Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 May 22;18(1):82.
doi: 10.1186/s12890-018-0634-4.

Outcomes of lung transplantation in adults with bronchiectasis

Jodie Birch  1 , Syba S Sunny  2 , Katy L M Hester  1   2 , Gareth Parry  3 , F Kate Gould  4 , John H Dark  3 , Stephen C Clark  3 , Gerard Meachery  3 , James Lordan  3 , Andrew J Fisher  1   3 , Paul A Corris  1   3 , Anthony De Soyza  5   6
Affiliations

Outcomes of lung transplantation in adults with bronchiectasis

Jodie Birch et al. BMC Pulm Med. .

Abstract

Background: Lung transplantation is a well-established treatment for end-stage non-cystic fibrosis bronchiectasis (BR), though information regarding outcomes of transplantation remains limited. Our results of lung transplantation for Br are reported here.

Methods: A retrospective review of case notes and transplantation databases was conducted for patients that had underwent lung transplantation for bronchiectasis at the Freeman Hospital between 1990 and 2013.

Results: Fourty two BR patients underwent lung transplantation, the majority (39) having bilateral sequential lung transplantation. Mean age at transplantation was 47.1 years. Pre-transplantation osteoporosis was a significant non-pulmonary morbidity (48%). Polymicrobial infection was common, with Pseudomonas aeruginosa infection frequently but not universally observed (67%). Forced expiratory volume in 1 second (% predicted) improved from a pre-transplantation mean of 0.71 L (22% predicted) to 2.56 L (79 % predicted) at 1-year post-transplantation. Our survival results were 74% at 1 year, 64% at 3 years, 61% at 5 years and 48% at 10 years. Sepsis was a common cause of early post-transplantation deaths.

Conclusions: Lung transplantation for end-stage BR is a useful therapeutic option, with good survival and lung function outcomes. Survival values were similar to other bilateral lung transplants at our centre. Pre-transplantation Pseudomonas infection is common.

Keywords: Bronchiectasis; Pseudomonas; Transplantation.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

These data were developed upon written patient consent and in accordance with national Transplant audit. Our local ethics committee, Tyne and Wear South advised additional ethical approvals were not required.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Actuarial survival of patients with non-CF bronchiectasis (BR) at the Freeman Hospital Lung Transplant Programme (n=42) compared with all other bilateral sequential single lung transplants (BSLTx) performed at our centre (n=409). No significant difference in survival was found between the cohorts (log-rank testing; Mantel-Cox, p = 0.23).
Fig. 2
Fig. 2
Microbial infections prior to transplantation. Percentage of the cohort (where data were available) infected with each pathogen is noted. The majority of patients had more than one pathogen isolated from the same individual’s sputa in the year before transplantation. MRSA, methicillin resistant S aureus.
See this image and copyright information in PMC

References

    1. O'Donnell AE. Bronchiectasis. Chest. 2008;134(4):815–823. doi: 10.1378/chest.08-0776. - DOI - PubMed
    1. Pasteur MC, Bilton D, Hill AT. British Thoracic Society guideline for non-CF bronchiectasis. Thorax. 65(Suppl 1):i1–58. - PubMed
    1. Pasteur MC, et al. An investigation into causative factors in patients with bronchiectasis. Am J Respir Crit Care Med. 2000;162(4 Pt 1):1277–1284. doi: 10.1164/ajrccm.162.4.9906120. - DOI - PubMed
    1. Chalmers JD, et al. The bronchiectasis severity index. An international derivation and validation study. Am J Respir Crit Care Med. 2014;189(5):576–585. doi: 10.1164/rccm.201309-1575OC. - DOI - PMC - PubMed
    1. Roberts HJ, Hubbard R. Trends in bronchiectasis mortality in England and Wales. Respir Med. 2010;104(7):981–985. doi: 10.1016/j.rmed.2010.02.022. - DOI - PubMed