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Published ahead of print on February 13, 2003, doi:10.1164/rccm.200205-410OC

Am. J. Respir. Crit. Care Med., Volume 167, Number 9, May 2003, 1271-1278

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Submitted on May 10, 2002
Accepted on February 5, 2003

Statin Use is Associated with Improved Function and Survival of Lung Allografts

Bruce A Johnson1, Aldo T Iacono1, Adriana Zeevi1, Kenneth R McCurry1, and Steven R Duncan1*

1 Medicine and Surgery, University of Pittsburgh, Pittsburgh, PA, USA

* To whom correspondence should be addressed. E-mail: duncsr{at}msx.upmc.edu.

3-Hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) are widely used anti-lipidemic agents that are also immunomodulatory. We evaluated possible effects of these agents following lung transplantation by comparing outcomes of 39 allograft recipients who were prescribed statins for hyperlipedemia, to those of 161 contemporaneous control recipients who did not receive these drugs. Acute rejection >=Grade II was less frequently found in the statin group (15.1 versus 25.6% of biopsies, p<0.01). None of 15 recipients started on statins during postoperative year one developed obliterative bronchiolitis, whereas cumulative incidence of this complications among controls was 37% (p<0.01). Total cellularity, as well as proportions of inflammatory neutrophils and lymphocytes, were significantly lower in bronchoalveolar lavages of statin recipients. Among double-lung recipients, those taking statins had significantly better spirometry: FVC (80 ± 2 versus 70 ± 1) and FEV1 (87 ± 2 versus 70 ± 1), as percentages of predicted values, and absolute FEV1/FVC (83.4 ± 1.2 versus 78.6 ± 0.5) (all p<0.01). The 6-year survival of recipients on statins (91%) was much greater than controls (54%) (p<0.01). These data suggest statin use may have substantial clinical benefits following pulmonary transplantation.
Key words: Transplantation, Hydroxymethylglutaryl CoA Reductase Inhibitors, Graft Rejection, Bronchiolitis Obliterans




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