Patients with non-cystic fibrosis bronchiectasis (NCFB) have similar outcomes and survival compared to lung transplants for other indications, according to a new analysis published in ERJ Open Research. NCFB has many causes, including alpha-1 antitrypsin deficiency (AATD).

During the study, the median survival time for patients with NCFB during the post-lung allocation score (LAS) period was 6.0 years (interquartile range [IQR], 2.3-11.9 years) compared to 5.5 years (IQR, 2.3-13.2 years) in an age-, sex-, and activation date-matched cohort.

Using Kaplan-Meier survival curves, patients with NCFB had 1-, 5-, and 10-year survival rates of 87%, 53%, and 16%, respectively. The NCFB curve was not significantly different from that of the matched cohort (P =.86) who had 1-, 5-, and 10-year survivals of 84%, 55%, and 28%, respectively.


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“Lung transplantation is a viable option for NCFB. Our study found that in the LAS period, survival for lung transplantation for NCFB was similar to age- and sex-matched controls who were transplanted for another indication,” the authors said.

Read more about AATD prognosis

At the time of data analysis, a total of 263 transplanted patients with NCFB (65%) had died. Of those patients, the most common causes of death were graft failure (24%), infection (23%), and respiratory failure (19%). The cause of death was unknown in 15% of those transplanted.

The median hospital stay after transplant was 18 days (IQR, 12-32 days). During the hospital stay, 5% of patients required dialysis, 3% had a stroke, and 2% developed airway dehiscence which was not significantly different when compared to the matched cohort.

“We propose that the development of specific transplant criteria for NCFB may improve patient selection and benefit a larger group of patients with this condition,” the authors recommended.

A total of 721 patients with NCFB were listed for lung transplantation during the study period, however, only 407 received transplantation (56.4%). The total number of patients listed for transplantation for all indications during the same period was 60,872 while only 39,864 received transplants (65.2%).

Following the implementation of the LAS in May of 2005, the total percentage of patients receiving transplants was higher, 25,725 out of 34,670 (74.2%). The median waiting-list time also decreased after implementation of the LAS from 254 days (IQR, 83-568 days) down to 119 days (IQR, 36-301 days).

Reference

Jung F, Riley L, Lascano J. Outcomes and survival following lung transplantation in non-cystic fibrosis bronchiectasis. ERJ Open Res. 2022;8(1):00607-02021. doi:10.1183/23120541.00607-2021