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Lung transplantation for diffuse panbronchiolitis: 5 cases from a single centre.

Abstract
Diffuse panbronchiolitis is a rare complex genetic disease predominantly affecting East Asians, and is characterized by chronic inflammation of the respiratory bronchioles and sinobronchial infection. Although long-term macrolide therapy has been shown to significantly improve the survival in patients with diffuse panbronchiolitis, some patients continue to deteriorate, eventually requiring lung transplantation. However, lung transplantation for diffuse panbronchiolitis has rarely been reported and the outcome in these patients remains unknown. We describe our experience of lung transplantation for diffuse panbronchiolitis. A total of 5 patients received long-term macrolide therapy and had airway colonization by Pseudomonas aeruginosa preoperatively. Three patients had undergone sinus surgery for chronic rhinosinusitis before the transplantation. Bilateral cadaveric lung transplantation was performed in 4 patients, and living-donor lung transplantation in 1. After the lung transplantation, 1 patient developed an A3 acute rejection episode; however, none of the recipients developed severe pneumonia or any fatal infections. One recipient developed chronic lung allograft dysfunction 3 years after the transplantation; however, none developed recurrence of diffuse panbronchiolitis. All of the 5 patients were still surviving after a median follow-up period of 4.9 years (3.7-12.3 years). Lung transplantation is a viable option for the treatment of progressive diffuse panbronchiolitis resistant to long-term macrolide therapy.
AuthorsSeiichiro Sugimoto, Kentaroh Miyoshi, Masaomi Yamane, Takahiro Oto
JournalInteractive cardiovascular and thoracic surgery (Interact Cardiovasc Thorac Surg) Vol. 22 Issue 5 Pg. 679-81 (05 2016) ISSN: 1569-9285 [Electronic] England
PMID26888742 (Publication Type: Journal Article)
Copyright© The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
Topics
  • Adult
  • Bronchiolitis (surgery)
  • Female
  • Follow-Up Studies
  • Forecasting
  • Haemophilus Infections (surgery)
  • Humans
  • Lung Transplantation (methods)
  • Male
  • Retrospective Studies
  • Tissue Donors
  • Treatment Outcome

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