Improved results of lung transplantation for patients with cystic fibrosis

Thomas M. Egan, Frank C. Detterbeck, Michael R. Mill, Linda J. Paradowski, Rudy P. Lackner, W. David Ogden, James R. Yankaskas, Jan H. Westerman, Jeanette T. Thompson, Meredith A. Weiner, Ellen L. Cairns, Benson R. Wilcox

Research output: Contribution to journalArticle

100 Citations (Scopus)

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 1/2 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).

Original languageEnglish (US)
Pages (from-to)224-235
Number of pages12
JournalThe Journal of Thoracic and Cardiovascular Surgery
Volume109
Issue number2
DOIs
StatePublished - Jan 1 1995
Externally publishedYes

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Lung Transplantation
Cystic Fibrosis
Burkholderia cepacia
Cause of Death
Transplantation
Forced Expiratory Volume
Lung Diseases
Bronchiolitis Obliterans
Bronchitis
Respiratory Function Tests
North America
Cardiopulmonary Bypass
Blood Transfusion
Ventilation
Survivors
Length of Stay
Pneumonia
Survival Rate
Morbidity
Bacteria

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Egan, T. M., Detterbeck, F. C., Mill, M. R., Paradowski, L. J., Lackner, R. P., Ogden, W. D., ... Wilcox, B. R. (1995). Improved results of lung transplantation for patients with cystic fibrosis. The Journal of Thoracic and Cardiovascular Surgery, 109(2), 224-235. https://doi.org/10.1016/S0022-5223(95)70383-7

Improved results of lung transplantation for patients with cystic fibrosis. / Egan, Thomas M.; Detterbeck, Frank C.; Mill, Michael R.; Paradowski, Linda J.; Lackner, Rudy P.; Ogden, W. David; Yankaskas, James R.; Westerman, Jan H.; Thompson, Jeanette T.; Weiner, Meredith A.; Cairns, Ellen L.; Wilcox, Benson R.

In: The Journal of Thoracic and Cardiovascular Surgery, Vol. 109, No. 2, 01.01.1995, p. 224-235.

Research output: Contribution to journalArticle

Egan, TM, Detterbeck, FC, Mill, MR, Paradowski, LJ, Lackner, RP, Ogden, WD, Yankaskas, JR, Westerman, JH, Thompson, JT, Weiner, MA, Cairns, EL & Wilcox, BR 1995, 'Improved results of lung transplantation for patients with cystic fibrosis', The Journal of Thoracic and Cardiovascular Surgery, vol. 109, no. 2, pp. 224-235. https://doi.org/10.1016/S0022-5223(95)70383-7
Egan, Thomas M. ; Detterbeck, Frank C. ; Mill, Michael R. ; Paradowski, Linda J. ; Lackner, Rudy P. ; Ogden, W. David ; Yankaskas, James R. ; Westerman, Jan H. ; Thompson, Jeanette T. ; Weiner, Meredith A. ; Cairns, Ellen L. ; Wilcox, Benson R. / Improved results of lung transplantation for patients with cystic fibrosis. In: The Journal of Thoracic and Cardiovascular Surgery. 1995 ; Vol. 109, No. 2. pp. 224-235.
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