Combined Double Lung–Liver Transplantation for Cystic Fibrosis Without Cardio‐Pulmonary By‐Pass

Corno, V.; Dezza, M.C.; Lucianetti, A.; Codazzi, Daniela; Carrara, B.; Pinelli, D.; Parigi, Piercarlo; Guizzetti, M.; Strazzabosco, Mario; Melzi, Maria Luisa; Gaffuri, G.; Sonzogni, Valter; Rossi, A.; Fagiuoli, Stefano; Colledan, M.

doi:10.1111/j.1600-6143.2007.01945.x

Cited by 20 publications

(14 citation statements)

References 21 publications

(28 reference statements)

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“…Patients with both severe respiratory failure and advanced liver cirrhosis as a result of CFLD are often excluded from consideration of sole lung transplantation or else are offered combined lung–liver transplantation (9). This is largely based on the assumption that CF patients with cirrhosis would be unable to survive the perioperative period and/or develop hepatocellular failure following lung transplantation.…”

mentioning

confidence: 99%

Outcomes of patients with cystic fibrosis undergoing lung transplantation with and without cystic fibrosis‐associated liver cirrhosis*

Nash

Volling

Gutiérrez

et al. 2011

Clinical Transplantation

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People with severe cystic fibrosis (CF) lung disease with co-existent CF-associated liver disease (CFLD) are often excluded from consideration of sole lung transplantation, largely because of the concerns that they will subsequently develop hepatic decompensation. This retrospective cohort study aimed at determining whether patients with severe cirrhosis caused by CFLD have any differences in perioperative and relevant post-transplant outcomes compared to CF patients without CFLD when undergoing sole lung transplantation. Six patients with CFLD were matched with 18 CF patients without CFLD undergoing sole lung transplant at the same institution. There were no differences in total operative time or intra-operative requirements for cardiopulmonary bypass or blood products. Over a period of five yr post-transplant, no differences were observed between the two groups in body mass index, six-min walk, lung function, and survival. None of the CFLD subjects developed variceal bleeding; however, one developed hepatocellular and renal failure at four yr post-transplant and is being assessed for liver-kidney transplant. One additional patient with CFLD required repeat lung transplantation for bronchiolitis obliterans syndrome. This study provides evidence that CF patients with liver cirrhosis caused by CFLD can safely be considered for sole lung transplantation provided there is no evidence of significant hepatocellular dysfunction with decompensated cirrhosis or hepatic synthetic failure.

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mentioning

confidence: 99%

Outcomes of patients with cystic fibrosis undergoing lung transplantation with and without cystic fibrosis‐associated liver cirrhosis*

Nash

Volling

Gutiérrez

et al. 2011

Clinical Transplantation

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“…In rare cases combined liver and lung transplantation has been performed, but the risk of perioperative complications is high and larger series are not available [180, 181]. In one small series the overall survival of those receiving a combined liver and lung transplantation was 70% at one and three years [181].…”

Section: Other Topicsmentioning

confidence: 99%

Practical Guidelines: Lung Transplantation in Patients with Cystic Fibrosis

Hirche¹,

Knoop

Hebestreit

et al. 2014

Pulmonary Medicine

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There are no European recommendations on issues specifically related to lung transplantation (LTX) in cystic fibrosis (CF). The main goal of this paper is to provide CF care team members with clinically relevant CF-specific information on all aspects of LTX, highlighting areas of consensus and controversy throughout Europe. Bilateral lung transplantation has been shown to be an important therapeutic option for end-stage CF pulmonary disease. Transplant function and patient survival after transplantation are better than in most other indications for this procedure. Attention though has to be paid to pretransplant morbidity, time for referral, evaluation, indication, and contraindication in children and in adults. This review makes extensive use of specific evidence in the field of lung transplantation in CF patients and addresses all issues of practical importance. The requirements of pre-, peri-, and postoperative management are discussed in detail including bridging to transplant and postoperative complications, immune suppression, chronic allograft dysfunction, infection, and malignancies being the most important. Among the contributors to this guiding information are 19 members of the ECORN-CF project and other experts. The document is endorsed by the European Cystic Fibrosis Society and sponsored by the Christiane Herzog Foundation.

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“…66 Patients with both severe respiratory failure and advanced liver cirrhosis are most often either offered combined lung-liver transplantation or excluded from transplantation; very few are considered for LT alone. 67 This is based on the assumption that these patients would be unable to survive the perioperative period or would develop hepatocellular failure. However, it has been demonstrated that post-transplant lung function and survival are not different between patients with or without CFLD who undergo LT alone.…”

Section: Liverd Is E a S Ementioning

confidence: 99%

Long‐term extrapulmonary comorbidities after lung transplantation in cystic fibrosis: Update of specificities

Jardel

Reynaud

Durieu

2018

Clinical Transplantation

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Lung transplantation (LT) is the standard therapeutic option for cystic fibrosis (CF) patients with end-stage lung disease. Both conditions lead to extrarespiratory complications, such as diabetes, renal insufficiency, bone disease, and cancer. The purpose of this study was to provide an update of the nonrespiratory comorbidities following LT in adult patients with CF and their specificities regarding their multisystemic underlying condition despite their younger age compared to other patients undergoing LT. Diabetes, renal insufficiency, metabolic bone disease, hypertension, liver disease, and cancer are the comorbidities considered in this review. The increase in CF adults living with a lung transplant justifies an update of knowledge for this specific situation (the prevalence of these complications, underlying risk factors), to provide better medical care and establish early diagnosis strategies.

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Combined Double Lung–Liver Transplantation for Cystic Fibrosis Without Cardio‐Pulmonary By‐Pass

Cited by 20 publications

References 21 publications

Outcomes of patients with cystic fibrosis undergoing lung transplantation with and without cystic fibrosis‐associated liver cirrhosis*

Outcomes of patients with cystic fibrosis undergoing lung transplantation with and without cystic fibrosis‐associated liver cirrhosis*

Practical Guidelines: Lung Transplantation in Patients with Cystic Fibrosis

Long‐term extrapulmonary comorbidities after lung transplantation in cystic fibrosis: Update of specificities

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