Observational study of lung transplant recipients surviving 20 years

Sasiharan Sithamparanathan, Logan Thirugnanasothy, Stephen Clark, John H Dark, Andrew J Fisher, Kate F Gould, Asif Hasan, James L Lordan, Gerard Meachery, Gareth Parry, Paul A Corris

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)

Abstract

BACKGROUND: Lung transplant recipients have reduced long-term survival compared with other solid organ recipients. There is a lack of published data on the characteristics of very long term survivors.

METHODS: We describe the demographics, clinical history and post-procedure function of all lung transplant recipients who have survived greater than 20 years at our centre.

RESULTS: At the time of analysis there were 21 (16.4%) of 128 patients who survived over 20 years. The mean age at transplantation was 31.8 ± 9.9 years. Five of 21 had undergone single-lung, eight double-lung and eight heart-lung transplant procedures. At the last evaluation, mean percentage predicted FEV1 in recipients of single and double lung were 51.3% and 57.9% respectively. By 20 years, 19 (90.5%) patients had developed bronchiolitis obliterans syndrome (BOS) with three (14%) BOS 1, six (29%) BOS 2 and 10 (48%) BOS 3 and two (9.5%) free from BOS. The median time to onset of BOS was 9.7 years (range 1.6-17.9). Of eight patients (38%) who required renal replacement, four (19%) had successfully undergone renal transplantation and four (19%) were on haemodialysis. Only one patient (5%) had symptomatic osteoporosis. Nineteen patients (90%) were treated for hypertension. Five patients (24%) had diabetes, all with an underlying diagnosis of cystic fibrosis and four of them developing diabetes post operatively.

CONCLUSIONS: In our experience, 20-year survivors of lung transplantation had a delayed onset of BOS and morbidities due to immunosuppression that can be appropriately managed leading to long-term survival.

Original languageEnglish
Pages (from-to)103-8
Number of pages6
JournalRespiratory Medicine
Volume117
Early online date7 Jun 2016
DOIs
Publication statusPublished - Aug 2016

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