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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.
Aanæs,
Bacterial sinusitis can be a focus for initial lung colonisation and chronic lung infection in patients with cystic fibrosis.
2013, Pubmed
Aanæs,
Bacterial sinusitis can be a focus for initial lung colonisation and chronic lung infection in patients with cystic fibrosis.
2013,
Pubmed
Amaral,
Infected tracheal diverticulum: a rare association with alpha-1 antitrypsin deficiency.
2014,
Pubmed
Berkhout,
Sinonasal manifestations of cystic fibrosis: a correlation between genotype and phenotype?
2014,
Pubmed
Borthwick,
Pseudomonas aeruginosa accentuates epithelial-to-mesenchymal transition in the airway.
2011,
Pubmed
Ciofu,
P. aeruginosa in the paranasal sinuses and transplanted lungs have similar adaptive mutations as isolates from chronically infected CF lungs.
2013,
Pubmed
Early,
Congenital tracheal diverticulum.
2002,
Pubmed
Elborn,
Cystic fibrosis.
2016,
Pubmed
Feise,
Do multiple outcome measures require p-value adjustment?
2002,
Pubmed
Fisher,
Symptomatic Respiratory Virus Infection and Chronic Lung Allograft Dysfunction.
2016,
Pubmed
Gayer,
Tracheal diverticula in cystic fibrosis-A potentially important underreported finding on chest CT.
2016,
Pubmed
Goo,
Right paratracheal air cysts in the thoracic inlet: clinical and radiologic significance.
1999,
Pubmed
Gottlieb,
Impact of graft colonization with gram-negative bacteria after lung transplantation on the development of bronchiolitis obliterans syndrome in recipients with cystic fibrosis.
2009,
Pubmed
Habib,
Association between Chronic Rhinosinusitis and Health-Related Quality of Life in Adults with Cystic Fibrosis.
2015,
Pubmed
Holzmann,
Effects of sinus surgery in patients with cystic fibrosis after lung transplantation: a 10-year experience.
2004,
Pubmed
Leung,
Effects of sinus surgery on lung transplantation outcomes in cystic fibrosis.
2008,
Pubmed
Lewiston,
Cystic fibrosis patients who have undergone heart-lung transplantation benefit from maxillary sinus antrostomy and repeated sinus lavage.
1991,
Pubmed
Lin,
Tracheal diverticulum: a case report and literature review.
2014,
Pubmed
MACKINNON,
Tracheal diverticula.
1953,
Pubmed
Mainz,
Sinonasal persistence of Pseudomonas aeruginosa after lung transplantation.
2012,
Pubmed
Reicher,
Increased prevalence of tracheal diverticula in cystic fibrosis patients.
2016,
Pubmed
Teh,
Infected tracheocoele (acquired tracheal diverticulum): case report and literature review.
2011,
Pubmed
Todd,
Impact of forced vital capacity loss on survival after the onset of chronic lung allograft dysfunction.
2014,
Pubmed
Valentine,
Single-institution study evaluating the utility of surveillance bronchoscopy after lung transplantation.
2009,
Pubmed
Vital,
Impact of sinus surgery on pseudomonal airway colonization, bronchiolitis obliterans syndrome and survival in cystic fibrosis lung transplant recipients.
2013,
Pubmed
Vos,
Pseudomonal airway colonisation: risk factor for bronchiolitis obliterans syndrome after lung transplantation?
2008,
Pubmed
Walker,
Primary tracheomalacia and persistent wheezing in cystic fibrosis during infancy.
2011,
Pubmed
Yusen,
The Registry of the International Society for Heart and Lung Transplantation: Thirty-third Adult Lung and Heart-Lung Transplant Report-2016; Focus Theme: Primary Diagnostic Indications for Transplant.
2016,
Pubmed
