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Are heart-lung transplant recipients protected from developing bronchiolitis obliterans syndrome?
Ann Thorac Surg. 2006 Jan; 81(1):286-91; discussion 291.AT

Abstract

BACKGROUND

Heart-lung transplant recipients, when compared with heart transplant recipients, are relatively spared from allograft coronary artery disease. This study was undertaken to investigate whether heart-lung transplant recipients are also spared from experiencing bronchiolitis obliterans syndrome (BOS) when compared with double-lung transplant recipients. In addition, the risk factors for developing BOS after lung transplantation were analyzed.

METHODS

Heart-lung and bilateral sequential double-lung transplant recipients were reviewed retrospectively from 1990 to 2000 using the Stanford Transplant Database. The heart-lung transplant group consisted of 77 heart-lung transplant recipients and the double-lung transplant group consisted of 51 double-lung transplant recipients. The rates of BOS, survival, acute rejection, and cytomegalovirus infection at 1, 3, and 5 years were measured.

RESULTS

There were no significant differences in patient demographics between the two groups. Rates of survival and acute rejection were similar in the two transplant groups. The incidence of cytomegalovirus infection was significantly higher in heart-lung transplant recipients. Freedom from BOS was similar in the two transplant groups. Risk factors for the development of BOS in the heart-lung and double-lung transplant recipients included male donor, younger recipient age, a diagnosis other than cystic fibrosis, nonuse of cardiopulmonary bypass, and the use of OKT3 induction therapy.

CONCLUSIONS

Heart-lung transplant recipients exhibit BOS at a rate similar to double-lung transplant recipients. The immunoprotective effect the lung allograft presumably provides the heart is not reciprocated by the heart in preventing the development of BOS.

Authors+Show Affiliations

Department of Cardiothoracic Surgery, Stanford University, Stanford, California, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

16368382

Citation

Moffatt-Bruce, Susan D., et al. "Are Heart-lung Transplant Recipients Protected From Developing Bronchiolitis Obliterans Syndrome?" The Annals of Thoracic Surgery, vol. 81, no. 1, 2006, pp. 286-91; discussion 291.
Moffatt-Bruce SD, Karamichalis J, Robbins RC, et al. Are heart-lung transplant recipients protected from developing bronchiolitis obliterans syndrome? Ann Thorac Surg. 2006;81(1):286-91; discussion 291.
Moffatt-Bruce, S. D., Karamichalis, J., Robbins, R. C., Whyte, R. I., Theodore, J., & Reitz, B. A. (2006). Are heart-lung transplant recipients protected from developing bronchiolitis obliterans syndrome? The Annals of Thoracic Surgery, 81(1), 286-91; discussion 291.
Moffatt-Bruce SD, et al. Are Heart-lung Transplant Recipients Protected From Developing Bronchiolitis Obliterans Syndrome. Ann Thorac Surg. 2006;81(1):286-91; discussion 291. PubMed PMID: 16368382.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Are heart-lung transplant recipients protected from developing bronchiolitis obliterans syndrome? AU - Moffatt-Bruce,Susan D, AU - Karamichalis,John, AU - Robbins,Robert C, AU - Whyte,Richard I, AU - Theodore,James, AU - Reitz,Bruce A, PY - 2004/01/24/received PY - 2005/07/30/revised PY - 2005/08/15/accepted PY - 2005/12/22/pubmed PY - 2006/8/26/medline PY - 2005/12/22/entrez SP - 286-91; discussion 291 JF - The Annals of thoracic surgery JO - Ann Thorac Surg VL - 81 IS - 1 N2 - BACKGROUND: Heart-lung transplant recipients, when compared with heart transplant recipients, are relatively spared from allograft coronary artery disease. This study was undertaken to investigate whether heart-lung transplant recipients are also spared from experiencing bronchiolitis obliterans syndrome (BOS) when compared with double-lung transplant recipients. In addition, the risk factors for developing BOS after lung transplantation were analyzed. METHODS: Heart-lung and bilateral sequential double-lung transplant recipients were reviewed retrospectively from 1990 to 2000 using the Stanford Transplant Database. The heart-lung transplant group consisted of 77 heart-lung transplant recipients and the double-lung transplant group consisted of 51 double-lung transplant recipients. The rates of BOS, survival, acute rejection, and cytomegalovirus infection at 1, 3, and 5 years were measured. RESULTS: There were no significant differences in patient demographics between the two groups. Rates of survival and acute rejection were similar in the two transplant groups. The incidence of cytomegalovirus infection was significantly higher in heart-lung transplant recipients. Freedom from BOS was similar in the two transplant groups. Risk factors for the development of BOS in the heart-lung and double-lung transplant recipients included male donor, younger recipient age, a diagnosis other than cystic fibrosis, nonuse of cardiopulmonary bypass, and the use of OKT3 induction therapy. CONCLUSIONS: Heart-lung transplant recipients exhibit BOS at a rate similar to double-lung transplant recipients. The immunoprotective effect the lung allograft presumably provides the heart is not reciprocated by the heart in preventing the development of BOS. SN - 1552-6259 UR - https://www.unboundmedicine.com/medline/citation/16368382/Are_heart_lung_transplant_recipients_protected_from_developing_bronchiolitis_obliterans_syndrome L2 - https://linkinghub.elsevier.com/retrieve/pii/S0003-4975(05)01387-1 DB - PRIME DP - Unbound Medicine ER -