Austin Health

Title
Outcomes Of Non-Cystic Fibrosis Related Bronchiectasis Post Lung Transplantation.
Publication Date
2021-03-03
Author(s)
Kennedy, Jessica
Walker, Anne
Ellender, Claire M
Steinfort, Kate
Martin, Catherine
Smith, Catherine
Snell, Gregory
Whitford, Helen
Subject
Bronchiectasis
lung transplantation
morbidity
respiratory tract diseases
Type of document
Journal Article
OrcId
0000-0003-2086-743X
DOI
10.1111/imj.15256
Abstract
Lung transplantation is a recognised treatment for end-stage lung disease due to bronchiectasis. Non-CF bronchiectasis and CF are often combined into one cohort, however outcomes for non-CF bronchiectasis patients varies between centres, and in comparison to those for CF. To compare lung transplantation mortality and morbidity of bronchiectasis (non-CF) patients to those with CF and other indications. Retrospective analysis of patients undergoing lung transplantation between 01 January 2008-31 December 2013. Time to and cause of lung allograft loss was censored on 01 April 2018. A case-note review was conducted on a sub-group of 78 patients, to analyse hospital admissions as a marker of morbidity. 341 patients underwent lung transplantation, 22 (6%) had bronchiectasis compared to 69 (20%) with CF. The 5-year survival for the bronchiectasis group was 32%, compared to CF 69%, obstructive lung disease (OLD) 64%, pulmonary hypertension 62% and ILD 55% (p = 0.008). Lung allograft loss due to CLAD with predominant infection was significantly higher in the bronchiectasis group at 2 years. The rate of acute admissions was 2.24 higher in the bronchiectasis group when compared to OLD (p = 0.01). Patients with bronchiectasis spent 45.81 days in hospital per person year after transplantation compared with 18.21 days for CF. Bronchiectasis patients in this study had a lower 5-year survival and poorer outcomes in comparison to other indications including CF. Bronchiectasis should be considered a separate entity to CF in survival analysis. This article is protected by copyright. All rights reserved.
Link
Citation
Internal Medicine Journal 2021; online first: 3 March
Jornal Title
Internal Medicine Journal

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