COMPLICATIONS FOLLOWING LUNG TRANSPLANTATION FOR CYSTIC-FIBROSIS

Patients with Cystic Fibrosis (CF) are in some respect potentially ide al candidates for lung transplantation. However the transplantation su rgeon has to face same complex specific problems typical of CF patient s, which may cause increased complications and mortality. Consciousnes s and prevention of these problems, as well as timely treatment, is th e key for success. For this reason we have reviewed the postoperative complications which occurred in our experience with 13 patients underg oing bilateral sequential double lung transplantation, followed for 5 to 16 months. One patient died in the 15th postoperative day for pneum onia and sepsis. Another patient died 45 days postoperatively for rena l and cardiac failure associated with pneumonia and sepsis. Eleven pat ients left the hospital without oxygen after 19 to 36 days and live cu rrently a normal life. One patient had phrenic nerve palsy which solve d spontaneously two months after the transplant. Three patients had a partial dehiscence of the surgical wound which required reclosure. Two patients had osteomielitis of the sternum which required surgical man agement. Out of 26 brochial anastomoses, 3 (in 2 patients) developed a stenosis which required Laser treatment. In one case the problem was permanently solved, while in the other patient the stenosis recurred f or over 4 months with mucosal hyperplasia and was successfully treated by increased in steroid dosage. Eight patients had pneumonia which wa s successfully treated, and 10 had CMV infection. In conclusion, patie nts with FC have an increased risk for postransplant complications. Th ese can however be successfully treated without jeopardizing lung term results.