Il trapianto polmonare in pazienti affetti da fibrosi cistica: Follow-up medico

From between 1996 to November 1997 13 bilateral lung transplantation in Cystic Fibrosis patients (4 m, 9 f) aged 19-38 years (mean 26 years) are perfomed. Pre Tx evaluation included: Shwachman Score, Chrispin Score, HR chest tomography, respiratory function tests, pulmonary perfusion and ventilation scans, cardiac catheterism. The basterial, fungal and viral status of each patient was also evaluated. Immunosoppression was achieved with cyclosporine 2 mg/Kg/day, azathioprine 2 mg/Kg/day; ALG (10 mg/Kg/day) for 5 days and metilprednisolone 125 mg x 3 day for 3 days. 11 pts are alive after a follow up from 5-16 months, 2 pts (1 m, 1 f) died for sepsis and multiorgam failure, 2 pts needed Nd-Yag Laser and 1 of them stenting of the bronchus for bronchial anastomotic stricture. Other complication were: diabetes (3), seizures (2), renal failure (2), meconium ileus equivalent (1), acute rejection (4), bacterial pulmonary infection (10), CMV infection (10), varicella (1). Shwachman score modified (Shw score) and respiratory function (FEV1) improved (Shwachman score mean: pre Tx 43/75 vs post Tx 70/75; FEV1 mean: pre Tx 16% vs 77% at 6 months post Tx and 72% at 12 months post Tx). This reports documents that, for CF pts end-stage lung disease, double lung transplantation can offer an improved survival and quality of life.