Clinical outcomes of bilateral lung transplantation for cystic fibrosis in frame of the european multicentric COLT study

The main long term complication of lung transplantation is CLAD (Chronic Lung Allograft Dysfunction). COLT (Cohort in Lung Transplantation) is the largest biocollection in Europe set up in order to identify a biological marker of CLAD. The objective of the study is to describe clinical outcomes of cystic fibrosis (CF) patients in COLT, with at least one year follow up post transplantation. From september 2009 to june 2012, 156 CF patients underwent bilateral lung transplantation. 48% were men, with mean age 27,5 and 18 IMC. 65% lung transplant recipients (LTR) with CF were infected with Pseudomonas aeruginosa , 33% with Staphylococcus Aureus . Before transplantation, 38% patients were colonizated with Aspergillus Fumigatus . The median time on waiting list was 123+/- 418 days with 27% High Emergency (HE) transplanted patients (waiting time: 7 +/- 5 days). 38% were transplanted with a miss-match of CMV, 12% for EBV. Patients required invasive ventilation during 9 days (median: 2 days) in intensive care unit. The post-transplantation morbidity was: 12,8% tracheotomy, 12% dialysis, 12% Extra Corporeal Membrane Oxygenation support. The actuarial survival rates were respectively 89%, 85,4%, and 85,4% at 1, 2 and 3 years. Concerning HE transplanted patients, the actuarial survival rates were respectively 80,5 %, 75,5%, and 75,5% at 1, 2 and 3 years. Evolution of mean FEV1 was 76, 81, and 69 % at 1, 2 and 3 years. This work shows encouraging results in COLT of bilateral lung transplantation in term of morbi-mortality, even for HE transplanted patients. The COLT study represents a large population which should allowed great improvement in CLAD understanding.