Nutrition in the CF Population: Impact on Wait-List and Post-Transplant Survival, a Single Center’s Experience

Abstract

<h3>Purpose</h3> Body mass index (BMI) affects mortality outcomes in cystic fibrosis (CF) and optimizing BMI is an important part of CF care. Enteral nutritional support through initiation of a percutaneous endoscopic gastrostomy (PEG) tube is a known method to increase BMI. Our aim was to investigate how BMI goals and aggressive nutritional interventions apply to patients undergoing lung transplantation. <h3>Methods and Materials</h3> A single center retrospective cohort analysis was performed on all CF patients who have undergone lung transplantation from 200-2011. BMI at time of listing and at time of removal/transplant, wait-list and post-transplant survival were analyzed using Kaplan Meier survival estimates and assessed with a log-rank value. <h3>Results</h3> 81 CF patients were included in the cohort, 57 survived to lung transplant and 24 patients expired while waiting for transplant. There was no significant difference in wait list survival based on BMI, although there was a trend towards improved survival with the presence of a PEG tube. Survival in the one year following transplant was improved in patients with BMIs <18 with PEG tubes in place prior to transplant. [figure 1] <h3>Conclusions</h3> In patients with suboptimal BMIs, the presence of a PEG tube resulted in improved survival in the year following lung transplantation. Additional nutritional factors that may impact survival which need to be examined include contact with dietician prior to transplant and assessment of pre-albumin measurements.