Klinisch II - P18 - Pretransplant HRCT Characteristics are Associated with Worse Outcome of Lung Transplantation for Cystic Fibrosis Patients

G. Belle-van Meerkerk, P.A. de Jong, H.W. de Valk, T. Neefjes, F.A. Pameijer, J.M. Kwakkel-van Erp, E.A. van de Graaf

Chair(s): prof. dr. Herold Metselaar, MDL-arts, Erasmus MC Rotterdam

Thursday 10 march 2016

12:30 - 13:00h at Foyer

Categories: Postersessie

Parallel session: Postersessies XI - Opgesplitst in 3 tijdblokken en 3 categoriëen (klinisch, basaal, donatie)

Peri- and postoperative complications diminish the outcome of lung transplantation (LTx) in patients with cystic fibrosis (CF). We hypothesized that the degree of pathological findings on pre-LTx high resolution computed tomography (HRCT) is associated with higher morbidity and mortality in CF. 

All our CF patients undergoing LTx between 2001 and 2011 were included. HRCT examinations were evaluated according to a scoring system for pulmonary disease in CF patients, the Severe Advanced Lung Disease (SALD) score and for pleural involvement. 

Fifty-three patients were included. Dominant infectious/inflammatory disease according to the SALD score was observed in 10 patients (19%). Five (50%) of those patients died within one week after LTx, compared to 2 (5%) patients without dominant infectious/inflammatory disease (p<0.001). This difference in survival percentage remained also significant after multivariate analysis. Patients with infectious/inflammatory disease were transfused more packed red blood cells; 26 versus 8 in the first week (p<0.001). Pleural thickening was associated with higher requirement (10 units) for blood transfusion during LTx, compared to patients with normal pleura (4 units). 

The analysis of HRCT in CF patients according to the SALD score showed that dominant infectious/inflammatory disease is associated with a higher mortality after LTx. HRCT may be a tool for estimating the risk of mortality after LTx in patients with CF.