Lower incidence of bronchiolitis obliterans in pediatric liver-lung transplant recipients with cystic fibrosis

Albert Faro, Ross Shepherd, Charles B. Huddleston, Jeffrey Lowell, Sanjiv Gandhi, Michelle Nadler, Stuart C. Sweet

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

BACKGROUND. Simultaneous liver-lung transplantation is an infrequent but technically feasible procedure in patients with end-stage lung disease and advanced liver disease. We characterize the outcomes of pediatric patients who underwent this procedure at our institution. METHODS. We performed a retrospective, case-control study and reviewed the medical records of all patients referred to our transplant program from its inception. Seven patients were listed for simultaneous liver-lung transplant. The five patients who survived to transplant were matched to 13 controls who underwent isolated bilateral sequential lung transplant for underlying diagnosis, age at time of transplant, gender, and era of transplant. Outcome measures included patient and graft survival, occurrence of bronchiolitis obliterans (BO), and episodes of rejection. RESULTS. Of the five study patients who underwent liver-lung transplant, one died of multiorgan failure 11 days after transplant compared with 9 of 13 controls who died. The median survival for the study patients was 89 months (range, 0-112 months) compared with the controls, who had a median survival of 34 months (range, 0-118 months). The remaining four patients had bronchiolitis obliterans syndrome scores of 0 compared with 5 of 13 control patients (P=0.02). The rate of acute rejection per 100 patient days was 0.012 for the study patients compared with 0.11 for the controls (P=0.025). CONCLUSIONS. Simultaneous liver-lung transplantation is a technically feasible procedure with excellent long-term outcomes. The surviving study subjects remain free from bronchiolitis obliterans syndrome. These results suggest that the transplanted liver may bestow immunologic privilege to the lung allograft.

Original languageEnglish
Pages (from-to)1435-1439
Number of pages5
JournalTransplantation
Volume83
Issue number11
DOIs
StatePublished - Jun 2007

Keywords

  • Bronchiolitis obliterans
  • Cystic fibrosis
  • Liver transplantation
  • Lung transplantation
  • Pediatrics

Fingerprint

Dive into the research topics of 'Lower incidence of bronchiolitis obliterans in pediatric liver-lung transplant recipients with cystic fibrosis'. Together they form a unique fingerprint.

Cite this