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

Jardel, S.; Reynaud, Quitterie; Durieu, I.

doi:10.1111/ctr.13269

Cited by 9 publications

(8 citation statements)

References 89 publications

(197 reference statements)

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“…Since the first human lung transplant was performed in 1963, almost 55,000 lung transplantations have been performed worldwide, now with nearly 4600 lung transplantations performed annually [10]. Up to 68% of lung transplant recipients develop AKI, which has been associated with increased one-year mortality, length of hospital stay, higher resource utilization, and related health care burden [10,11,12,13,14,15,16,17,18,19,20,21,22]. Though survival following lung transplantation has improved over the past few decades, morbidity and mortality related to AKI after lung transplantation and resultant progressive CKD remain relatively high and is a cause for increasing concern [16,23,24,25].…”

Section: Introductionmentioning

confidence: 99%

Acute Kidney Injury after Lung Transplantation: A Systematic Review and Meta-Analysis

Lertjitbanjong

Cheungpasitporn

O'Corragain

et al. 2019

JCM

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Background: Lung transplantation has been increasingly performed worldwide and is considered an effective therapy for patients with various causes of end-stage lung diseases. We performed a systematic review to assess the incidence and impact of acute kidney injury (AKI) and severe AKI requiring renal replacement therapy (RRT) in patients after lung transplantation. Methods: A literature search was conducted utilizing Ovid MEDLINE, EMBASE, and Cochrane Database from inception through June 2019. We included studies that evaluated the incidence of AKI, severe AKI requiring RRT, and mortality risk of AKI among patients after lung transplantation. Pooled incidence and odds ratios (ORs) with 95% confidence interval (CI) were obtained using random-effects meta-analysis. The protocol for this meta-analysis is registered with PROSPERO (International Prospective Register of Systematic Reviews; no. CRD42019134095). Results: A total of 26 cohort studies with a total of 40,592 patients after lung transplantation were enrolled. Overall, the pooled estimated incidence rates of AKI (by standard AKI definitions) and severe AKI requiring RRT following lung transplantation were 52.5% (95% CI: 45.8–59.1%) and 9.3% (95% CI: 7.6–11.4%). Meta-regression analysis demonstrated that the year of study did not significantly affect the incidence of AKI (p = 0.22) and severe AKI requiring RRT (p = 0.68). The pooled ORs of in-hospital mortality in patients after lung transplantation with AKI and severe AKI requiring RRT were 2.75 (95% CI, 1.18–6.41) and 10.89 (95% CI, 5.03–23.58). At five years, the pooled ORs of mortality among patients after lung transplantation with AKI and severe AKI requiring RRT were 1.47 (95% CI, 1.11–1.94) and 4.79 (95% CI, 3.58–6.40), respectively. Conclusion: The overall estimated incidence rates of AKI and severe AKI requiring RRT in patients after lung transplantation are 52.5% and 9.3%, respectively. Despite advances in therapy, the incidence of AKI in patients after lung transplantation does not seem to have decreased. In addition, AKI after lung transplantation is significantly associated with reduced short-term and long-term survival.

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Section: Introductionmentioning

confidence: 99%

Acute Kidney Injury after Lung Transplantation: A Systematic Review and Meta-Analysis

Lertjitbanjong

Cheungpasitporn

O'Corragain

et al. 2019

JCM

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“…It also affects the liver and pancreas. Jardel et al published a study assessing extrapulmonary conditions like diabetes, renal insufficiency, metabolic bone disease, hypertension, and liver disease as they considered these co-morbidities to be important [32]. It is worth remembering that immunosuppressive treatment after lung transplantation is burdened by adverse effects.…”

Section: Discussionmentioning

confidence: 99%

Cystic Fibrosis: From Qualification to Lung Transplantation, a Single Center Experience

et al. 2019

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Background Cystic fibrosis (CF) is congenital multisystem disorder, that leads to gradual deterioration of pulmonary function. Advancements in therapy of CF-related lung disease have delayed its progression. However, lung transplantation remains the only therapeutic option for majority of such patients. Aim of the study was to assess qualification process and outcome of lung transplantation as a treatment of CF patients qualified in a single center between 2011 and 2018. Material/Methods This retrospective study assessed 41 patients who were qualified to be treated by means of lung transplantation due to CF in Lung Transplant Program of Silesian Center for Heart Diseases between 2011 and 2018. Analysis of patients during qualification process and after lung transplantation was performed. Lung recipients were observed during 1-year follow-up by means of pulmonary function tests. Results 1-year survival was noted among 80% of the patients; 3-year survival and 5-year survival were noted among 70% of the recipients. Mean forced expiratory volume in 1 second (FEV1) increased after lung transplantation: 21.19% at qualification; and 76.67% at 12 months after lung transplantation. Mean forced vital capacity (FVC) results also improved: 34.18% at qualification and 78.34% at 12 months after lung transplantation. The 6-minute walk test (6MWT) before and after treatment noted an increase of 175.55 m. Conclusions Lung transplantation improves respiratory capacity of CF patients and prolongs their life.

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“…Lung transplantation (LT) is the only option for patients with end‐stage lung disease in cystic fibrosis (CF) . CF accounts for approximately 23% of bilateral LT recipients, and CF patients have better survival than patients receiving LT for other indications .…”

Section: Introductionmentioning

confidence: 99%

“…The mean age at transplantation for CF patients was 31.5 years in France in 2016, and the young age of CF patients at the time of transplantation is specific to the disease. In addition to the comorbidities associated with LT, CF patients remain exposed to CF comorbidities, such as cystic fibrosis‐related diabetes (CFRD) . LT may modify the natural history of CF comorbidities, but the data are lacking.…”

Section: Introductionmentioning

confidence: 99%

Cystic fibrosis‐related diabetes before lung transplantation is associated with lower survival but does not affect long‐term renal function

Mainbourg

Philit

Touzet

et al. 2019

Pediatric Pulmonology

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Objective: To describe the prevalence of cystic fibrosis-related diabetes (CFRD) before and after lung transplantation (LT); to analyse the survival and renal function after LT according to the CFRD status before LT. Methods: Sixty cystic fibrosis (CF) patients transplanted at the Lyon UniversityHospital between 2004 and 2014 were included. Genotype, pancreatic status, age at LT, survival were recorded. Glucose tolerance status, daily insulin dose requirement, glomerular filtration rate (GFR), and daily glucocorticoid (GC) dose were recorded before LT and until December 2016.Results: The median follow-up was 5.6 (3.8-8.2) years, and nine patients died. Survival was poorest for patients with CFRD before LT compared with those without CFRD (P = 0.03) but was not correlated with the GFR before LT, with sex, age at LT, or CF genotype. The prevalence of CFRD was 68% at 2 years and 54% at 5 years. For persistent insulin-treated CFRD, the insulin requirement decreased (−2.1 IU/d/y; P < 0.01) and was correlated with the daily GC dose (+0.4 IU/d for one additional milligram, P = 0.012). Seven (11%) patients who had insulin-treated CFRD before LT became nondiabetic after LT, with a median time of 2 (1-4) years. After LT, the GFR decreased (−5.3 ml/min/1.73 m 2 /y; P < 0.001) and was not correlated with the CFRD status before LT.Conclusions: CFRD before LT is associated with poor survival after LT, which should lead to better management of diabetes. Some patients with pre-LT CFRD became nondiabetic after LT. CFRD is not associated with renal insufficiency after LT. K E Y W O R D S cystic fibrosis, cystic fibrosis-related diabetes, lung transplantation, renal function Pediatric Pulmonology. 2019;54:977-983.wileyonlinelibrary.com/journal/ppul

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

Cited by 9 publications

References 89 publications

Acute Kidney Injury after Lung Transplantation: A Systematic Review and Meta-Analysis

Acute Kidney Injury after Lung Transplantation: A Systematic Review and Meta-Analysis

Cystic Fibrosis: From Qualification to Lung Transplantation, a Single Center Experience

Cystic fibrosis‐related diabetes before lung transplantation is associated with lower survival but does not affect long‐term renal function

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