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

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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)

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Objectives:
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. 

Methods:
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. 

Results:
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). 

Conclusions:
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.