Cepacia Transplant Article

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Title: Lung Transplants Warranted In Cystic Fibrosis

URL: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=R

European Journal of Cardio-Thoracic Surgery 2002; 22(4):602.

" Long term results of lung transplantation for cystic fibrosis. "

Bilateral sequential lung transplants result in acceptable long-term

survival in cystic fibrosis adults and children with end stage disease.

Even though patients colonised with [burkholderia cepacia have a worse

outcome, transplantation is still warranted, say specialists in the

Division of Cardiothoracic Surgery, University of North Carolina at

Chapel Hill, North Carolina, United States. To pinpoint the factors

which influenced long-term survival, the specialists reviewed their

experience with 131 lung transplants for cystic fibrosis in 123 patients

over a 10-year period. Of these, 114 had bilateral sequential lung

transplants and nine had bilateral lower lobe transplants from living

donors. Three patients had retransplants for acute graft failure and

five patients had late retransplant for bronchiolitis obliterans

syndrome. The actuarial survival for the entire group of bilateral

sequential lung transplants cystic fibrosis patients was 81 percent at

one year, 59 percent at five years and 38 percent at 10 years. Lobar

transplant was associated with poorer survival (37.5 percent at one and

five years). Of the 114 bilateral sequential lung transplants patients,

22 had colonisation with Burkholderia cepacia. This was associated with

poorer outcomes than in non-cepacia patients - 60 percent versus 86

percent at one year and 36 percent versus 64 percent at five years.

Survival duration was similar in the 22 bilateral sequential lung

transplants patients who were younger than 20 years and the 90 who were

older. Being on a ventilator at the time of transplant (n=8) was not

associated with poorer survival. Noting that bronchiolitis obliterans

syndrome affects more survivors with time, the specialists reported that

five cystic fibrosis patients were retransplanted because of it. There

was one operative death and one-year survival was 60 percent.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=R

Becki

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