title: Lung transplantation in patients with cystic fibrosis: the Israeli experience.
abstract: BACKGROUND
  Lung transplantation is a well-established therapeutic option for end-stage lung disease in cystic fibrosis. Although it confers a clear survival advantage, outcome differs among centers according to local experience, patient selection, transplantation procedure, and postoperative care.
  
  
  OBJECTIVE
  To evaluate the national Israeli experience with lung transplantation in patients with CF.
  
  
  METHODS
  We reviewed the medical charts of all CF patients who underwent lung transplantation between January 1996 and June 2005 at the two Israeli centers that perform this procedure.
  
  
  RESULTS
  Eighteen transplantations were performed in 17 patients. Mean patient age at transplantation was 25.3 +/- 9.1 years, and mean duration of follow-up in survivors (n=14) was 37.2 months (range 1-113 months). The actuarial survival rate was 88% at 1 year and 74% at 5 years. Pulmonary function, expressed as percent of predicted normal forced expiratory volume in 1 sec, improved from 22.4 +/- 8.1% to 76 +/- 16.8% at one year after transplantation. Bronchiolitis obliterans syndrome was diagnosed in 5 patients (29%), of whom 2 died and 2 are currently candidates for retransplantation. Median time to onset of BOS was 34.2 months (range 17-64 months).
  
  
  CONCLUSIONS
  In Israel, the early and intermediate-term results of lung transplantation for cystic fibrosis are encouraging. BOS remains a major complication that threatens long-term outcome.
authors.affiliation: Pulmonary Institute, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: Dario
authors.initials: D
authors.lastname: Prais
authors.forename: Yael
authors.initials: Y
authors.lastname: Raviv
authors.forename: David
authors.initials: D
authors.lastname: Shitrit
authors.forename: Alon
authors.initials: A
authors.lastname: Yellin
authors.forename: Gideon
authors.initials: G
authors.lastname: Sahar
authors.forename: Danielle
authors.initials: D
authors.lastname: Bendayan
authors.forename: Yaacov
authors.initials: Y
authors.lastname: Yahav
authors.forename: Ori
authors.initials: O
authors.lastname: Efrati
authors.forename: Nira
authors.initials: N
authors.lastname: Reichart
authors.forename: Hannah
authors.initials: H
authors.lastname: Blau
authors.forename: Ilana
authors.initials: I
authors.lastname: Bakal
authors.forename: Gila
authors.initials: G
authors.lastname: Buchman
authors.forename: Milton
authors.initials: M
authors.lastname: Saute
authors.forename: Bernardo
authors.initials: B
authors.lastname: Vidne
authors.forename: Mordechai R
authors.initials: MR
authors.lastname: Kramer
mesh_terms: D000206:Actuarial Analysis; D000293:Adolescent; D000328:Adult; D001989:Bronchiolitis Obliterans / Q000209:etiology; D003550:Cystic Fibrosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D007557:Israel; D016040:Lung Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D008499:Medical Records; D012189:Retrospective Studies; D016019:Survival Analysis