Management of cystic fibrosis patients - The South Australian lung transplant satellite centre experience

Introduction: Lung Transplantation (LTx) has been shown to improve the morbidity and mortality in selected patients with cystic fibrosis (CF). The South Australian (SA) LTx unit is a unique non-surgical LTx centre, which manages CF patients pre and post-operatively (after 3 months of transplant).There is to date no published data regarding the outcomes of LTx recipients with CF who are being managed by a satellite centre. Aim: To measure the outcomes of CF patients managed by the SA lung transplant unit and compare this with national and international data Methods: Retrospective single-centre observational study using case-notes and laboratory data Results: Thirty one SA CF patients received LTx between 1990-2011.This accounts for 25.4% of LTx recipients managed at this centre (Compared to 26.9% from 2010 International society for heart and lung transplantation (ISHLT) data and 35% from the Australia and New Zealand Cardiothoracic Organ Transplant Registry(ANZCOTR). Mean age at LTx transplant was 29 years. Twenty-eight patients received double lung transplant and 3 patients received heart-lung transplant. Mean FEV1 pre-LTx was 19.6% predicted. 1-year survival post LTx was 94% and 5-year-survival after LTx was 66.7% compared to 84.3% and 60.58% (ISHLT data) and 87.8% and 60% (ANZCOTR data) respectively. Sixty four percent of patients were free from bronchiolitis obliterans syndrome (BOS) at the end of 5 years, compared to 53.9% (ISHLT). Conclusions: Outcomes from management at the SA satellite centre following LTx for CF are equivalent or better than Australian and International results.