Impact of lung transplantation on serum lipids in adults with cystic fibrosis.
BACKGROUND
Cystic fibrosis (CF) is an inherited condition that causes progressive respiratory failure and is the third most common indication for adult bilateral lung transplantation. Post-transplant hyperlipidemia commonly affects lung transplant recipients, but the impact of lung transplantation on serum lipids in the adult CF population is not well studied. The aim of this study was to examine the impact of lung transplantation on the prevalence of hyperlipidemia in CF adults.


METHODS
We retrospectively analyzed prospectively collected data in 108 CF adults undergoing bilateral sequential lung transplantation from 1996 to 2007 at our institution.


RESULTS
The prevalence of hypercholesterolemia (>5.2 mmol/liter) and hypertriglyceridemia (>2.2 mmol/liter) increased significantly after lung transplant (14.8% vs 32.4%, p = 0.002; 8.3% vs 41.7%, p < 0.0001, respectively). Cyclosporine A (CsA) use was associated with significantly higher post-transplant total and LDL cholesterol compared with tacrolimus use. Post-transplant calculated Framingham risk score was <10% in all but 1 subject.


CONCLUSIONS
Hyperlipidemia was common in our cohort of post-lung transplant CF adults, with a higher prevalence in those receiving CsA. Despite these findings, calculated cardiovascular risk remained low and none of these subjects developed clinically evident cardiovascular disease.
Nash
Edward F
EF
Toronto Adult Cystic Fibrosis Centre, University Health Network, Toronto, Ontario, Canada. edward.nash@heartofengland.nhs.uk
Stephenson
Anne
A
Helm
Emma J
EJ
Durie
Peter R
PR
Tullis
Elizabeth
E
Singer
Lianne G
LG
Chaparro
Cecilia
C
D000328:Adult; D015331:Cohort Studies; D016572:Cyclosporine / Q000627:therapeutic use; D003550:Cystic Fibrosis / Q000601:surgery*; D005260:Female; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000453:epidemiology*; D015228:Hypertriglyceridemia / Q000097:blood / Q000453:epidemiology*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008055:Lipids / Q000097:blood*; D016040:Lung Transplantation / Q000276:immunology; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D012189:Retrospective Studies; D016559:Tacrolimus / Q000627:therapeutic use
D007166:Immunosuppressive Agents; D008055:Lipids; D016572:Cyclosporine; D016559:Tacrolimus