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Improved results of lung transplantation for patients with cystic fibrosis
- Publication Year :
- 1995
- Publisher :
- The University of North Carolina at Chapel Hill University Libraries, 1995.
-
Abstract
- Patients with cystic fibrosis pose particular challenges for lung transplantation surgeons. Earlier reports from North America centers suggested that patients with cystic fibrosis were greater risk for heart-lung or isolated lung transplantation than other patients with end-stage pulmonary disease. During a 3 ½ year period, 44 patients with end-stage lung disease resulting from cystic fibrosis underwent double lung transplantation at this institution. During the same interval, 18 patients with cystic fibrosis, died while waiting for a double lung transplantation. The ages of the recipients ranged from 8 to 45 years, and mean forced expiratory volume in 1 second was 21% predicted. Seven patients had Pseudomonas cepacia bacteria before transplantation. Bilateral sequential implantation with omentopexy was used in all patients. There were no operative deaths, although two patients required urgent retransplantation because of graft failure. Cardiopulmonary bypass was necessary in six procedures in five patients and was associated with an increased blood transfusion requirement, longer postoperative ventilation, and longer hospital stay. Actuarial survival rate was 85% at 1 year and 67% at 2 years. Infection was the most common cause of death within 6 months of transplantation ( Pseudomonas cepacia pneumonia was the cause of death in two patients), and bronchitis obliterans was the most common cause of death after 6 months. Actuarial freedom form development of clinically significant bronchiolitis obliterans was 59% at 2 years. Results of pulmonary function tests improved substantially in survivors, with forced expiratory volume in 1 second averaging 78% predicted 2 years after transplantation. Double lung transplantation can be accomplished with acceptable morbidity and mortality in patients with cystic fibrosis. (J THORAC CARDIOVAS SURG 1995;109-:204-35)
- Subjects :
- Adult
Male
Reoperation
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Time Factors
Cystic Fibrosis
medicine.medical_treatment
Bronchiolitis obliterans
Burkholderia cepacia
Cystic fibrosis
Pulmonary function testing
Postoperative Complications
Actuarial Analysis
Risk Factors
Cause of Death
medicine
Pneumonia, Bacterial
Lung transplantation
Humans
Bronchiolitis Obliterans
Cause of death
Immunosuppression Therapy
Cardiopulmonary Bypass
business.industry
medicine.disease
Surgery
Respiratory Function Tests
Transplantation
Pneumonia
Bronchitis
Female
business
Cardiology and Cardiovascular Medicine
Lung Transplantation
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....98abc95239d90e452e01223035eda625
- Full Text :
- https://doi.org/10.17615/1619-wv91