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Long‐Term Impact of Liver Transplantation on Respiratory Function and Nutritional Status in Children and Adults With Cystic Fibrosis
Author(s) -
Dowman J. K.,
Watson D.,
Loganathan S.,
Gunson B. K.,
Hodson J.,
Mirza D. F.,
Clarke J.,
Lloyd C.,
Honeybourne D.,
Whitehouse J. L.,
Nash E. F.,
Kelly D.,
van Mourik I.,
Newsome P. N.
Publication year - 2012
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/j.1600-6143.2011.03904.x
Subject(s) - medicine , cystic fibrosis , cirrhosis , liver transplantation , transplantation , gastroenterology , body mass index , liver disease , respiratory disease , pulmonary function testing , surgery , lung
Early liver transplant (LT) has been advocated for patients with cystic fibrosis liver disease (CFLD) and evidence of deterioration in nutritional state and respiratory function to prevent further decline. However, the impact of single LT on long‐term respiratory function and nutritional status has not been adequately addressed. We performed a retrospective analysis of the outcomes of 40 (21 adult/19 pediatric) patients with CFLD transplanted between 1987 and 2009 with median follow‐up of 47.8 months (range 4–180). One and five‐year actuarial survival rates were 85%/64% for adult and 90%/85% for pediatric LT cohorts, respectively. Lung function remained stable until 4 years (FEV 1 % predicted; pretransplant 48.4% vs. 45.9%, 4 years posttransplant) but declined by 5 years (42.4%). Up to 4 years posttransplant mean annual decline in FEV 1 % was lower (0.74%; p = 0.04) compared with the predicted 3% annual decline in CF patients with comorbidity including diabetes. Number of courses of intravenous antibiotics was reduced following LT, from 3.9/year pretransplant to 1.1/year, 5 years posttransplant. Body mass index was preserved posttransplant; 18.0 kg/m 2 (range 15–24.3) pretransplant versus 19.6 kg/m 2 (range 16.4–22.7) 5 years posttransplant. In conclusion, LT is an effective treatment for selected patients with cirrhosis due to CFLD, stabilizing aspects of long‐term lung function and preserving nutritional status.