Successful Pseudomonas aeruginosa Eradication Improves Outcomes after Lung Transplantation.

PURPOSE: Pseudomonas aeruginosa (PA) is an established risk factor for chronic lung allograft dysfunction (CLAD) after lung transplantation (LTx). PA eradication in cystic fibrosis patients prevents pulmonary function decline. Therefore, we investigated the effect of PA eradication after LTx on CLAD-free survival, graft survival and pulmonary function. METHODS: Patients transplanted between 07/1991 and 02/2016 in our hospital with sufficient pulmonary function data, without redo LTx or CLAD onset before 09/2011 were retrospectively included and classified according to PA presence in respiratory samples between 09/2011 and 09/2016. PA positive patients were subsequently stratified according to success of PA eradication. CLAD-free and graft survival were compared between PA positive and PA negative patients and between patients with or without successful PA eradication. In addition, pulmonary function was assessed during the first year following PA isolation in both groups. RESULTS: CLAD-free and graft survival of PA negative patients (n=443, 82%) was better compared to PA positive patients (n=95, 18%) (p=0.0005, p=0.0011). PA eradicated patients (n=76, 80%) had better graft survival compared to patients with persistent PA (n=19, 20%) (p<0.0001) (fig 1A). Similarly, PA eradicated patients demonstrated better CLAD-free survival compared to patients with persistent PA (p=0.018) (fig 1B). Pulmonary function was better in successfully PA eradicated patients compared to unsuccessfully eradicated patients (p=0.035) (fig 1C). CONCLUSION: PA eradication after LTx improves CLAD-free and graft survival and helps maintain pulmonary function.

Jaar van publicatie:2020