Elevated gamma-glutamyltransferase is associated with mortality in lung transplantation for cystic fibrosis.
Cystic fibrosis (CF) is a life-threatening autosomal recessive hereditary disease, affecting multiple organs. In end stage disease, lung transplantation improves the quality of life and prolongs survival. CF liver disease (CFLD) as co-morbidity develops in 8-17% of CF patients. We aimed to investigate the impact of liver injury on prognosis following lung transplantation. Thirty-one patients with CF who underwent double lung transplantation (DLTx) from 1999 to 2009 were included. Post-transplant survival, liver serum parameters as well as INR, creatinine and the MELD-Score were determined preoperatively, 1 day and 4 weeks postoperatively. Prognostic impact of liver function on outcome was analysed. Mean patient age was 25 (15-38) and post-transplant 1 year-survival was 74%, 3 years 71% and 5 years 68%. Patients were grouped according to post-transplant survival, those deceased within the first year as group I (n = 8) and patients who survived longer as group II (n = 23). Group I exhibited significantly elevated gamma-glutamyltransferase (GGT), bilirubin and reduced platelets postoperatively. Low platelet count, increased bilirubin and GGT were associated with mortality after DLTx. Prospective studies are needed to determine a potential use and clinical implications for liver function tests in patients with CF before lung transplantation.
Department of Gastroenterology and Hepatology, University Hospital Essen, Essen, Germany.
Alexander
A
Wree
Lars P
LP
Bechmann
Nevitha
N
Kumarasamy
Urte
U
Sommerwerck
Christoph
C
Jochum
Heinz
H
Jakob
Hideo A
HA
Baba
Guido
G
Gerken
Markus
M
Kamler
Ali
A
Canbay
D000293:Adolescent; D000328:Adult; D001663:Bilirubin / Q000378:metabolism; D001792:Blood Platelets / Q000378:metabolism; D015331:Cohort Studies; D003550:Cystic Fibrosis / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D016040:Lung Transplantation / Q000379:methods*; D008297:Male; D011184:Postoperative Period; D011379:Prognosis; D016896:Treatment Outcome; D005723:gamma-Glutamyltransferase / Q000097:blood*
D005723:gamma-Glutamyltransferase; D001663:Bilirubin