Outcomes of combined liver-lung transplant in pediatric patients with cystic fibrosis: An ISHLT transplant registry study
Background: Concomitant liver and lung transplant (ConLi-LTx) may be indicated for select pediatric patients with cystic fibrosis (CF). This study aims to analyze pre-transplant predictors and post-transplant outcomes of ConLi-LTx and lung transplant (LTx) only in pediatric patients with cystic fibr...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-02-01
|
| Series: | JHLT Open |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2950133425000072 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1823864054616162304 |
|---|---|
| author | Renita Wilson, BS J. Asher Jenkins, MD Juan Maria Farina, MD Blake Langlais, MS Bashar Aqel, MD Ashraf Omar, MD Jonathan D’Cunha, MD PhD Pedro Reck dos Santos, MD PhD |
| author_facet | Renita Wilson, BS J. Asher Jenkins, MD Juan Maria Farina, MD Blake Langlais, MS Bashar Aqel, MD Ashraf Omar, MD Jonathan D’Cunha, MD PhD Pedro Reck dos Santos, MD PhD |
| author_sort | Renita Wilson, BS |
| collection | DOAJ |
| description | Background: Concomitant liver and lung transplant (ConLi-LTx) may be indicated for select pediatric patients with cystic fibrosis (CF). This study aims to analyze pre-transplant predictors and post-transplant outcomes of ConLi-LTx and lung transplant (LTx) only in pediatric patients with cystic fibrosis. Methods: The ISHLT International Thoracic Organ Transplant Registry was queried for patients <18 years old with CF who underwent ConLi-LTx and LTx-only from 1994-June 2018. Data were propensity matched to LTx-only controls and analyzed with Fisher’s exact, Wilcoxon rank sum tests, Kaplan-Meier methods, and Cox proportional hazards where appropriate. Results: We identified 18 ConLi-LTx who were compared to 72 LTx-only cases. No significant differences were identified in patient demographics, resting oxygen requirement prior to transplant, or six-minute walking distance at time of listing. Interestingly, ConLi-LTx patients demonstrated significantly improved overall (p=0.0220) and BOS-free survival (p=0.0167). Conclusions: There were no differences in pre-transplant predictors of simultaneous liver and lung transplantation in pediatric patients with cystic fibrosis compared to those who received LTx-only. The noted survival benefits of ConLi-LTx remains uncertain, as patients who underwent simultaneous transplant are likely well-selected as candidates for such an extensive procedure, and we hypothesize that the liver may play a role in immunologic benefit. Further research is warranted regarding pre-transplant characteristics of pediatric cystic fibrosis patients who may be considered for concomitant liver with lung transplant. |
| format | Article |
| id | doaj-art-084bff0992c248b991b7ba88a6a33bfe |
| institution | Kabale University |
| issn | 2950-1334 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JHLT Open |
| spelling | doaj-art-084bff0992c248b991b7ba88a6a33bfe2025-02-09T05:02:03ZengElsevierJHLT Open2950-13342025-02-017100212Outcomes of combined liver-lung transplant in pediatric patients with cystic fibrosis: An ISHLT transplant registry studyRenita Wilson, BS0J. Asher Jenkins, MD1Juan Maria Farina, MD2Blake Langlais, MS3Bashar Aqel, MD4Ashraf Omar, MD5Jonathan D’Cunha, MD PhD6Pedro Reck dos Santos, MD PhD7Mayo Clinic Alix School of Medicine, Phoenix, AZ, United StatesDepartment of Cardiothoracic Surgery, Mayo Clinic Arizona, Phoenix, AZ, United StatesDepartment of Cardiothoracic Surgery, Mayo Clinic Arizona, Phoenix, AZ, United StatesDivision of Clinical Trials and Biostatistics, Mayo Clinic Arizona, Phoenix, AZ, United StatesDivision of Gastroenterology and Hepatology, Mayo Clinic Arizona, Phoenix, AZ, United StatesDivision of Transplant Pulmonology, Mayo Clinic Arizona, Phoenix, AZ, United StatesDepartment of Cardiothoracic Surgery, Mayo Clinic Arizona, Phoenix, AZ, United StatesDepartment of Cardiothoracic Surgery, Mayo Clinic Arizona, Phoenix, AZ, United States; Correspondence to: Department of Cardiothoracic Surgery, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ 85054.Background: Concomitant liver and lung transplant (ConLi-LTx) may be indicated for select pediatric patients with cystic fibrosis (CF). This study aims to analyze pre-transplant predictors and post-transplant outcomes of ConLi-LTx and lung transplant (LTx) only in pediatric patients with cystic fibrosis. Methods: The ISHLT International Thoracic Organ Transplant Registry was queried for patients <18 years old with CF who underwent ConLi-LTx and LTx-only from 1994-June 2018. Data were propensity matched to LTx-only controls and analyzed with Fisher’s exact, Wilcoxon rank sum tests, Kaplan-Meier methods, and Cox proportional hazards where appropriate. Results: We identified 18 ConLi-LTx who were compared to 72 LTx-only cases. No significant differences were identified in patient demographics, resting oxygen requirement prior to transplant, or six-minute walking distance at time of listing. Interestingly, ConLi-LTx patients demonstrated significantly improved overall (p=0.0220) and BOS-free survival (p=0.0167). Conclusions: There were no differences in pre-transplant predictors of simultaneous liver and lung transplantation in pediatric patients with cystic fibrosis compared to those who received LTx-only. The noted survival benefits of ConLi-LTx remains uncertain, as patients who underwent simultaneous transplant are likely well-selected as candidates for such an extensive procedure, and we hypothesize that the liver may play a role in immunologic benefit. Further research is warranted regarding pre-transplant characteristics of pediatric cystic fibrosis patients who may be considered for concomitant liver with lung transplant.http://www.sciencedirect.com/science/article/pii/S2950133425000072Concomitant transplantLung transplantCystic fibrosisPediatric |
| spellingShingle | Renita Wilson, BS J. Asher Jenkins, MD Juan Maria Farina, MD Blake Langlais, MS Bashar Aqel, MD Ashraf Omar, MD Jonathan D’Cunha, MD PhD Pedro Reck dos Santos, MD PhD Outcomes of combined liver-lung transplant in pediatric patients with cystic fibrosis: An ISHLT transplant registry study JHLT Open Concomitant transplant Lung transplant Cystic fibrosis Pediatric |
| title | Outcomes of combined liver-lung transplant in pediatric patients with cystic fibrosis: An ISHLT transplant registry study |
| title_full | Outcomes of combined liver-lung transplant in pediatric patients with cystic fibrosis: An ISHLT transplant registry study |
| title_fullStr | Outcomes of combined liver-lung transplant in pediatric patients with cystic fibrosis: An ISHLT transplant registry study |
| title_full_unstemmed | Outcomes of combined liver-lung transplant in pediatric patients with cystic fibrosis: An ISHLT transplant registry study |
| title_short | Outcomes of combined liver-lung transplant in pediatric patients with cystic fibrosis: An ISHLT transplant registry study |
| title_sort | outcomes of combined liver lung transplant in pediatric patients with cystic fibrosis an ishlt transplant registry study |
| topic | Concomitant transplant Lung transplant Cystic fibrosis Pediatric |
| url | http://www.sciencedirect.com/science/article/pii/S2950133425000072 |
| work_keys_str_mv | AT renitawilsonbs outcomesofcombinedliverlungtransplantinpediatricpatientswithcysticfibrosisanishlttransplantregistrystudy AT jasherjenkinsmd outcomesofcombinedliverlungtransplantinpediatricpatientswithcysticfibrosisanishlttransplantregistrystudy AT juanmariafarinamd outcomesofcombinedliverlungtransplantinpediatricpatientswithcysticfibrosisanishlttransplantregistrystudy AT blakelanglaisms outcomesofcombinedliverlungtransplantinpediatricpatientswithcysticfibrosisanishlttransplantregistrystudy AT basharaqelmd outcomesofcombinedliverlungtransplantinpediatricpatientswithcysticfibrosisanishlttransplantregistrystudy AT ashrafomarmd outcomesofcombinedliverlungtransplantinpediatricpatientswithcysticfibrosisanishlttransplantregistrystudy AT jonathandcunhamdphd outcomesofcombinedliverlungtransplantinpediatricpatientswithcysticfibrosisanishlttransplantregistrystudy AT pedroreckdossantosmdphd outcomesofcombinedliverlungtransplantinpediatricpatientswithcysticfibrosisanishlttransplantregistrystudy |