Lung transplantation for non-cystic fibrosis bronchiectasis: analysis of a 13-year experience.
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.
Beirne
Paul Adrian
PA
Royal Brompton and Harefield Hospital, Harefield, Middlesex, United Kingdom. pbeirne@doctors.org.uk
Banner
Nicholas R
NR
Khaghani
Asghar
A
Hodson
Margaret E
ME
Yacoub
Magdi H
MH
D000328:Adult; D000402:Airway Obstruction / Q000209:etiology; D001987:Bronchiectasis / Q000503:physiopathology / Q000601:surgery*; D001989:Bronchiolitis Obliterans / Q000209:etiology; D017023:Coronary Angiography; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000209:etiology; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000601:surgery; D016027:Heart Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007239:Infections / Q000209:etiology; D016040:Lung Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012086:Reoperation; D012129:Respiratory Function Tests; D016019:Survival Analysis; D016896:Treatment Outcome
D007166:Immunosuppressive Agents