One-year lung transplantation outcomes for engineered stone countertop workers with silicosis at a single center in Southern California, 2019 to 2023
Reice Robinson, MD,
Jeremy T. Hua, MD, MPH,
Bryanna Lee,
Karen Villegas,
Samvel Gaboyan,
Cecile S. Rose, MD, MPH,
Christine M. Lin, MD,
Eugene Golts, MD,
Gordon Yung, MD,
Tara Akins, NP-BC,
Catherine Gaissert, PA-C,
Christina Malles, PA-C,
Ana Maria Gloria, NP-C,
Kamyar Afshar, DO
Affiliations
Reice Robinson, MD
Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine & Physiology, University of California, San Diego, San Diego, California; Corresponding author: Reice Robinson, MD, Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine & Physiology, University of California, San Diego, San Diego, California.
Jeremy T. Hua, MD, MPH
Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, Colorado; Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine, Aurora, Colorado; Department of Environmental and Occupational Health, Colorado School of Public Health, Aurora, Colorado
Bryanna Lee
Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine & Physiology, University of California, San Diego, San Diego, California
Karen Villegas
Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine & Physiology, University of California, San Diego, San Diego, California
Samvel Gaboyan
Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine & Physiology, University of California, San Diego, San Diego, California
Cecile S. Rose, MD, MPH
Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, Colorado; Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine, Aurora, Colorado; Department of Environmental and Occupational Health, Colorado School of Public Health, Aurora, Colorado
Christine M. Lin, MD
Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine & Physiology, University of California, San Diego, San Diego, California
Eugene Golts, MD
Department of Surgery, Division of Cardiothoracic Surgery, University of California, San Diego, San Diego, California
Gordon Yung, MD
Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine & Physiology, University of California, San Diego, San Diego, California
Tara Akins, NP-BC
Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine & Physiology, University of California, San Diego, San Diego, California
Catherine Gaissert, PA-C
Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine & Physiology, University of California, San Diego, San Diego, California
Christina Malles, PA-C
Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine & Physiology, University of California, San Diego, San Diego, California
Ana Maria Gloria, NP-C
Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine & Physiology, University of California, San Diego, San Diego, California
Kamyar Afshar, DO
Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine & Physiology, University of California, San Diego, San Diego, California
Background: In the past decade, growing industrial exposure to respirable crystalline silica from manufacturing engineered stone (ES) products has caused rapidly progressive, irreversible silicosis worldwide. Consequently, there has been a recent surge in lung transplants for ES silicosis but few reports of post-transplant outcomes. We compared perioperative and 1-year post-transplant outcomes for silicosis and nonsilicosis interstitial lung disease (ILD) recipients at UC San Diego (UCSD) Health. Methods: Using the electronic health record and United Network for Organ Sharing database, we identified 7 patients with silicosis and 69 with nonsilicosis ILD who underwent double lung transplantation at UCSD from 2019-2023. We compared pretransplant, perioperative, and 1-year post-transplant outcomes between groups. Results: Recipients with silicosis were younger than those with nonsilicosis ILD (43.1 ± 9.9 vs 59.3 ± 7.1 years; p < 0.001). All 7 patients with silicosis were male, and 6 reported Hispanic/Latino ethnicity. All silicosis patients reported employment in the countertop industry using ES products. Before transplant, patients with silicosis had significantly lower mean percent predicted (PP) forced expiratory volume in 1 second (24.3 PP vs 46.6 PP; p < 0.001) and forced vital capacity (28.7 PP vs 43.3 PP; p < 0.01) than patients with nonsilicosis ILDs. Though ischemic times were greater for silicosis recipients, perioperative complication rates were similar. At 1-year post-transplant, there were no differences in survival, allograft rejection rates, or pulmonary function tests. Conclusions: Though reflecting a failure of prevention, lung transplantation should be considered as a therapeutic option for patients with end-stage silicosis from exposure to ES.
