Conclusions

This observational study indicates variability in the use of anti-fibrotic drugs prior to lung transplant in patients with IPF.
Descriptive analyses did not suggest differences in the following outcomes depending on when anti-fibrotic therapy was discontinued relative to transplant: need for intra-operative red blood cell transfusion; primary graft dysfunction; surgical wound dehiscence; survival to discharge; length of stay in hospital.
Anastomotic and sternal dehiscence were only seen in patients whose anti-fibrotic therapy was discontinued <5 medication half-lives prior to transplant; however, these events were infrequent.
The possibility of disease acceleration and waitlist death with cessation of anti-fibrotic therapy at listing needs to be balanced against the potential for intra- and post-operative complications related to anti-fibrotic therapy.
The full data set from this study will provide additional insights, but further study will be needed to determine the optimal time to discontinue anti-fibrotic drugs prior to lung transplant.