title: Lung transplantation for cystic fibrosis: a single center experience of 100 consecutive cases.
abstract: OBJECTIVE
  Lung transplantation is the ultimate treatment option for patients with end-stage cystic fibrosis (CF) lung disease. Despite poorer reports on survival benefit for CF patients undergoing lung transplantation, several centers, including ours were able to show a survival benefit. This study compares our center's experience with 100 consecutive recipients in two different eras.
  
  
  METHODS
  All CF patients who underwent lung transplantation at our center were included (1992-2009). Survival rates were calculated and compared between the earlier era (before 2000) and later era (since 2000).
  
  
  RESULTS
  CF patients constituted 35% of all transplantations performed at our institution. Mean age at transplantation was 27 years (range 12-52). Fifty-one percent of the patients were female. Waiting list time was lower in the earlier era compared to the later era (p = 0.04). Lobar transplantation was performed in 10 cases. Thirty-four percent of the cases required downsizing of the graft. In 33% of the cases, transplantations were done on cardiopulmonary bypass. There were no anastomotic complications. Total intensive care unit stay was significantly lower in the later era compared to earlier era (p = 0.001). The other parameters such as C-reactive protein at the time of transplantation, total cold ischemic time, and total operation time were comparable between the two eras. Overall 30-day mortality was 5%. The 30-day mortality was significantly lower in the second period (p = 0.006). In the earlier era, 3-month, 1-year, and 5-year survival were 85 ± 6%, 77 ± 8%, and 60 ± 9%, respectively, and in the later era improved to 96 ± 2%, 92 ± 3%, and 78 ± 5% (p = 0.03).
  
  
  CONCLUSIONS
  Improved results obtained in the early postoperative period since 2000 is most likely due to change in surgical management approach. Improved surgical outcome for CF patients can be obtained, especially in experienced transplant centers.
authors.affiliation: Division of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland. ilhan.inci@usz.ch
authors.forename: Ilhan
authors.initials: I
authors.lastname: Inci
authors.forename: Olivia
authors.initials: O
authors.lastname: Stanimirov
authors.forename: Christian
authors.initials: C
authors.lastname: Benden
authors.forename: Peter
authors.initials: P
authors.lastname: Kestenholz
authors.forename: Markus
authors.initials: M
authors.lastname: Hofer
authors.forename: Annette
authors.initials: A
authors.lastname: Boehler
authors.forename: Walter
authors.initials: W
authors.lastname: Weder
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003550:Cystic Fibrosis / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D053208:Kaplan-Meier Estimate; D007902:Length of Stay / Q000706:statistics & numerical data; D016040:Lung Transplantation / Q000379:methods / Q000401:mortality / Q000706:statistics & numerical data / Q000639:trends*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013557:Switzerland / Q000453:epidemiology; D016896:Treatment Outcome; D014850:Waiting Lists; D055815:Young Adult