One-year lung transplantation outcomes for engineered stone countertop workers with silicosis at a single center in Southern California, 2019 to 2023

Reice Robinson; Jeremy T Hua; Bryanna Lee; Karen Villegas; Samvel Gaboyan; Cecile S Rose; Christine M Lin; Eugene Golts; Gordon Yung; Tara Akins; Catherine Gaissert; Christina Malles; Ana Maria Gloria; Kamyar Afshar

doi:10.1016/j.jhlto.2025.100280

One-year lung transplantation outcomes for engineered stone countertop workers with silicosis at a single center in Southern California, 2019 to 2023

JHLT Open. 2025 May 5:9:100280. doi: 10.1016/j.jhlto.2025.100280. eCollection 2025 Aug.

Authors

Reice Robinson¹, Jeremy T Hua^{2

3

4}, Bryanna Lee¹, Karen Villegas¹, Samvel Gaboyan¹, Cecile S Rose^{2

3

4}, Christine M Lin¹, Eugene Golts⁵, Gordon Yung¹, Tara Akins¹, Catherine Gaissert¹, Christina Malles¹, Ana Maria Gloria¹, Kamyar Afshar¹

Affiliations

¹ Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine & Physiology, University of California, San Diego, San Diego, California.
² Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, Colorado.
³ Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine, Aurora, Colorado.
⁴ Department of Environmental and Occupational Health, Colorado School of Public Health, Aurora, Colorado.
⁵ Department of Surgery, Division of Cardiothoracic Surgery, University of California, San Diego, San Diego, California.

Abstract

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.

Keywords: artificial stone; engineered stone; lung transplantation; occupational medicine; silicosis.