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ECB-ART-45658
J Cyst Fibros 2017 Nov 01;166:735-743. doi: 10.1016/j.jcf.2017.07.015.
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Tracheal diverticula in advanced cystic fibrosis: Prevalence, features, and outcomes after lung transplantation.

Kapnadak SG , Kicska GA , Ramos KJ , Marshall DA , Carroll TY , Pipavath SN , Mulligan MS , Goss CH , Aitken ML .


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BACKGROUND: Tracheal diverticula (TD) are rare anomalies that may harbor infected secretions, posing potential risk to patients with lung disease. In an end-stage cystic fibrosis (CF) cohort, we describe the characteristics and associated post-lung transplant (LTx) outcomes of TD. METHODS: Pre-transplant computed tomography (CT)''s were reviewed in CF patients undergoing LTx. TD were characterized radiographically and on autopsy when available. Pre-transplant clinical variables and post-transplant outcomes were compared by TD status. RESULTS: Of 93 patients, 35 (37.6%) had TD. 58% of TD had fat-stranding, and post-mortem TD examinations revealed histology carrying intense submucosal inflammation, and purulent contents that cultured identical species to sputum. There was no difference in post-LTx survival [HR 1.77 (0.82-3.82), p=0.147], bacterial re-colonization, or rejection in patients with TD compared to those without. Patients with TD were more likely to die from infection, but the result was not statistically significant [HR 2.02 (0.62-6.63), p=0.245]. CONCLUSIONS: We found a high prevalence of TD in end-stage CF, where diverticula may represent a large-airway bacterial reservoir. TD were not associated with differences in post-LTx outcomes, but given the infectious concerns further investigation is necessary.

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Genes referenced: fat4 LOC115925415

References [+] :
Aanæs, Bacterial sinusitis can be a focus for initial lung colonisation and chronic lung infection in patients with cystic fibrosis. 2013, Pubmed