Evidence map›Paper›PMID 42425729›Full record

ArticleThe European respiratory journal2026

Lung transplantation for pulmonary alveolar proteinosis: a retrospective international multicentre analysis.

Stefan Schwarz, Helmut Prosch, Erdal Yekeler, Piergiorgio Solli, Xavier Demant, Don Hayes, Masayuki Chida, Kieran Halloran, Mark Greer, Puneet Garcha and 27 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The European respiratory journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

37 authors.

Stefan SchwarzDepartment of Thoracic Surgery, Comprehensive Center for Chest Diseases, Medical University of Vienna, Vienna, Austria stefan.a.schwarz@meduniwien.ac.at.
Helmut ProschDepartment of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.ORCID https://orcid.org/0000-0002-6119-6364
Erdal YekelerDepartment of Thoracic Surgery and Lung Transplantation, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.
Piergiorgio SolliDepartment of Cardio-Thoracic Surgery and Heart and Lung Transplantation, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Xavier DemantService de Pneumologie et Transplantation Pulmonaire, CHU de Bordeaux, Bordeaux, France.
Don HayesHeart Institute and Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Masayuki ChidaDepartment of Thoracic Surgery, Dokkyo Medical University, Tochigi, Japan.
Kieran HalloranDepartment of Medicine, Division of Pulmonary Medicine, University of Alberta, Edmonton, AB, Canada.
Mark GreerDepartment of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Germany.ORCID https://orcid.org/0000-0003-3234-306X
Puneet GarchaDepartment of Medicine, Baylor College of Medicine, Houston, TX, USA.
Laurens J CeulemansDepartment of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium.
Sandra LindstedtDepartment of Cardiothoracic Surgery and Transplantation, Skåne University Hospital, Lund, Sweden.
Claire MerveilleuxDepartment of Pneumology, Louis Pradel Hospital, Hospices Civils de Lyon, Lyon, France.
Robert M ReedDepartment of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.ORCID https://orcid.org/0000-0002-4681-7070
Michael MuskDepartment of Respiratory Medicine, Fiona Stanley Hospital, Perth, Australia.
Osnat ShtraichmanPulmonary Institute, Rabin Medical Center, Affiliated with Sackler School of Medicine Tel Aviv University, Petach Tikva, Israel.
Pablo G SanchezDepartment of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Rayid AbdulqawiLung Health Centre, Organ Transplant Centre of Excellence, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
David M SayahDivision of Pulmonary, Critical Care Medicine (D.M.S.), David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.ORCID https://orcid.org/0000-0001-7021-8273
Victor M MoraLung Transplant Unit, Department of Respiratory Medicine, H. Marqués de Valdecilla, Santander, Spain.ORCID https://orcid.org/0000-0002-8161-0462
Jesper M MagnussonTransplant Institute, Sahlgrenska University Hospital, Gothenburg, Sweden.ORCID https://orcid.org/0000-0002-5630-0155
María Nieves Balaguer CartagenaLung Transplant Unit, University Hospital La Fe, University of Valencia, Valencia, Spain.
Ricardo A Zapata GonzalezThoracic Surgery Department, Clínica Cardio VID, Medellín, Colombia.
Andrew J FisherInstitute of Transplantation, Freeman Hospital and Institute of Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
Joel RosadoDepartment of Thoracic Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
Juan M OssesCardiovascular and Thoracic Surgery Division, Favaloro Foundation, Buenos Aires, Argentina.
Achim KochDepartment of Thoracic Transplantation and Assist Devices, Cardiothoracic Surgery, West German Heart and Vascular Center, University Hospital Essen, Essen, Germany.
John M ReynoldsDivision of Pulmonary, Allergy, and Critical Care Medicine, Duke University School of Medicine, Durham, NC, USA.
Clement PicardService de Pneumologie et Transplantation Pulmonaire, Hôpital Foch, Suresnes, France.
Kinan El HusseiniPulmonology Department, Bichat University Hospital, AP-HP, Paris, France.ORCID https://orcid.org/0000-0001-9188-833X
Meghan AversaToronto Lung Transplant Program, Ajmera Transplant Centre, University Health Network, Department of Medicine, University of Toronto, Toronto, ON, Canada.
Vaidehi KazaDivision of Pulmonary and Critical Care Medicine, UT Southwestern Medical Center, Dallas, TX, USA.
Alberto BenazzoDepartment of Thoracic Surgery, Comprehensive Center for Chest Diseases, Medical University of Vienna, Vienna, Austria.ORCID https://orcid.org/0000-0002-3549-4720
Clemens AignerDepartment of Thoracic Surgery, Comprehensive Center for Chest Diseases, Medical University of Vienna, Vienna, Austria.ORCID https://orcid.org/0000-0002-7787-991X
Francesco BonellaCentre for Interstitial and Rare Lung Disease, Department of Pneumology, Ruhrlandklinik University Hospital Essen, Essen, Germany.ORCID https://orcid.org/0000-0001-7579-9767
Peter JakschDepartment of Thoracic Surgery, Comprehensive Center for Chest Diseases, Medical University of Vienna, Vienna, Austria.ORCID https://orcid.org/0000-0003-4635-3242
Konrad HoetzeneckerDepartment of Thoracic Surgery, Comprehensive Center for Chest Diseases, Medical University of Vienna, Vienna, Austria.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPulmonary alveolar proteinosis (PAP) is a rare disease. Only a small number of case reports describing lung transplantation (LTx) as a treatment option for PAP have been published. Due to this limited evidence, current guidelines on LTx for PAP remain vague. To address this gap, we collected cases of LTx for PAP worldwide.

methods214 centres were approached to contribute any cases of LTx performed for PAP. Re-transplantations and multi-organ transplantations were excluded. Patients were divided into two groups based on the presence of PAP recurrence after LTx. Time-to-event analyses were performed using Kaplan-Meier curves and Cox proportional-hazards modelling was performed with PAP recurrence as a time-dependent covariate.

resultsAt a response rate of 64%, 31 centres contributed 63 patients. Most had primary PAP (n=20; 39.2%). Six patients with secondary PAP were identified (11.8%), while seven (13.7%) had congenital and 18 (35.3%) unclassified PAP. Aetiology was not specified in 12. Patients underwent transplantation at a median (interquartile range) 11 (3-17) years after initial diagnosis. Nine (15%) patients developed PAP recurrence after LTx. No significant difference was found regarding patient characteristics between the patients with

conclusionLTx provides excellent peri-operative and long-term outcomes for patients with end-stage PAP and should be recommended in treatment guidelines. Although recurrence of PAP occurs in ∼15% of cases, overall survival appeared unaffected in our limited dataset.

Indexed as

Lung TransplantationPulmonary Alveolar ProteinosisAdolescentAdultFemaleHumansKaplan-Meier EstimateMaleMiddle AgedProportional Hazards ModelsRecurrenceRetrospective StudiesTreatment OutcomeYoung Adult

Identifiers

PMID42425729
PMCPMC13519837

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