title: Pulmonary resection after lung transplantation in cystic fibrosis patients.
abstract: Pulmonary resection after lung transplantation in end-stage cystic fibrosis presents unique challenges, and scant literature exists to guide physicians. We retrospectively reviewed 78 transplants for cystic fibrosis performed between 2003 and 2008. Fourteen patients underwent posttransplantation pulmonary resection. We analyzed the indications, surgical procedures, outcomes, and survival. Three pneumonectomies, 4 lobectomies, and 11 wedge resections were carried out. We identified 2 groups based on indication: a diagnostic group, and a therapeutic group of patients in whom the indications were septic native lung in 2, allograft infection in 2, lobar torsion in 2, pulmonary infarction in 2, and size mismatch in 4. The mean intensive care unit and hospital stays were 29 and 50 days, respectively. Four (28.57%) patients died during follow-up, including 2 who underwent pneumonectomy; 10 (71.43%) are still alive. Survival was 43.43 ± 8.06 months, and it was not significantly different from that in cystic fibrosis patients who had lung transplantation without pulmonary resection. Pulmonary resection following lung transplantation in cystic fibrosis patients showed acceptable survival and surgical risk, but metachronous pneumonectomy was associated with higher mortality.
authors: Thoracic Surgery and Lung Transplant Department, European Georges Pompidou, Paris, France. redha.souilamas@egp.aphp.fr
authors: Rédha
authors: R
authors: Souilamas
authors: Mauricio
authors: M
authors: Saueressig
authors: Véronique
authors: V
authors: Boussaud
authors: Catherine
authors: C
authors: Amrein
authors: Romain
authors: R
authors: Guillemain
authors: Joshua
authors: J
authors: Sonett
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003550:Cystic Fibrosis / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D016040:Lung Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D010297:Paris; D011013:Pneumonectomy / Q000009:adverse effects / Q000401:mortality; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult