Document Detail


The outcomes of lung transplantation in patients with bronchiectasis and antibody deficiency.
MedLine Citation:
PMID:  16210124     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Lung transplantation is an established treatment for end-stage bronchiectasis. A proportion of patients with bronchiectasis have an associated antibody deficiency. This group benefits from immunoglobulin replacement therapy, but the outcome of lung transplantation is not known. METHODS: We conducted a retrospective observational study of all who received a transplant for bronchiectasis at our unit. We compared the survival after transplant, number of infective and rejection episodes, and the change in forced expiratory volume in 1 second (FEV1). RESULTS: Five of the 37 patients identified with bronchiectasis had an antibody deficiency that required immunoglobulin replacement therapy. Actuarial survival was similar in the 2 groups, being 81% at 12 months in the Bronchiectasis Group and 80% in the Antibody Deficiency Group. The FEV1 at 12 months after transplantation was similar in each group, with a predicted mean +/- SD FEV1 of 83.7% +/- 24.2% in those with bronchiectasis and 83.0% +/- 30.4% in those with antibody deficiency as well. The infection and rejection rates in the first year after transplantation were lower in the Antibody Deficiency Group. Infection episodes per 100 patient-days for bronchiectasis alone were 0.90 vs 0.53 and rejection episodes per 100 patient-days were 0.59 vs 0.24. CONCLUSIONS: There was no evidence that transplant recipients with bronchiectasis and antibody deficiency have a worse prognosis than those with bronchiectasis alone.
Authors:
James A Nathan; Linda D Sharples; Andrew R Exley; Pasupathy Sivasothy; John Wallwork
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation     Volume:  24     ISSN:  1557-3117     ISO Abbreviation:  J. Heart Lung Transplant.     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-10-07     Completed Date:  2006-07-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9102703     Medline TA:  J Heart Lung Transplant     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1517-21     Citation Subset:  IM    
Affiliation:
Papworth Hospital NHS Trust, Papworth Everard, Cambridge, United Kingdom. janathan@btinternet.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Antifungal Agents / therapeutic use
Antiviral Agents / therapeutic use
Bronchiectasis / complications,  surgery*
Chemoprevention
Cytomegalovirus Infections / etiology
Female
Forced Expiratory Volume
Graft Rejection / etiology,  prevention & control
Heart Transplantation
Humans
Immunoglobulins, Intravenous / therapeutic use
Immunologic Deficiency Syndromes / complications,  surgery*
Immunosuppressive Agents / therapeutic use
Infection / etiology,  therapy
Lung Transplantation*
Male
Middle Aged
Retrospective Studies
Survival Analysis
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antifungal Agents; 0/Antiviral Agents; 0/Immunoglobulins, Intravenous; 0/Immunosuppressive Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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