-term outcomes. Thus, CF and IPF patients with end-stage lung and liver disease should be considered for LLTx.