*Purpose: Conflicting data exists on the effect of statin therapy on the development of bronchiolitis obliterans syndrome (BOS) following lung transplantation, and limited literature is available addressing the impact of early statin initiation in this setting. Prior studies have assessed patients started on statins by 3 months or at variable times post-transplant. This study evaluates whether early statin therapy within the first 30 days following lung transplantation reduces the incidence of BOS at 5 years.

*Methods: Single center, retrospective study of lung transplant recipients from September 2009 – September 2013. The statin group consisted of patients who received early statin therapy (< 30 days after transplant) and remained on therapy for at least 6 months. Patients were excluded if they died or required retransplantation within 6 months post-transplant. BOS was defined using the ISHLT criteria as a reduction in FEV1 to ≤ 80% of post-transplant baseline. Outcomes were assessed for 5 years from transplant and were evaluated using the chi-squared test and multivariate logistic regression.

*Results: Seventy-nine patients were included. Patients in the statin group (n=55) were older, had a lower lung allocation score (LAS), and were more likely to have idiopathic pulmonary fibrosis, whereas the non-statin group (n=24) was more likely to have cystic fibrosis (Table 1). Statins were prescribed for 70% of patients with pravastatin being the most common (94.6% of statin patients). The incidence of BOS at 5 years for statin and non-statin groups was 34.5% and 33.3% (p=0.917). Five year post-transplant survival in the statin and non-statin group was 65.5% and 62.5% (p=0.801). Time to development of BOS and survival free from BOS, retransplantation, or death at 5 years were also not statistically different between the two groups (Table 2). After adjusting for age, native lung disease, and LAS, early statin therapy did not significantly impact the odds of developing BOS (OR 1.44, CI 0.4-5.0, p=0.589).

*Conclusions: Early statin therapy following lung transplantation was not associated with a decreased incidence of BOS, mortality, or event free survival.

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