Lung transplantation in cystic fibrosis patients in Israel: The importance of ethnicity and nutritional status

Levine, Hagit; Prais, Dario; Raviv, Yael; Rusanov, Victoria; Rosengarten, Dror; Sauté, Milton; Hoshen, Moshe; Mussaffi, Huda; Blau, Hannah; Kramer, Mordechai R.

doi:10.1111/ctr.13111

Cited by 10 publications

(2 citation statements)

References 31 publications

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“…However, for CF, only 2% patients were overweight and being underweight was associated with 5-year but not 1-year mortality [59]. In the meta-analysis, the pooled risk estimates from the two largest unique studies [18,24] did not reach statistical significance, findings corroborated by an ISHLT report [26] and six additional studies excluded from the meta-analysis because they evaluated graft survival [16,61] or included cases of multi-organ transplantation and/or retransplantation [60][61][62][63]. Two potential explanations for this lack of observed association could be a biphasic effect of BMI on post-LTx mortality which cannot be captured by the pooled risk estimates and a patient selection bias resulting from the exclusion of severely malnourished patients from LTx.…”

Section: Predictormentioning

confidence: 84%

Pre-transplant factors associated with mortality after lung transplantation in cystic fibrosis: A systematic review and meta-analysis

Koutsokera

Varughese

Sykes

et al. 2019

Journal of Cystic Fibrosis

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Background: Mortality risk stratification is essential in lung transplantation (LTx) to allow listing, prioritization and mitigating strategies. In cystic fibrosis (CF) patients, predictors of post-LTx mortality are not established. Methods: For this systematic review and meta-analysis, seven databases were searched until January 3, 2018 to identify predictors of post-LTx mortality in CF. We excluded studies of multi-organ transplantation, re-transplantation and graft survival. For multiple studies assessing the same population during overlapping time-periods, the largest one was analyzed. Risk of bias was assessed with the Newcastle-Ottawa scale (NOS). Pooled hazard ratios were calculated using random-effects models. Results: Fifty-four studies were included in the systematic review and 11 studies in the meta-analyses (low-tomoderate bias risk, NOS score ≥ 5). Among 10 factors assessed in the meta-analysis, B. cepacia complex (BCC) (N = 1451, unadjusted HR = 2.35, 95%CI:1.80-3.06; I 2 = 20.4% and adjusted HR = 2.49, 95%CI:1.74-3.57; I 2 = 46.2%) and ascending chronological year of LTx (N = 4207, unadjusted HR = 0.98, 95%CI:0.97-0.98, I 2 = 4.8%) were predictors of post-LTx mortality. Male gender (N = 2903, adjusted HR = 1.12, 95%CI:1.0-1.26, I 2 = 0%) and age in adults (N = 3677, unadjusted HR = 0.99, 95%CI:0.97-1.00; I 2 = 64.1% and N = 2605, adjusted HR = 0.98, 95%CI:0.97-0.99; I 2 = 34.3%) had borderline significant associations with post-LTx mortality. P. aeruginosa colonization, forced expiratory volume in one second (FEV 1 ), pulmonary hypertension, body mass index (BMI), pancreatic insufficiency and CF-related diabetes (CFRD) were not predictors of mortality. Conclusions: BCC was associated with a higher post-LTx mortality whereas FEV 1 , pulmonary hypertension, BMI, CFRD and female gender were not associated with post-LTx mortality. These findings indicate that CF-specific risk estimates of post-LTx mortality should be considered.

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Section: Predictormentioning

confidence: 84%

Pre-transplant factors associated with mortality after lung transplantation in cystic fibrosis: A systematic review and meta-analysis

Koutsokera

Varughese

Sykes

et al. 2019

Journal of Cystic Fibrosis

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show abstract

“…72,73 In CFLTRs, achieving goal body mass index (BMI) at 1 year after transplant was associated with improved survival and freedom from CLAD. 74,75 Given fluctuating energy needs, ongoing consultation by a CF dietitian is recommended to avoid malnutrition and obesity. 69,[76][77][78] The development of hypervitaminosis A and E has been observed in CF and non-CFLTRs; thus, the routine continuation of CF-specific combination vitamins after transplant is not recommended.…”

Section: Extra-pulmonary Cf Considerationsmentioning

confidence: 99%

Cystic fibrosis foundation consensus statements for the care of cystic fibrosis lung transplant recipients

Shah¹,

Lowery²,

Chaparro³

et al. 2021

The Journal of Heart and Lung Transplantation

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Sex Differences in Cystic Fibrosis Across the Lifespan

Bozkanat

Jain

2021

Physiology in Health and Disease

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Lung transplantation in cystic fibrosis patients in Israel: The importance of ethnicity and nutritional status

Abstract: Clinically important determinants for survival include BMI pre- and 1-year post-transplantation and improved freedom from BOS. Arab ethnicity correlated with higher incidence and earlier onset of BOS compared to Jewish ethnicity in Israel.

Cited by 10 publications

References 31 publications

Pre-transplant factors associated with mortality after lung transplantation in cystic fibrosis: A systematic review and meta-analysis

Pre-transplant factors associated with mortality after lung transplantation in cystic fibrosis: A systematic review and meta-analysis

Cystic fibrosis foundation consensus statements for the care of cystic fibrosis lung transplant recipients

Sex Differences in Cystic Fibrosis Across the Lifespan

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