Outcomes of Lung Transplantation for Cystic Fibrosis in the Setting of Extensively Drug-Resistant Organisms

Introduction: Since the largest study on extensively drug-resistant organisms and lung transplantation in patients with cystic fibrosis, there have been innovations and advancements in the treatment of .

Research Question: What differences exist for patients with cystic fibrosis with a history of extensively drug-resistant infections who undergo lung transplantation despite treatment advances with antimicrobial therapy?

Study Design: Two-center, retrospective, cohort study conducted in 44 patients with cystic fibrosis chronically infected with extensively drug-resistant organisms who received a lung transplant from January 2008 through August 2016. Patients in the resistant cohort were chronically infected with pan-resistant , polymyxin-sensitive only, or sensitive to 2 antibiotic classes (polymyxin plus one other); remaining patients with more susceptible or no remained in the control cohort. The primary outcome is a composite of patient survival, retransplantation, chronic lung allograft dysfunction, and acute rejection 12 months posttransplant. Categorical variables were analyzed using χ testing. The independent samples test was utilized for continuous variables.

Results: There was no difference in the primary outcome (40% vs 37%, = .831). Differences between patient survival (84% vs 95%, = .487), the incidence of acute rejection (20% vs 33%, = .323), and the incidence of chronic lung allograft rejection (12% vs 5%, = .441) were not different between groups.

Discussion: Recipients chronically infected with an extensively resistant had similar outcomes compared to those infected with more sensitive organisms.