Original Articles
Lung Transplant Therapy for Suppurative Diseases
A. de Pablo
, S. López, P. Ussetti, M.C. Carreño, R. Laporta, C. López García-Gallo, M.J. Ferreiro
Corresponding author
alic1575@separ.es
Correspondence: Dr. A. de Pablo. Servicio de Neumología. Clínica Puerta de Hierro. San Martín de Porres. 28035 Madrid. España
Correspondence: Dr. A. de Pablo. Servicio de Neumología. Clínica Puerta de Hierro. San Martín de Porres. 28035 Madrid. España
Servicio de Neumología, Clínica Puerta de Hierro, Madrid, Spain
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Gómez-Caro Andrés, P. Ausín Herrero, F.J. Moradiellos Díez, V. Díaz-Hellín, E. Larrú Cabrero, J.A. Pérez Antón, J.L. Martín de Nicolás" "autores" => array:7 [ 0 => array:3 [ "preGrado" => "Dr." "nombre" => "A." "apellidos" => "Gómez-Caro Andrés" ] 1 => array:2 [ "nombre" => "P." "apellidos" => "Ausín Herrero" ] 2 => array:2 [ "nombre" => "F.J." "apellidos" => "Moradiellos Díez" ] 3 => array:2 [ "nombre" => "V." "apellidos" => "Díaz-Hellín" ] 4 => array:2 [ "nombre" => "E." "apellidos" => "Larrú Cabrero" ] 5 => array:2 [ "nombre" => "J.A." "apellidos" => "Pérez Antón" ] 6 => array:2 [ "nombre" => "J.L." "apellidos" => "Martín de Nicolás" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212906602188?idApp=UINPBA00003Z" "url" => "/15792129/0000004100000005/v1_201305150216/S1579212906602188/v1_201305150216/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Articles</span>" "titulo" => "Lung Transplant Therapy for Suppurative Diseases" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "255" "paginaFinal" => "259" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "A. de Pablo, S. López, P. Ussetti, M.C. Carreño, R. Laporta, C. López García-Gallo, M.J. Ferreiro" "autores" => array:7 [ 0 => array:5 [ "preGrado" => "Dr." "nombre" => "A." "apellidos" => "de Pablo" "email" => array:1 [ 0 => "alic1575@separ.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:2 [ "nombre" => "S." "apellidos" => "López" ] 2 => array:2 [ "nombre" => "P." "apellidos" => "Ussetti" ] 3 => array:2 [ "nombre" => "M.C." "apellidos" => "Carreño" ] 4 => array:2 [ "nombre" => "R." "apellidos" => "Laporta" ] 5 => array:2 [ "nombre" => "C." "apellidos" => "López García-Gallo" ] 6 => array:2 [ "nombre" => "M.J." "apellidos" => "Ferreiro" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Neumología, Clínica Puerta de Hierro, Madrid, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr. A. de Pablo. Servicio de Neumología. Clínica Puerta de Hierro. San Martín de Porres. 28035 Madrid. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2004-03-10" "fechaAceptado" => "2004-10-26" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key Words" "identificador" => "xpalclavsec154064" "palabras" => array:5 [ 0 => "Lung transplantation" 1 => "Bronchiectasis" 2 => "Cystic fibrosis" 3 => "Pseudomonas" 4 => "Suppurative lung disease" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec154065" "palabras" => array:5 [ 0 => "Trasplante pulmonar" 1 => "Bronquiectasias" 2 => "Fibrosis quística" 3 => "Pseudomonas" 4 => "Enfermedad supurativa" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">Lung transplantation is a valid therapeutic approach for patients with bronchiectasis. The objective of the present study was to evaluate our experience with bronchiectasis patients and compare the results in patients with cystic fibrosis to results in those with bronchiectasis caused by other processes.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">We carried out a retrospective study of bronchiectasis patients treated by lung transplantation in order to analyze demographic, functional and microbiological characteristics before and after transplantation, and survival.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">From 1991 to 2002 lung transplants were performed on 171 patients, 44 of whom had suppurative lung disease (27 had cystic fibrosis and 17 had bronchiectasis caused by other processes). There were no significant differences in the demographic variables between the 2 groups. At transplantation, lung function variables showed severe bronchial obstruction (mean [SD] forced expiratory volume in 1 second of 808 [342] mL and forced vital capacity of 1390 [611] mL) and respiratory insufficiency (PaO<span class="elsevierStyleInf">2</span> at 52 [10] mm Hg and PaCO<span class="elsevierStyleInf">2</span> at 48 [9] mm Hg). Only PaO<span class="elsevierStyleInf">2</span> was significantly lower in patients with bronchiectasis from causes other than cystic fibrosis. Airway colonization was present in 91% of the patients; <span class="elsevierStyleItalic">Pseudomonas</span> spp germs were detected in 64% of the cases and were multiresistant in 9%. In the early postoperative period germs were isolated in 59% of the cases, half of which involved the same germ as had been isolated before transplantation. One year after lung transplantation, 34% of the patients continued to have bronchial colonization. Survival at 1 year was 79% and at 5 years, 49%, with no significant difference between the patients with cystic fibrosis and those with other suppurative diseases, nor between the patients with and without <span class="elsevierStyleItalic">Pseudomonas</span> colonization. Only 2 patients had died of bacterial pneumonia at 1 month after transplantation.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Although airway colonization in patients with suppurative diseases complicates postoperative management, the results in terms of survival are good.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">El trasplante pulmonar es una opción terapéutica válida para pacientes con bronquiectasias. El objetivo de nuestro trabajo ha sido analizar nuestra experiencia en estos pacientes y comparar los resultados entre los pacientes con fibrosis quística y bronquiectasias de otra etiología.</p> <span class="elsevierStyleSectionTitle">Patientes y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Se ha realizado un estudio retrospectivo de los pacientes trasplantados por bronquiectasias para analizar las características demográficas, funcionales y aspectos microbiológicos antes y después del trasplante, así como la supervivencia.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Entre 1991 y 2002 trasplantamos a 171 pacientes, de los cuales 44 presentaban enfermedad pulmonar supurativa (27 fibrosis quística y 17 bronquiectasias de otras etiologías). No había diferencias significativas en las variables demográficas entre ambos grupos. En el momento del trasplante la función pulmonar mostraba grave obstruc-ción bronquial (volumen espiratorio forzado en el primer segundo: 808 ± 342 ml; capacidad vital forzada: 1.390 ±611 ml) e insuficiencia respiratoria (presión arterial de oxígeno: 52 ± 10 mmHg; presión arterial de anhídrido carbónico: 48 ± 9 mmHg). Sólo la presión arterial de oxígeno fue significa-tivamente inferior en los pacientes con bronquiectasias de etiología diferente de la fibrosis quística. El 91% de los pacientes presentaba colonización de la vía aérea; el germen más frecuente fue <span class="elsevierStyleItalic">Pseudomona</span> spp. (64%), que en un 9% de los casos fue multirresistente. En el postoperatorio inmedia-to se aislaron gérmenes en el 59% de los casos; la mitad de ellos eran los mismos que se habían aislado antes del trasplante. Un año después del trasplante pulmonar, un 34% de los pacientes seguían mostrando colonización bronquial. La supervivencia al año fue del 79% y a los 5 años del 49%, sin diferencias significativas entre los pacientes con fibrosis quística y el resto de las enfermedades supurativas, ni entre los pacientes con o sin colonización por <span class="elsevierStyleItalic">Pseudomonas</span> spp. Sólo 2 pacientes fallecieron por neumonía bacteriana en el primer mes del trasplante pulmonar.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">A pesar de que la colonización de la vía aérea de los pacientes con enfermedad supurativa complica el manejo tras el trasplante pulmonar, los resultados en tér-minos de supervivencia son buenos.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:18 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The registry of 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 1 | 5 |
| 2024 October | 29 | 17 | 46 |
| 2024 September | 22 | 14 | 36 |
| 2024 August | 40 | 32 | 72 |
| 2024 July | 28 | 25 | 53 |
| 2024 June | 26 | 25 | 51 |
| 2024 May | 31 | 32 | 63 |
| 2024 April | 21 | 23 | 44 |
| 2024 March | 23 | 18 | 41 |
| 2024 February | 22 | 26 | 48 |
| 2023 March | 2 | 2 | 4 |
| 2023 February | 13 | 17 | 30 |
| 2023 January | 16 | 28 | 44 |
| 2022 December | 17 | 22 | 39 |
| 2022 November | 16 | 17 | 33 |
| 2022 October | 15 | 29 | 44 |
| 2022 September | 15 | 26 | 41 |
| 2022 August | 18 | 37 | 55 |
| 2022 July | 15 | 39 | 54 |
| 2022 June | 17 | 33 | 50 |
| 2022 May | 20 | 32 | 52 |
| 2022 April | 13 | 19 | 32 |
| 2022 March | 16 | 37 | 53 |
| 2022 February | 18 | 42 | 60 |
| 2022 January | 10 | 26 | 36 |
| 2021 December | 18 | 42 | 60 |
| 2021 November | 20 | 44 | 64 |
| 2021 October | 56 | 38 | 94 |
| 2021 September | 34 | 48 | 82 |
| 2021 August | 39 | 28 | 67 |
| 2021 July | 29 | 29 | 58 |
| 2021 June | 11 | 30 | 41 |
| 2021 May | 8 | 23 | 31 |
| 2021 April | 28 | 47 | 75 |
| 2021 March | 15 | 20 | 35 |
| 2021 February | 12 | 15 | 27 |
| 2021 January | 14 | 16 | 30 |
| 2020 December | 11 | 16 | 27 |
| 2020 November | 6 | 12 | 18 |
| 2020 October | 9 | 7 | 16 |
| 2020 September | 13 | 6 | 19 |
| 2020 August | 11 | 12 | 23 |
| 2020 July | 14 | 18 | 32 |
| 2020 June | 7 | 8 | 15 |
| 2020 May | 11 | 20 | 31 |
| 2020 April | 14 | 17 | 31 |
| 2020 March | 22 | 16 | 38 |
| 2020 February | 40 | 15 | 55 |
| 2020 January | 63 | 15 | 78 |
| 2019 December | 19 | 14 | 33 |
| 2019 November | 10 | 10 | 20 |
| 2019 October | 10 | 7 | 17 |
| 2019 September | 18 | 5 | 23 |
| 2019 August | 12 | 12 | 24 |
| 2019 July | 9 | 16 | 25 |
| 2019 June | 6 | 4 | 10 |
| 2019 May | 11 | 15 | 26 |
| 2019 April | 14 | 34 | 48 |
| 2019 March | 15 | 19 | 34 |
| 2019 February | 8 | 12 | 20 |
| 2019 January | 11 | 4 | 15 |
| 2018 December | 9 | 14 | 23 |
| 2018 November | 14 | 9 | 23 |
| 2018 October | 15 | 18 | 33 |
| 2018 September | 14 | 11 | 25 |
| 2018 May | 1 | 0 | 1 |
| 2018 April | 4 | 9 | 13 |
| 2018 March | 3 | 3 | 6 |
| 2018 February | 4 | 7 | 11 |
| 2018 January | 7 | 12 | 19 |
| 2017 December | 6 | 7 | 13 |
| 2017 November | 4 | 13 | 17 |
| 2017 October | 8 | 9 | 17 |
| 2017 September | 6 | 9 | 15 |
| 2017 August | 6 | 11 | 17 |
| 2017 July | 2 | 4 | 6 |
| 2017 June | 8 | 11 | 19 |
| 2017 May | 6 | 10 | 16 |
| 2017 April | 2 | 5 | 7 |
| 2017 March | 3 | 5 | 8 |
| 2017 February | 2 | 6 | 8 |
| 2017 January | 3 | 3 | 6 |
| 2016 December | 8 | 9 | 17 |
| 2016 November | 13 | 5 | 18 |
| 2016 October | 15 | 10 | 25 |
| 2016 September | 12 | 2 | 14 |
| 2016 August | 14 | 5 | 19 |
| 2016 July | 5 | 0 | 5 |
| 2016 March | 1 | 0 | 1 |
| 2016 February | 1 | 0 | 1 |
| 2015 December | 2 | 0 | 2 |
| 2015 November | 2 | 0 | 2 |
| 2015 October | 34 | 1 | 35 |
| 2015 September | 41 | 11 | 52 |
| 2015 August | 39 | 12 | 51 |
| 2015 July | 36 | 8 | 44 |
| 2015 June | 25 | 6 | 31 |
| 2015 May | 56 | 12 | 68 |
| 2015 April | 31 | 11 | 42 |
| 2015 March | 33 | 3 | 36 |
| 2015 February | 36 | 4 | 40 |
| 2015 January | 27 | 5 | 32 |
| 2014 December | 34 | 4 | 38 |
| 2014 November | 41 | 5 | 46 |
| 2014 October | 55 | 7 | 62 |
| 2014 September | 42 | 11 | 53 |
| 2014 August | 35 | 5 | 40 |
| 2014 July | 42 | 9 | 51 |
| 2014 June | 49 | 14 | 63 |
| 2014 May | 56 | 8 | 64 |
| 2014 April | 47 | 6 | 53 |
| 2014 March | 61 | 11 | 72 |
| 2014 February | 52 | 6 | 58 |
| 2014 January | 49 | 10 | 59 |
| 2013 December | 38 | 9 | 47 |
| 2013 November | 37 | 9 | 46 |
| 2013 October | 40 | 5 | 45 |
| 2013 September | 33 | 15 | 48 |
| 2013 August | 37 | 4 | 41 |
| 2013 July | 50 | 8 | 58 |
| 2013 June | 26 | 4 | 30 |
| 2013 May | 42 | 5 | 47 |
| 2013 April | 12 | 6 | 18 |
| 2013 March | 6 | 2 | 8 |
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