LUNG TRANSPLANTATION FOR CYSTIC-FIBROSIS - EFFECTIVE AND DURABLE THERAPY IN A HIGH-RISK GROUP

Background. The purpose of this study was to review our experience wit h lung transplantation in patients with end-stage cystic fibrosis. Met hods. Eight-two patients with cystic fibrosis have undergone bilateral lung transplantation (n = 76) or bilateral lower lobe transplantation (n = 6) since October 1990. Results. Actuarial survival for the entir e cohort is 79% at 1 year and 57% at 5 years. The development of bronc hiolitis obliterans syndrome is the leading cause of death after the f irst year. Freedom from bronchiolitis obliterans syndrome is 84% at 1 year and 51% at 3 years. Pulmonary function tests improve dramatically in recipients. There was no association between death within 1 year a nd recipient age, weight, graft ischemic time, cytomegalovirus seroneg ativity, or the presence of panresistant organisms. Similarly, there w as no association between the development of bronchiolitis obliterans syndrome within 2 years and ischemic time, number of rejection episode s, cytomegalovirus seronegativity, or the presence of panresistant org anisms. Conclusions. Despite their poor nutritional status and the pre sence of multiply resistant organisms, patients with cystic fibrosis c an undergo bilateral lung transplantation with acceptable morbidity an d mortality. (C) 1998 by The Society of Thoracic Surgeons.