Outcomes of lung transplantation in adults with bronchiectasis

BMC Pulm Med. 2018 May 22;18(1):82. doi: 10.1186/s12890-018-0634-4.

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: Bronchiectasis; Pseudomonas; Transplantation.

MeSH terms

  • Adult
  • Bronchiectasis / microbiology*
  • Bronchiectasis / mortality
  • Bronchiectasis / surgery*
  • Databases, Factual
  • Female
  • Forced Expiratory Volume
  • Humans
  • Lung / physiopathology
  • Lung Transplantation*
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Pseudomonas Infections / epidemiology
  • Retrospective Studies
  • Survival Analysis
  • Time Factors
  • Young Adult