AI Article Synopsis
- A study was conducted to analyze the effects of prior Burkholderia cepacia complex (BCC) infection on lung transplant outcomes in cystic fibrosis (CF) patients between 2000 and 2019, comparing BCC-infected and uninfected individuals.
- Out of 205 patients, 17 were BCC-infected, showing a one-year survival rate of 82.4% for these patients compared to 92.5% for those uninfected; however, when adjusted for various factors, BCC infection did not significantly affect survival rates.
- The analysis indicated that urgency of transplantation may be linked to worse outcomes for BCC-infected CF patients, suggesting that additional considerations should be made when evaluating them for lung
Article Abstract
Background: Prior infection with Burkholderia cepacia complex (BCC) has been associated with poorer outcomes after lung transplantation, posing an important dilemma for cystic fibrosis (CF). Although current guidelines consider BCC infection to be a relative contraindication, some centers continue to offer lung transplantation to BCC-infected CF patients.
Methods: We conducted a retrospective cohort study which included all consecutive CF-LTR between 2000 and 2019 to compare the postoperative survival of BCC-infected CF lung transplant recipients (CF-LTR) to BCC-uninfected patients. We used a Kaplan-Meier analysis to compare survival of BCC-infected to BCC-uninfected CF-LTR and fitted a multivariable Cox model, adjusted for age, sex, BMI and year of transplantation as potential confounders. As an exploratory analysis, Kaplan-Meier curves were also stratified by the presence of BCC and urgency of transplantation.
Results: A total of 205 patients were included with a mean age of 30.5 years. Seventeen patients (8%) were infected with BCC prior to LT. Patients were infected with the following species: B. multivorans, B. vietnamiensis, combined B. multivorans and B. vietnamiensis and others. None of the patients were infected with B. cenocepacia. Three patients were infected with B. gladioli. One-year survival was 91.7% (188/205) for the entire cohort, 82.4% (14/17) among BCC-infected CF-LTR, and 92.5% (173/188) among BCC uninfected CF-LTR (crude HR = 2.19; 95%CI 0.99-4.85; p = 0.05). In the multivariable model, presence of BCC was not significantly associated with worse survival (adjusted HR 1.89; 95%CI 0.85-4.24; p = 0.12). In the stratified analysis for both presence of BCC and urgency of transplantation, urgency of transplantation among BCC-infected CF-LTR appeared to be associated with poorer outcome (p = 0.003 across the 4 subgroups).
Conclusion: Our results suggest that non-cenocepacia BCC-infected CF-LTR have comparable survival rate to BCC-uninfected CF-LTR.
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| http://dx.doi.org/10.1016/j.healun.2023.02.001 | DOI Listing |
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