Tracheal diverticula in advanced cystic fibrosis: Prevalence, features, and outcomes after lung transplantation.
Tracheal diverticula in advanced cystic fibrosis: Prevalence, features, and outcomes after lung transplantation.
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晚期囊性纤维化中的气管憩室：肺移植后的患病率、特征和结果。
DOI：
10.1016/j.jcf.2017.07.015
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Aitken,MoiraL
中科院分区：
文献类型：
--
作者：
Kapnadak,SiddharthaG;Kicska,GregoryA;Ramos,KathleenJ;Marshall,DesireeA;Carroll,TamaraY;Pipavath,SudhakarN;Mulligan,MichaelS;Goss,ChristopherH;Aitken,MoiraL
BackgroundTracheal 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.MethodsPre-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.ResultsOf 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].ConclusionsWe 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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