Survival after lung transplantation of cystic fibrosis patients infected with Burkholderia dolosa (genomovar VI)

Clin Transplant. 2018 May;32(5):e13236. doi: 10.1111/ctr.13236.

Abstract

Cystic fibrosis (CF) with severe lung disease is a well-recognized indication for lung transplantation. Colonization with various organisms in CF patients may impact post-transplant morbidity and mortality. Burkholderia cepacia complex (BCC) is made up of distinct genomovars with significant morbidity and mortality associated with B. cenocepacia (genomovar III) following lung transplant. The outcomes of patients infected with genomovar B. dolosa (genomovar VI) have yet to be described in the literature. We performed a retrospective chart review of all cystic fibrosis patients colonized with B. dolosa from our center who underwent lung transplantation (n = 11) at various medical centers across the US between 2000 and 2014. Survival rates were 73%, 53%, and 30% for 1, 3, and 5 years, respectively. Median survival was 44 months (95% CI = 11.1-76.8). CF patients with B. dolosa that have undergone lung transplantation have decreased one-year survival when compared to all patients transplanted with cystic fibrosis. Conditional 5-year survival for B. dolosa-infected patients was 43% in patients that survived the first year post-transplant, suggesting that this first year is crucial in managing the infection. Importantly, the survival of the B. dolosa patients was higher than compared to previously reported survival rates of B. cenocepacia patients post-transplant.

Keywords: Burkholderia dolosa; Burkholderia cepacia complex; Burkholderia infections; cystic fibrosis; lung transplantation.

MeSH terms

  • Adolescent
  • Adult
  • Burkholderia Infections / epidemiology
  • Burkholderia Infections / microbiology
  • Burkholderia Infections / mortality*
  • Burkholderia cepacia complex
  • Child
  • Cystic Fibrosis / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Lung Transplantation / adverse effects*
  • Male
  • North Carolina / epidemiology
  • Postoperative Complications / mortality*
  • Prognosis
  • Retrospective Studies
  • Survival Rate
  • Young Adult