Lung transplantation in cystic fibrosis patients in Israel: The importance of ethnicity and nutritional status.

Abstract

To assess the characteristics that correlate with better outcomes after lung transplantation for patients with cystic fibrosis (CF). We retrospectively reviewed the charts of all patients with CF who underwent lung transplantation between 1996 and 2014 at Rabin Medical Center, Israel. Fifty patients with CF underwent 55 lung transplantations. Eighteen patients (36%) died during the study period. Actuarial survival was 83%, 68%, 62%, and 39% at 1, 3, 5, and 10 years, respectively. Better survival correlated with: BMI at 6 months and 1 year after transplantation (P=.002 and P=.003, respectively), ischemic time of less than 300minutes (P=.023), absence of liver disease (P=.012), and Jewish compared to Arab ethnicity (P=.007). Freedom from bronchiolitis obliterans syndrome (BOS) was 87%, 75%, and 72% at 1, 3, and 5 years, respectively. BOS was more common and appeared earlier in the Arab than in the Jewish population (P=.012, P=.007). Additionally, prolonged time free of BOS correlated with male gender (P=.039), older age (P<.001), absence of liver disease (P=.012), and higher BMI 1 year after transplantation (P<.001). Clinically important determinants for survival include BMI pre- and 1-year post-transplantation and improved freedom from BOS. Arab ethnicity correlated with higher incidence and earlier onset of BOS compared to Jewish ethnicity in Israel.