Publication
Outcomes of non‐cystic fibrosis‐related bronchiectasis post‐lung transplantation
Publisher:
Wiley
Date:
31-05-2022
DOI:
10.1111/IMJ.15256
Abstract: Lung transplantation is a recognised treatment for end‐stage lung disease due to bronchiectasis. Non‐cystic fibrosis (CF) bronchiectasis and CF are often combined into one cohort however, outcomes for non‐CF bronchiectasis patients vary between centres, and in comparison with those for CF. To compare lung transplantation mortality and morbidity of bronchiectasis (non‐CF) patients with those with CF and other indications. Retrospective analysis of patients undergoing lung transplantation between 1 January 2008 and 31 December 2013. Time to and cause of lung allograft loss was censored on 1 April 2018. A case‐note review was conducted on a subgroup of 78 patients, to analyse hospital admissions as a marker of morbidity. A total of 341 patients underwent lung transplantation 22 (6%) had bronchiectasis compared with 69 (20%) with CF. The 5‐year survival for the bronchiectasis group was 32%, compared with CF (69%), obstructive lung disease (OLD) (64%), pulmonary hypertension (62%) and ILD (55%) ( P = 0.008). Lung allograft loss due to chronic lung allograft dysfunction with predominant infection was significantly higher in the bronchiectasis group at 2 years. The rate of acute admissions was 2.24 higher in the bronchiectasis group when compared with OLD ( P = 0.01). Patients with bronchiectasis spent 45.81 days in hospital per person year after transplantation compared with 18.21 days for CF. Bronchiectasis patients in the present study had a lower 5‐year survival and poorer outcomes in comparison with other indications including CF. Bronchiectasis should be considered a separate entity to CF in survival analysis.