Lung transplantation for non-cystic fibrosis bronchiectasis: analysis of a 13-year experience

J Heart Lung Transplant. 2005 Oct;24(10):1530-5. doi: 10.1016/j.healun.2004.12.114.

Abstract

Background: Lung transplantation is a well-established treatment for end-stage cystic fibrosis, and there are considerable data on medium- and long-term results. However, less information exists about transplantation for non-cystic fibrosis bronchiectasis.

Methods: Between December 1988 and June 2001, 22 patients (12 men, 10 women) underwent transplantation for bronchiectasis not due to cystic fibrosis. Procedures were bilateral sequential single-lung transplants (BSSLTX) in 4 patients, en bloc double lung transplants (DLTX) in 5, heart-lung transplants (HLTX) in 6, and single-lung transplants (SLTX) in 7. Lifelong outpatient follow-up was continued at a minimum of every 6 months.

Results: One-year Kaplan-Meier survival for all patients was 68% (95% confidence interval [CI], 54%-91%), and 5-year survival was 62% (95% CI, 41-83%). One-year survival after SLTX was 57% (95% CI, 20%-94%) vs 73% (95% CI, 51-96%) for those receiving 2 lungs. At 6 months, mean forced expiratory volume in 1 second was 73% predicted (range, 58%-97%), and mean forced vital capacity was 68% predicted (range, 53%-94%) after receiving 2 lungs (n = 10); in the SLTX group at 6 months, mean forced expiratory volume in 1 second was 50% predicted (range, 34%-61%), and mean forced vital capacity was 53% predicted (range 46-63%) (n = 4).

Conclusions: Survival and lung function after transplantation for non-cystic fibrosis bronchiectasis was similar to that after transplantation for cystic fibrosis. A good outcome is possible after single lung transplantation in selected patients.

MeSH terms

  • Adult
  • Airway Obstruction / etiology
  • Bronchiectasis / physiopathology
  • Bronchiectasis / surgery*
  • Bronchiolitis Obliterans / etiology
  • Coronary Angiography
  • Female
  • Follow-Up Studies
  • Graft Rejection / etiology
  • Heart Diseases / diagnostic imaging
  • Heart Diseases / surgery
  • Heart Transplantation
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Infections / etiology
  • Lung Transplantation / adverse effects*
  • Lung Transplantation / mortality
  • Male
  • Middle Aged
  • Postoperative Complications
  • Reoperation
  • Respiratory Function Tests
  • Survival Analysis
  • Treatment Outcome

Substances

  • Immunosuppressive Agents