Lung transplantation for patients with cystic fibrosis and Burkholderia cepacia complex infection: A single-center experience

Soyza, Anthony De; Meachery, Gerard; Hester, Katy L.M.; Nicholson, A.; Parry, Gareth; Tocewicz, K.; Pillay, Thasee; Clark, Stephen; Lordan, James; Schueler, Stephan; Fisher, Andrew J.; Dark, John H.; Gould, F.K.; Corris, Paul A.

doi:10.1016/j.healun.2010.06.007

Cited by 158 publications

(106 citation statements)

References 37 publications

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“…В мировой научной медицинской литературе до настоящего времени отсутствуют методические рекомендации или клинические обзоры по лече-нию данной группы пациентов после транспланта-ции легких, имеются лишь сообщения отдельных трансплантационных центров об удачных или не-удачных схемах послеоперационной антимикроб-ной терапии [13][14][15]. Успех лечения в нашем на-блюдении обусловлен, по-видимому, комбинацией агрессивной хирургической тактики, адекватной лекарственной терапии (применение больших доз противомикробных лекарственных средств с целью преодоления антибиотикорезистентности), редук-ции иммуносупрессии и применением гиперба-рической оксигенации (ГБО).…”

Section: Discussionunclassified

LUNG TRANSPLANTATION IN CYSTIC FIBROSIS PATIENT WITH CHRONIC AIRWAYS INFECTION OF BURKHOLDERIA CEPACIA (the first case in Russian Federation)

Готье

Головинский

Попцов

et al. 2016

RJTAO

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Cystic fibrosis (CF) is the third most common indication for lung transplantation. The recipients with CF have shown the best early and late survival rates after surgery. The special group of CF patients consists of those, whose airways were infected with Burkholderia cepacia (B. cepacia), since the recurrence of B. cepacia infection after transplantation are coupled with extremely high risk of death. Up to the present, the question whether the patients in such conditions should be included onto the lung transplant waiting list is still unanswered. We describe a case of lung transplantation in the patient with late postoperative complication in the form of severe pyoseptic infl ammatory process caused by the recurrence of B. cepacia infection. The success of the treatment of this patient was achieved thanks to combined multidisciplinary approach. This therapeutic approach could be considered as a standard treatment protocol in case of its validation by further clinical experience.

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Section: Discussionunclassified

LUNG TRANSPLANTATION IN CYSTIC FIBROSIS PATIENT WITH CHRONIC AIRWAYS INFECTION OF BURKHOLDERIA CEPACIA (the first case in Russian Federation)

Готье

Головинский

Попцов

et al. 2016

RJTAO

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“…MMP-9 activity was also elevated in sputa from lung transplant patients, and those with the highest levels of MMP-9 activity were associated with patients with chronic lung transplant rejection (5). Transplanted CF patients that have been colonized with B. cenocepacia have poorer prognosis compared with patients colonized with other members of the complex (8). The activation of MMP-9 in response to B. cenocepacia infection together with its likely role in lung damage, shown here, may provide one mechanism whereby B. cenocepacia-colonized patients have poorer outcomes on transplant than patients colonized by B. cepacia complex species other than B. cenocepacia and is worthy of further study.…”

Section: Discussionmentioning

confidence: 99%

Activation of MMP-9 by human lung epithelial cells in response to the cystic fibrosis-associated pathogen Burkholderia cenocepacia reduced wound healing in vitro

Wright

Pilkington

Callaghan

et al. 2011

American Journal of Physiology-Lung Cellular and Molecular Phys

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Burkholderia cepacia complex is a group of bacterial pathogens that cause opportunistic infections in cystic fibrosis (CF). The most virulent of these is Burkholderia cenocepacia . Matrix metalloproteinases (MMPs) are upregulated in CF patients. The aim of this work was to examine the role of MMPs in the pathogenesis of B. cepacia complex, which has not been explored to date. Real-time PCR analysis showed that B. cenocepacia infection upregulated MMP-2 and MMP-9 genes in the CF lung cell line CFBE41o− within 1 h, whereas MMP-2, -7, and -9 genes were upregulated in the non-CF lung cell line 16HBE14o−. Conditioned media from both cell lines showed increased MMP-9 activation following B. cenocepacia infection. Conditioned media from B. cenocepacia -infected cells significantly reduced the rate of wound healing in confluent lung epithelia ( P < 0.05), in contrast to conditioned media from Pseudomonas aeruginosa -infected cells, which showed predominant MMP-2 activation. Treatment of control conditioned media from both cell lines with the MMP activator 4-aminophenylmercuric acetate (APMA) also resulted in clear activation of MMP-9 and to a much lesser extent MMP-2. APMA treatment of control media also delayed the repair of wound healing in confluent epithelial cells. Furthermore, specific inhibition of MMP-9 in medium from cells exposed to B. cenocepacia completely reversed the delay in wound repair. These data suggest that MMP-9 plays a role in the reduced epithelial repair observed in response to B. cenocepacia infection and that its activation following B. cenocepacia infection contributes to the pathogenesis of this virulent pathogen.

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“…These findings have important implications for CF subjects referred for lung tranpslant with active M. abscessus complex infections, as we believe that active infection should not be seen as a contraindication for transplantation. Risk stratification may be warranted in M. abscessus complex, as was recently described for Burkholderia cepacia complex [4], with greater risk in those colonised with M. abscessus (sensu stricto) and lower risk with other species. These pilot data do not directly test this hypothesis and direct testing with multicentre retrospective data is challenging given the low rate of transplantation listing of these subjects; of 5200 screened transplant cases, only two out of 17 with posttransplantation infection had isolated pre-transplant [8].…”

Section: Paediatric Lung Transplant Outcomes Vary With Mycobacterium mentioning

confidence: 93%

“…The current approach to listing varies markedly across transplant centres and refusal to consider transplantation in those with active infection is common. Recent data have suggested a stratified approach to transplant listing for CF subjects with Burkholderia cepacia complex may be appropriate, as poor outcomes were attributable to genomovar III (B. cenocepacia) alone [4].…”

Section: Paediatric Lung Transplant Outcomes Vary With Mycobacterium mentioning

confidence: 99%

Paediatric lung transplant outcomes vary withMycobacterium abscessuscomplex species

et al. 2013

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Lung transplantation for patients with cystic fibrosis and Burkholderia cepacia complex infection: A single-center experience

Cited by 158 publications

References 37 publications

LUNG TRANSPLANTATION IN CYSTIC FIBROSIS PATIENT WITH CHRONIC AIRWAYS INFECTION OF BURKHOLDERIA CEPACIA (the first case in Russian Federation)

LUNG TRANSPLANTATION IN CYSTIC FIBROSIS PATIENT WITH CHRONIC AIRWAYS INFECTION OF BURKHOLDERIA CEPACIA (the first case in Russian Federation)

Activation of MMP-9 by human lung epithelial cells in response to the cystic fibrosis-associated pathogen Burkholderia cenocepacia reduced wound healing in vitro

Paediatric lung transplant outcomes vary withMycobacterium abscessuscomplex species

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