TY - JOUR
T1 - Timing and priorities for cystic fibrosis patients candidates to lung transplantation
AU - Venuta, F.
AU - Rendina, E. A.
AU - De Giacomo, T.
AU - Quattrucci, Serena
AU - Vizza, D.
AU - Ciccone, Anna Maria
AU - Guarino, E.
AU - Della Rocca, C.
AU - Ricci, Constante
PY - 1998/10
Y1 - 1998/10
N2 - Bilateral lung transplantation is actually considered a valuable option for patients with endstage lung disease related to cystic fibrosis. Timing is crucial to transplant successfully as many patients as possible and it is mainly based on the progressive worsening of pulmonary function tests and quality of life. We reviewed the charts of all patients accepted for lung transplantation at our Institution, in order to assess the role of several functional and demographic parameters; we compared the group of patients able to successfully wait for transplantation (Group A) with patients dying on the waiting list (Group B). Twenty-eight patients were accepted: 15 were successfully transplanted (2 at other institutions) (mean waiting time: 117 days). 7 died waiting (mean waiting time: 108 days) and 6 are still on the list. We recorded FEV-1, FVC, PaO2, PaCO2, supplemental O2 requirement, 6- minute walking test, right ventricular ejection fraction (RVEF) and cardio- pulmonary hemodynamics measured at right heart catheterization; we recorded also age at time of diagnosis and at time of evaluation, sex, weight and Schwachman score. These parameters were compared be- tween Group A and B. Age at time of evaluation, sex, weight and Schwachman score did not present any difference between the two groups, as well as pulmonary function tests, PaO2, 6-minute walk test and RVEF. A statistically significant difference was found in terms of PaCO2 (43.9 ± 9.3 in Group Avs 69.1 ± 32.4 in Group B, heart rate at rest (102 ± 21 vs 131 ± 12) mean pulmonary artery pressure (20.6 ± 2.9 vs 36 ± 15.7), pulmonary vascular resistances (350 ± 96 vs 460 ± 119.4), cardiac index (3.2 ± 0.6 vs 5.4 ±0.9). On the base of our initial experience we conclude that a careful evaluation of CF candidates for lung transplantation is recommended. A deterioration of pulmonary function tests and quality of life are useful parameters to accept patients in the waiting list; however priority should be attributed also on the base of cardio-pulmonary hemodynamics. A larger series of patients is required to draw definitive conclusions.
AB - Bilateral lung transplantation is actually considered a valuable option for patients with endstage lung disease related to cystic fibrosis. Timing is crucial to transplant successfully as many patients as possible and it is mainly based on the progressive worsening of pulmonary function tests and quality of life. We reviewed the charts of all patients accepted for lung transplantation at our Institution, in order to assess the role of several functional and demographic parameters; we compared the group of patients able to successfully wait for transplantation (Group A) with patients dying on the waiting list (Group B). Twenty-eight patients were accepted: 15 were successfully transplanted (2 at other institutions) (mean waiting time: 117 days). 7 died waiting (mean waiting time: 108 days) and 6 are still on the list. We recorded FEV-1, FVC, PaO2, PaCO2, supplemental O2 requirement, 6- minute walking test, right ventricular ejection fraction (RVEF) and cardio- pulmonary hemodynamics measured at right heart catheterization; we recorded also age at time of diagnosis and at time of evaluation, sex, weight and Schwachman score. These parameters were compared be- tween Group A and B. Age at time of evaluation, sex, weight and Schwachman score did not present any difference between the two groups, as well as pulmonary function tests, PaO2, 6-minute walk test and RVEF. A statistically significant difference was found in terms of PaCO2 (43.9 ± 9.3 in Group Avs 69.1 ± 32.4 in Group B, heart rate at rest (102 ± 21 vs 131 ± 12) mean pulmonary artery pressure (20.6 ± 2.9 vs 36 ± 15.7), pulmonary vascular resistances (350 ± 96 vs 460 ± 119.4), cardiac index (3.2 ± 0.6 vs 5.4 ±0.9). On the base of our initial experience we conclude that a careful evaluation of CF candidates for lung transplantation is recommended. A deterioration of pulmonary function tests and quality of life are useful parameters to accept patients in the waiting list; however priority should be attributed also on the base of cardio-pulmonary hemodynamics. A larger series of patients is required to draw definitive conclusions.
KW - Bilateral lung transplantation
KW - Cardiopulmonary hemodynamic criteria
KW - Cystic fibrosis
KW - Options for transplantation
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M3 - Article
C2 - 9825236
AN - SCOPUS:0031732601
VL - 8
SP - 274
EP - 277
JO - European Journal of Pediatric Surgery
JF - European Journal of Pediatric Surgery
SN - 0939-7248
IS - 5
ER -