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Observational study of lung transplant recipients surviving 20 years

Lookup NU author(s): Sasiharan Sithamparanathan, Dr Logan Thirugnanasothy, Professor John Dark, Professor Andrew Fisher, Professor Kate Gould, Dr James Lordan, Dr Gareth Parry, Professor Paul Corris

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Abstract

Background: Lung transplant recipients have reduced long-term survival compared with other solid organ recipients. There is a lack of published data on the characteristics of very long term survivors.Methods: We describe the demographics, clinical history and post-procedure function of all lung transplant recipients who have survived greater than 20 years at our centre.Results: At the time of analysis there were 21 (16.4%) of 128 patients who survived over 20 years. The mean age at transplantation was 31.8 +/- 9.9 years. Five of 21 had undergone single-lung, eight double-lung and eight heart-lung transplant procedures. At the last evaluation, mean percentage predicted FEV1 in recipients of single and double lung were 51.3% and 57.9% respectively. By 20 years, 19 (90.5%) patients had developed bronchiolitis obliterans syndrome (BOS) with three (14%) BOS 1, six (29%) BOS 2 and 10 (48%) BOS 3 and two (9.5%) free from BOS. The median time to onset of BOS was 9.7 years (range 1.6-17.9). Of eight patients (38%) who required renal replacement, four (19%) had successfully undergone renal transplantation and four (19%) were on haemodialysis. Only one patient (5%) had symptomatic osteoporosis. Nineteen patients (90%) were treated for hypertension. Five patients (24%) had diabetes, all with an underlying diagnosis of cystic fibrosis and four of them developing diabetes post operatively.Conclusions: In our experience, 20-year survivors of lung transplantation had a delayed onset of BOS and morbidities due to immunosuppression that can be appropriately managed leading to long-term survival. (C) 2016 Elsevier Ltd. All rights reserved.


Publication metadata

Author(s): Sithamparanathan S, Thirugnanasothy L, Clark S, Dark JH, Fisher AJ, Gould KF, Hasan A, Lordan JL, Meachery G, Parry G, Corris PA

Publication type: Article

Publication status: Published

Journal: Respiratory Medicine

Year: 2016

Volume: 117

Pages: 103-108

Print publication date: 01/08/2016

Online publication date: 07/06/2016

Acceptance date: 06/06/2016

ISSN (print): 0954-6111

ISSN (electronic): 1532-3064

Publisher: W.B. Saunders Co. Ltd.

URL: http://dx.doi.org/10.1016/j.rmed.2016.06.008

DOI: 10.1016/j.rmed.2016.06.008


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