Publication:
Lung transplantation for cystic fibrosis: differential characteristics and outcomes between children and adults.

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Date

2015-09-10

Authors

Moreno, Paula
Alvarez, Antonio
Carrasco, Guadalupe
Redel, Javier
Guaman, Hugo Dario
Baamonde, Carlos
Algar, Francisco Javier
Cerezo, Francisco
Salvatierra, Angel

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Oxford University Press
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Abstract

The survival benefit of lung transplantation (LTx) for cystic fibrosis (CF) patients is well demonstrated. We aim to compare children and adult CF recipients to assess whether there are differences in survival and clinical outcomes, and to identify risk factors for mortality. A retrospective analysis of 442 consecutive LTx performed at our institution in a 20-year period was conducted. CF patients were distributed into two groups: children (age The study group included 120 consecutive CF patients: 50 children (13 ± 3 years) and 70 adults (25 ± 6 years) undergoing 111 bilateral, 4 lobar, 4 combined and 1 unilateral LTx. Comparative analysis (children versus adults): survival (overall; 5, 10 and 15 years) 57, 45, 35% vs 67, 55, 43% (P = 0.32); survival (1-year survivors; 5, 10 and 15 years): 75, 64, 46% vs 90, 75, 59% (P = 0.09); 30-day mortality: 14 vs 16% (P = 0.27); urgent LTx: 32 vs 17% (P = 0.04); use of cardiopulmonary bypass (CPB): 56 vs 28% (P = 0.002); intensive care unit stay: 20 ± 19 vs 10 ± 9 days (P = 0.006); AR episodes (n): 1.4 ± 0.7 vs 1.2 ± 0.8 (P = 0.004). Incidence of PGD and freedom from CLAD did not differ between groups. Predictors of mortality were: use of CPB (HR 3.12; 95% CI 1.33-7.35; P Paediatric CF patients usually present with poorer pre-transplant status, require CPB more frequently and have a higher incidence of post-LTx diabetes and infections. This might explain the trend towards a better long-term survival observed in adult CF patients.

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MeSH Terms

Adolescent
Adult
Child
Cystic fibrosis
Female
Humans
Lung transplantation
Male
Retrospective studies
Risk factors
Survival analysis
Treatment outcome
Young adult

DeCS Terms

Análisis de supervivencia
Estudios retrospectivos
Fibrosis quística
Niño
Resultado del tratamiento
Trasplante de pulmón

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Keywords

Adults, Cystic fibrosis, Lung transplantation, Outcomes, Paediatrics

Citation

Moreno P, Alvarez A, Carrasco G, Redel J, Guaman HD, Baamonde C, et al. Lung transplantation for cystic fibrosis: differential characteristics and outcomes between children and adults. Eur J Cardiothorac Surg. 2016 May;49(5):1334-43