Outcomes of lung transplantation in adults with bronchiectasis

Jodie Birch; Syba S Sunny; Katy L M Hester; Gareth Parry; F Kate Gould; John H Dark; Stephen Clark; Gerard Meachery; James Lordan; Andrew J Fisher; Paul A Corris; Anthony De Soyza

doi:10.1186/s12890-018-0634-4

Outcomes of lung transplantation in adults with bronchiectasis

Jodie Birch, Syba S Sunny, Katy L M Hester, Gareth Parry, F Kate Gould, John H Dark, Stephen Clark, Gerard Meachery, James Lordan, Andrew J Fisher, Paul A Corris, Anthony De Soyza

Applied Sciences

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Abstract

BACKGROUND: Lung transplantation is a well-established treatment for end-stage non-cystic fibrosis bronchiectasis (BR), though information regarding outcomes of transplantation remains limited. Our results of lung transplantation for Br are reported here.

METHODS: A retrospective review of case notes and transplantation databases was conducted for patients that had underwent lung transplantation for bronchiectasis at the Freeman Hospital between 1990 and 2013.

RESULTS: Fourty two BR patients underwent lung transplantation, the majority (39) having bilateral sequential lung transplantation. Mean age at transplantation was 47.1 years. Pre-transplantation osteoporosis was a significant non-pulmonary morbidity (48%). Polymicrobial infection was common, with Pseudomonas aeruginosa infection frequently but not universally observed (67%). Forced expiratory volume in 1 second (% predicted) improved from a pre-transplantation mean of 0.71 L (22% predicted) to 2.56 L (79 % predicted) at 1-year post-transplantation. Our survival results were 74% at 1 year, 64% at 3 years, 61% at 5 years and 48% at 10 years. Sepsis was a common cause of early post-transplantation deaths.

CONCLUSIONS: Lung transplantation for end-stage BR is a useful therapeutic option, with good survival and lung function outcomes. Survival values were similar to other bilateral lung transplants at our centre. Pre-transplantation Pseudomonas infection is common.

Original language	English
Article number	82
Journal	BMC Pulmonary Medicine
Volume	18
DOIs	https://doi.org/10.1186/s12890-018-0634-4
Publication status	Published - 22 May 2018

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Birch et al - Outcomes of lung transplantation in adults with bronchiectasis OAFinal published version, 706 KBLicence: CC BY

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title = "Outcomes of lung transplantation in adults with bronchiectasis",

abstract = "BACKGROUND: Lung transplantation is a well-established treatment for end-stage non-cystic fibrosis bronchiectasis (BR), though information regarding outcomes of transplantation remains limited. Our results of lung transplantation for Br are reported here.METHODS: A retrospective review of case notes and transplantation databases was conducted for patients that had underwent lung transplantation for bronchiectasis at the Freeman Hospital between 1990 and 2013.RESULTS: Fourty two BR patients underwent lung transplantation, the majority (39) having bilateral sequential lung transplantation. Mean age at transplantation was 47.1 years. Pre-transplantation osteoporosis was a significant non-pulmonary morbidity (48%). Polymicrobial infection was common, with Pseudomonas aeruginosa infection frequently but not universally observed (67%). Forced expiratory volume in 1 second (% predicted) improved from a pre-transplantation mean of 0.71 L (22% predicted) to 2.56 L (79 % predicted) at 1-year post-transplantation. Our survival results were 74% at 1 year, 64% at 3 years, 61% at 5 years and 48% at 10 years. Sepsis was a common cause of early post-transplantation deaths.CONCLUSIONS: Lung transplantation for end-stage BR is a useful therapeutic option, with good survival and lung function outcomes. Survival values were similar to other bilateral lung transplants at our centre. Pre-transplantation Pseudomonas infection is common.",

keywords = "Transplantation, Bronchiectasis, Pseudomonas",

author = "Jodie Birch and Sunny, {Syba S} and Hester, {Katy L M} and Gareth Parry and {Kate Gould}, F and Dark, {John H} and Stephen Clark and Gerard Meachery and James Lordan and Fisher, {Andrew J} and Corris, {Paul A} and {De Soyza}, Anthony",

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doi = "10.1186/s12890-018-0634-4",

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T1 - Outcomes of lung transplantation in adults with bronchiectasis

AU - Birch, Jodie

AU - Sunny, Syba S

AU - Hester, Katy L M

AU - Parry, Gareth

AU - Kate Gould, F

AU - Dark, John H

AU - Clark, Stephen

AU - Meachery, Gerard

AU - Lordan, James

AU - Fisher, Andrew J

AU - Corris, Paul A

AU - De Soyza, Anthony

PY - 2018/5/22

Y1 - 2018/5/22

N2 - BACKGROUND: Lung transplantation is a well-established treatment for end-stage non-cystic fibrosis bronchiectasis (BR), though information regarding outcomes of transplantation remains limited. Our results of lung transplantation for Br are reported here.METHODS: A retrospective review of case notes and transplantation databases was conducted for patients that had underwent lung transplantation for bronchiectasis at the Freeman Hospital between 1990 and 2013.RESULTS: Fourty two BR patients underwent lung transplantation, the majority (39) having bilateral sequential lung transplantation. Mean age at transplantation was 47.1 years. Pre-transplantation osteoporosis was a significant non-pulmonary morbidity (48%). Polymicrobial infection was common, with Pseudomonas aeruginosa infection frequently but not universally observed (67%). Forced expiratory volume in 1 second (% predicted) improved from a pre-transplantation mean of 0.71 L (22% predicted) to 2.56 L (79 % predicted) at 1-year post-transplantation. Our survival results were 74% at 1 year, 64% at 3 years, 61% at 5 years and 48% at 10 years. Sepsis was a common cause of early post-transplantation deaths.CONCLUSIONS: Lung transplantation for end-stage BR is a useful therapeutic option, with good survival and lung function outcomes. Survival values were similar to other bilateral lung transplants at our centre. Pre-transplantation Pseudomonas infection is common.

AB - BACKGROUND: Lung transplantation is a well-established treatment for end-stage non-cystic fibrosis bronchiectasis (BR), though information regarding outcomes of transplantation remains limited. Our results of lung transplantation for Br are reported here.METHODS: A retrospective review of case notes and transplantation databases was conducted for patients that had underwent lung transplantation for bronchiectasis at the Freeman Hospital between 1990 and 2013.RESULTS: Fourty two BR patients underwent lung transplantation, the majority (39) having bilateral sequential lung transplantation. Mean age at transplantation was 47.1 years. Pre-transplantation osteoporosis was a significant non-pulmonary morbidity (48%). Polymicrobial infection was common, with Pseudomonas aeruginosa infection frequently but not universally observed (67%). Forced expiratory volume in 1 second (% predicted) improved from a pre-transplantation mean of 0.71 L (22% predicted) to 2.56 L (79 % predicted) at 1-year post-transplantation. Our survival results were 74% at 1 year, 64% at 3 years, 61% at 5 years and 48% at 10 years. Sepsis was a common cause of early post-transplantation deaths.CONCLUSIONS: Lung transplantation for end-stage BR is a useful therapeutic option, with good survival and lung function outcomes. Survival values were similar to other bilateral lung transplants at our centre. Pre-transplantation Pseudomonas infection is common.

KW - Transplantation

KW - Bronchiectasis

KW - Pseudomonas

U2 - 10.1186/s12890-018-0634-4

DO - 10.1186/s12890-018-0634-4

M3 - Article

C2 - 29789006

VL - 18

JO - BMC Pulmonary Medicine

JF - BMC Pulmonary Medicine

SN - 1471-2466

M1 - 82

ER -

Outcomes of lung transplantation in adults with bronchiectasis

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