title: Lung transplantation for non-cystic fibrosis bronchiectasis.
abstract: Lung transplantation (LTx) is a well-established treatment for end-stage pulmonary disease. However, data regarding microbiology and outcome of patients with non-cystic fibrosis bronchiectasis (NCFB) after lung transplantation are limited.
  
  
  
  A retrospective analysis between August 1992 and September 2014 of all patients undergoing lung transplantation at our program of all recipients with a primary diagnosis of bronchiectasis was performed. Microbiology of sputum and bronchoalveolar lavage specimens, lung function and clinical parameters pre- and post-LTx were assessed retrospectively. Overall survival was compared to the total cohort of lung transplant recipients at institution. The survival and development of chronic lung allograft dysfunction (CLAD) was compared in patients with and without chronic Pseudomonas aeruginosa (PSA) infection after LTx.
  
  
  
  34 patients were transplanted. Median age at transplantation was 40 (IQR 33-52) years. The most common etiologies of bronchiectasis were idiopathic (41%), chronic obstructive pulmonary disease (COPD) (21%) and post-infectious (15%). The most common organism of pre- and posttransplant chronic airway infection was PSA. One-year Kaplan-Meier survival for patients with bronchiectasis was 85% and 5-year survival was 73% and similar to the entire cohort. All three patients with an associated diagnosis of immunodeficiency died due to infection and sepsis within the first year. Patients with persistent colonization with Pseudomonas aeruginosa after transplantation had worse long-term survival by trend and developed chronic lung allograft dysfunction more frequently.
  
  
  
  Overall survival of patients with bronchiectasis after LTx is comparable to other underlying diseases. A reduced survival was observed in patients with the underlying diagnosis of immunodeficiency.
authors.affiliation: Dept. of Respiratory Medicine, Hannover Medical School, Carl- Neuberg Str. 1, Hannover, Germany. Electronic address: rademacher.jessica@mh-hannover.de.
authors.forename: Jessica
authors.initials: J
authors.lastname: Rademacher
authors.affiliation: Dept. of Respiratory Medicine, Hannover Medical School, Carl- Neuberg Str. 1, Hannover, Germany; BREATH, Biomedical Research in End-stage and Obstructive Lung Disease, Hannover Medical School, Member of the German Center for Lung Research (DZL), Carl- Neuberg Str. 1, Germany.
authors.forename: Felix C
authors.initials: FC
authors.lastname: Ringshausen
authors.affiliation: Dept. of Respiratory Medicine, Hannover Medical School, Carl- Neuberg Str. 1, Hannover, Germany.
authors.forename: Hendrik
authors.initials: H
authors.lastname: Suhling
authors.affiliation: BREATH, Biomedical Research in End-stage and Obstructive Lung Disease, Hannover Medical School, Member of the German Center for Lung Research (DZL), Carl- Neuberg Str. 1, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Fuge
authors.affiliation: Dept. of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl- Neuberg Str. 1, Hannover, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Marsch
authors.affiliation: BREATH, Biomedical Research in End-stage and Obstructive Lung Disease, Hannover Medical School, Member of the German Center for Lung Research (DZL), Carl- Neuberg Str. 1, Germany; Dept. of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl- Neuberg Str. 1, Hannover, Germany.
authors.forename: Gregor
authors.initials: G
authors.lastname: Warnecke
authors.affiliation: BREATH, Biomedical Research in End-stage and Obstructive Lung Disease, Hannover Medical School, Member of the German Center for Lung Research (DZL), Carl- Neuberg Str. 1, Germany; Dept. of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl- Neuberg Str. 1, Hannover, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Haverich
authors.affiliation: Dept. of Respiratory Medicine, Hannover Medical School, Carl- Neuberg Str. 1, Hannover, Germany; BREATH, Biomedical Research in End-stage and Obstructive Lung Disease, Hannover Medical School, Member of the German Center for Lung Research (DZL), Carl- Neuberg Str. 1, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Welte
authors.affiliation: Dept. of Respiratory Medicine, Hannover Medical School, Carl- Neuberg Str. 1, Hannover, Germany; BREATH, Biomedical Research in End-stage and Obstructive Lung Disease, Hannover Medical School, Member of the German Center for Lung Research (DZL), Carl- Neuberg Str. 1, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Gottlieb
mesh_terms: D000328:Adult; D001987:Bronchiectasis / Q000150:complications* / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D001989:Bronchiolitis Obliterans / Q000150:complications / Q000209:etiology / Q000382:microbiology; D018893:Bronchoalveolar Lavage; D003550:Cystic Fibrosis / Q000150:complications / Q000382:microbiology / Q000601:surgery*; D005260:Female; D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000150:complications / Q000175:diagnosis; D016040:Lung Transplantation / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D055031:Primary Graft Dysfunction / Q000150:complications; D011552:Pseudomonas Infections / Q000150:complications / Q000401:mortality; D011550:Pseudomonas aeruginosa / Q000254:growth & development / Q000302:isolation & purification; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000453:epidemiology; D012129:Respiratory Function Tests / Q000379:methods; D012189:Retrospective Studies; D013183:Sputum / Q000382:microbiology; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Bronchiectasis; Bronchiolitis obliterans syndrome; Chronic airway infection; Lung transplantation; Pseudomonas aeruginosa; Survival