Lung transplantation outcomes in patients with coal workers' pneumoconiosis compared with non-occupational interstitial lung disease: a single-center cohort study.
- 1Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Kentucky, Lexington, KY, USA.
- 2School of Medicine, University of Kentucky, Lexington, KY, USA.
- 3Department of Thoracic Surgery, University of Kentucky, Lexington, KY, USA.
Abstract
Coal workers' pneumoconiosis (CWP) is a lung disease caused by long-term coal dust exposure. Appalachian miners experience disproportionately high disease prevalence and mortality. Lung transplantation offers outcomes comparable to other interstitial lung diseases (ILDs), yet limited data exist on patients with CWP. This study examines regional disease burden and lung transplant outcomes for CWP at our institution compared with non-occupational ILD. A retrospective cohort study evaluated lung transplant recipients with CWP, autoimmune-ILD (A-ILD), and nonautoimmune-ILD (NA-ILD) at the University of Kentucky from 2017 to 2025. Patients were categorized by ILD etiology, and demographic, clinical, and post-transplant outcome data were collected from institutional records under institutional review board-approved protocols. Continuous variables were analyzed using one-way analysis of variance (ANOVA) or the Kruskal-Wallis test. Categorical variables were compared using Pearson's Chi-squared test or Fisher's exact test. Survival was evaluated using Kaplan-Meier analysis. Among 67 lung transplant recipients, 23 had CWP, 11 had A-ILD, and 33 had NA-ILD. CWP recipients were exclusively male and had a lower body mass index (BMI). Transplant recipients across all cohorts were predominantly male. Rates of acute kidney injury (AKI), renal replacement therapy (RRT), and hospital stay were similar across groups. Bronchial stenosis post-transplant was significantly more common with cardiac-death donors. Survival analyses suggested similar survival between the cohorts. This study observed no statistically significant differences in survival or postoperative complications in patients with CWP compared to those with non-occupational ILD. Female underrepresentation was found despite modern increases in women in coal-mining fields. Post-transplant complications of bronchial stenosis requiring dilatation ± stent were more likely in those who received organ donation after circulatory death (DCD). Limited impact of pre-transplant comorbidities was also noted. Despite small, single-center design, results suggest lung transplantation as a feasible treatment option in carefully selected patients with advanced CWP and highlight the need for larger multicenter studies.
Related
- Familial Interstitial Pneumonia with Occupational Mixed Dust Exposure in a Dental Technician
- Impact of Tiered Service Delivery Model on Antifibrotic Adherence and Outcomes Among Patients With Interstitial Lung Disease
- Sarcopenia affects the outcomes and tolerability in patients with interstitial lung disease receiving nintedanib: a retrospective study.
- Progressive Interstitial Lung Disease Following Hematopoietic Stem Cell Transplantation for Combined Immunodeficiency: A Novel Homozygous SLC7A7 Variant Suggestive of Lysinuric Protein Intolerance
- PROMISE: a PROspective randomised double-blind parallel group placebo-controlled multicentre trial of faecal MIcrobiota tranSplantation to improve outcomEs in patients with cirrhosis over 24 months—study protocol for a clinical trial
BibTeX
@article{riedi2026lung,
title = {{Lung transplantation outcomes in patients with coal workers' pneumoconiosis compared with non-occupational interstitial lung disease: a single-center cohort study.}},
author = {Sarah Alise Riedi and Dielle Crasta and Madhav Dahal and Colleen McMullen and Jin Woo Chung and Naureen Narula},
journal = {Journal of thoracic disease},
year = {2026},
month = oct,
doi = {10.21037/jtd-2026-2264},
url = {https://europepmc.org/article/MED/42996948},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Lung transplantation outcomes in patients with coal workers' pneumoconiosis compared with non-occupational interstitial lung disease: a single-center cohort study.
AU - Sarah Alise Riedi
AU - Dielle Crasta
AU - Madhav Dahal
AU - Colleen McMullen
AU - Jin Woo Chung
AU - Naureen Narula
PY - 2026
DA - 2026/10/26
JO - Journal of thoracic disease
DO - 10.21037/jtd-2026-2264
UR - https://europepmc.org/article/MED/42996948
AB - Coal workers' pneumoconiosis (CWP) is a lung disease caused by long-term coal dust exposure. Appalachian miners experience disproportionately high disease prevalence and mortality. Lung transplantation offers outcomes comparable to other interstitial lung diseases (ILDs), yet limited data exist on patients with CWP. This study examines regional disease burden and lung transplant outcomes for CWP at our institution compared with non-occupational ILD. A retrospective cohort study evaluated lung transplant recipients with CWP, autoimmune-ILD (A-ILD), and nonautoimmune-ILD (NA-ILD) at the University of Kentucky from 2017 to 2025. Patients were categorized by ILD etiology, and demographic, clinical, and post-transplant outcome data were collected from institutional records under institutional review board-approved protocols. Continuous variables were analyzed using one-way analysis of variance (ANOVA) or the Kruskal-Wallis test. Categorical variables were compared using Pearson's Chi-squared test or Fisher's exact test. Survival was evaluated using Kaplan-Meier analysis. Among 67 lung transplant recipients, 23 had CWP, 11 had A-ILD, and 33 had NA-ILD. CWP recipients were exclusively male and had a lower body mass index (BMI). Transplant recipients across all cohorts were predominantly male. Rates of acute kidney injury (AKI), renal replacement therapy (RRT), and hospital stay were similar across groups. Bronchial stenosis post-transplant was significantly more common with cardiac-death donors. Survival analyses suggested similar survival between the cohorts. This study observed no statistically significant differences in survival or postoperative complications in patients with CWP compared to those with non-occupational ILD. Female underrepresentation was found despite modern increases in women in coal-mining fields. Post-transplant complications of bronchial stenosis requiring dilatation ± stent were more likely in those who received organ donation after circulatory death (DCD). Limited impact of pre-transplant comorbidities was also noted. Despite small, single-center design, results suggest lung transplantation as a feasible treatment option in carefully selected patients with advanced CWP and highlight the need for larger multicenter studies.
SN - 2072-1439
SN - 2077-6624
ER -