Lung infections in pediatric lung transplantation: experience in 49 cases

Métras, D; Viard, L.; Kreitmann, Bernard; Ribéri, Alberto; Pannetier-Mille, Adrienne; Garbi, Olivier; Marti, Jean-Yves; Geigle, Pierre

doi:10.1016/s1010-7940(99)00059-7

Cited by 35 publications

(22 citation statements)

References 11 publications

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“…Most centres report frequent early infectious complications and infection as the most common cause of early mortality [15,18]. In our experience, infection was a challenge generally within the first 6 months posttransplant.…”

Section: Discussionmentioning

confidence: 54%

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Long-term outcome of lung transplantation for cystic fibrosis ? Danish results

Bech

2004

European Journal of Cardio-Thoracic Surgery

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Section: Discussionmentioning

confidence: 54%

“…Median time on the waiting list among recipients was 267 days (range 14-902). Most candidates were in poor nutritional status with median body-mass index of 17.7 (range [14][15][16][17][18][19][20][21]. Forty-five percent of the recipients were diagnosed with IDDM at time of transplantation.…”

Section: Patients' Clinical Characteristicsmentioning

confidence: 99%

Long-term outcome of lung transplantation for cystic fibrosis ? Danish results

Bech

2004

European Journal of Cardio-Thoracic Surgery

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“…Infections are an important cause of early and late complications and death in transplant patients [11,22,23]. Although infections were a major cause of morbidity also in our program, only four patients died of infections: one patient (10%) during the early postoperative period and three patients (33.3%) during the follow-up.…”

Section: Discussionmentioning

confidence: 81%

Lung transplantation for cystic fibrosis: 6-year follow-up

Quattrucci

Rolla

Cimino

et al. 2005

Journal of Cystic Fibrosis

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Lung transplantation is currently the most effective means of improving survival and quality of life in patients with end-stage cystic fibrosis. In reviewing our 6-year experience we sought to evaluate complications and survival after sequential bilateral lung transplantation. Between October 1996 and October 2002, 114 patients with cystic fibrosis were referred to us from 15 Italian regional centers and 2 support centers for cystic fibrosis as possible candidates for lung transplantation. Of these 114 patients, 99 were included in the waiting list and 15 were refused. The mean time spent on the waiting list was 6.8+/-5.2 months (range 1 day-21 months) for those patients receiving lung transplantation, and 5.4+/-4.5 months (range 10 days-18 months) for those 35 patients who died while on the waiting list. A total 55 patients (6 children and 49 adults), mean age 25.6+/-6.6 years (range 9-52 years), 29 males, underwent bilateral sequential lung transplantation. One patient had a second transplantation 14 months after the first. The most frequent medical non-infective complications after transplantation were chronic renal failure (n=27 patients), diabetes (n=31), osteoporosis (n=17), arterial hypertension (n=14), seizures (n=4), transient cerebral ischaemia (n=1), and transient bilateral blindness (n=1). Bacterial lower airways respiratory infections with the organisms that colonized patients' airways before lung transplantation developed in 42 patients; cytomegalovirus (CMV) infection in 41; and opportunistic infections of the lung with Pneumocystis carinii in 3 patients. Cultures of sputum or bronchoalveolar lavage fluid grew Aspergillus fumigatus in nine patients; aspergillosis of right bronchial anastomosis developed in one patient and a lung infection in another. Another patient had a pulmonary infection secondary to Aspergillus niger. An average of 1.3 episodes of acute rejection developed per patient in the first 6 months after lung transplantation. Freedom from bronchiolitis obliterans syndrome was 95% at 1 year, 82.5% at 2 years, 70% at 3 years, and 65% at 4, 5 and 6 years. Actuarial survival rates were 80% at 1 month, 79% at 1 year, 74% at 2 years, 70% at 3 years and 58% at 4, 5 and 6 years. Ten patients (17.8%) died in the early postoperative period (1-30 days) for the following reasons: primary graft failure (n=4), multiorgan failure (n=3), Burkholderia cepacia sepsis (n=1), myocardial infarction (n=1), and pulmonary embolism (n=1). Mortality was accounted for by 9 patients (16%) who died from 9 to 43 months after lung transplantation, for the following reasons: P. carinii infection (n=2), bronchiolitis obliterans syndrome (n=4), A. fumigatus pulmonary infection (n=1), unknown cause (n=1) and suicide (n=1). In conclusion, the leading causes of morbidity after lung transplantation for cystic fibrosis are pulmonary bacterial infection and opportunistic infections. Bronchiolitis obliterans develops in more than half of lung transplant recipients who survive for more than 3 years and is an important cause of...

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“…One report from France indicated only 2 of 49 patients developed post-transplant mycotic lung infection, whereas another group reported invasive fungal infections diagnosed post-mortem in conjunction with bronchiolitis obliterans. 14,15 Cases of Paecilomyces variotii and zygomycetes in pediatric lung recipients have been reported as well. 16,17 No comprehensive evaluation of pulmonary fungal infections (PFIs), including associated risks after pediatric lung transplantation, has been reported previously.…”

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confidence: 99%