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Clin Transplant. 2017 Nov;31(11). doi: 10.1111/ctr.13111.

Lung transplantation in cystic fibrosis patients in Israel: The importance of ethnicity and nutritional status.

Author information

1
Rabin Medical Center, Pulmonary Institute, Petach Tiqva, Israel.
2
Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.
3
Pulmonary Institute and Graub Cystic Fibrosis Center, Schneider Children's Medical Center, Petach Tiqva, Israel.
4
Cardiothoracic Surgery Department, Rabin Medical Center, Petach Tiqva, Israel.
5
Clalit Research Institute, Clalit Health Services, Tel-Aviv, Israel.

Abstract

OBJECTIVES:

To assess the characteristics that correlate with better outcomes after lung transplantation for patients with cystic fibrosis (CF).

METHODS:

We retrospectively reviewed the charts of all patients with CF who underwent lung transplantation between 1996 and 2014 at Rabin Medical Center, Israel.

RESULTS:

Fifty patients with CF underwent 55 lung transplantations. Eighteen patients (36%) died during the study period. Actuarial survival was 83%, 68%, 62%, and 39% at 1, 3, 5, and 10 years, respectively. Better survival correlated with: BMI at 6 months and 1 year after transplantation (P = .002 and P = .003, respectively), ischemic time of less than 300 minutes (P = .023), absence of liver disease (P = .012), and Jewish compared to Arab ethnicity (P = .007). Freedom from bronchiolitis obliterans syndrome (BOS) was 87%, 75%, and 72% at 1, 3, and 5 years, respectively. BOS was more common and appeared earlier in the Arab than in the Jewish population (P = .012, P = .007). Additionally, prolonged time free of BOS correlated with male gender (P = .039), older age (P < .001), absence of liver disease (P = .012), and higher BMI 1 year after transplantation (P < .001).

CONCLUSIONS:

Clinically important determinants for survival include BMI pre- and 1-year post-transplantation and improved freedom from BOS. Arab ethnicity correlated with higher incidence and earlier onset of BOS compared to Jewish ethnicity in Israel.

KEYWORDS:

bronchiolitis obliterans; cystic fibrosis; lung transplantation; pulmonary outcome

PMID:
28886227
DOI:
10.1111/ctr.13111
[Indexed for MEDLINE]

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