RT Journal Article
SR Electronic
T1 Colonization of bacteria after lung transplantation in cystic fibrosis (CF) patients occurs early but does not impact survival
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA1297
DO 10.1183/13993003.congress-2015.PA1297
VO 46
IS suppl 59
A1 Anna Engell Holm
A1 Hans Henrik Schutz
A1 Michael Perch
A1 Tacjana Pressler
A1 Jørn Carlsen
A1 Martin Iversen
YR 2015
UL http://erj.ersjournals.com/content/46/suppl_59/PA1297.abstract
AB Introduction: The majority of CF patients referred for transplantation are colonized with opportunistic bacteria. It is well known that colonization in CF patients impairs survival pre-transplant. The rate of colonziation after transplantation has been described, but the impact on survival after stratification of bacteria is not clearly defined.Methods: A retrospective analysis comprising 99 consecutive CF patients undergoing lung transplantation since beginning of the programme in 1992 until October 2014. Two were excluded due to re-transplantation. The analysis was focused on Pseudomonas Aureginosa (PA), Stenotrophomonas maltophilia (SM), Achromobacter xylosoxidans (AX) and Burkholderia cephacia complex (BCC) which in our population were the most frequent microbes. Patients were followed-up with bronchoscopy and bronchoalveolar lavage (BAL) at 2, 4, 8 and 12 weeks and 6, 12, 18 and 24 months after transplantation. Time to colonization was defined as time from transplantation to the first persistent positive culture, in BAL fluid or tracheal mucous.Results: Seventy-three of 97 had sufficient data for analyses with a median of 7 (1-91) cultures available. Median colonization-free survival was 23 days. At 2 years 86,7% was colonized, 33 (48,5%) with PA, 12 (17,6%) with AX, 7 (10,3%) with BCC and 7 (10,3%) with SM. No difference in survival was observed between the patients colonized within the first 2 years and those not colonized.Conclusion: Colonization of bacteria in the lower airways occurs at a median of 23 days after transplantation in CF patients. In this population overall survival was not influenced by time to colonization or type of bacteria present.