Article Text
Abstract
Background Lung transplantation is currently the most effective means of improving quality of life and survival in patients with end stage CF. Improvements in surgical technique, lung preservation, immune suppression and infection management have improved short and long term mortality and morbidity.
The number of significant medical complications encounter following lung transplantation can have significant impact on long term management of CF.
Aim To identify the frequency of medical complications that occur in a large cohort of post-transplant CF patients.
Method Retrospective review of electronic records to assess complications in all patients with CF who underwent Lung transplantation between September 1992 and June 2015.
Results 54 patients underwent lung transplantation (heart/lung -3, lung/liver -1) at different transplant centres, (female-35, male-19 current median age 36 years (range,22–66), current 10, 15 and 20 year survival rates are 43%, 22% and 7% respectively (median 87 months). Complications are shown in Table 1.
9 (17%) post-transplant patients died (median survival 77 months). Of these, 3 (33%) died secondary to malignancy.
Conclusion In addition to organ rejection and infective causes common systemic complications included hypertensive disease (50%), gastro-oesophageal reflux disease (30%), chronic kidney disease (26%), and osteoporosis (19%). It is notable that one third of patient mortality was due to malignancy. As patient survival improves we may need to consider increased screening of these high risk patients. Frequent monitoring and excellent collaboration between transplant and CF centres may lead to earlier detection and treatment of these complications.