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Monday, April 5, 2010

Defending B.Cepacia Transplants

B. cepacia colonization should not exclude CF patients from lung transplantation
By Will Boggs, MD
Published Online: September 16, 2008 - 1:14:32 PM (CDT)

Clinical

B. cepacia colonization should not exclude CF patients from lung transplantation

Last Updated: 2008-08-25 8:30:05 -0400 (Reuters Health)

By Will Boggs, MD

NEW YORK (Reuters Health) - Colonization with Burkholderia cepacia complex (BCC) should not be an automatic contraindication to lung transplantation in cystic fibrosis (CF) patients, according to a report from France in the August issue of Thorax.

"Despite recent publications, major transplantation centers are still reluctant to perform transplantation in patients infected with BCC," Dr. Veronique Boussaud from Hopital Europeen Georges Pompidou, Paris, told Reuters Health. "CF patients colonized with BCC should not be excluded from the transplantation list, unless there are other reasons."

For their study, Dr. Boussaud and colleagues retrospectively reviewed outcomes of 247 lung transplant patients with CF.

Seventeen of 22 BCC-positive patients had postoperative pulmonary specimens that tested positive for BCC, the authors report, compared with no patients without BCC infection before lung transplantation.

Overall mortality risk was similar in the BCC and non-BCC groups, the report indicates, though early mortality rates tended to be higher in the BCC group, and median survival was longer for non-BCC patients (79 months) than for BCC patients (43 months).

Patients infected with B. cenocepacia had significantly higher mortality rates than did patients infected with other strains of BCC, the researchers note.

The cumulative incidence of bronchiolitis obliterans syndrome was higher in the BCC group (38% at 5 years) than in the non-BCC group (24%), the investigators say, but the difference was not statistically significant.

"We don't think that there are effective methods to prevent any post-transplantation infection, specifically for BCC," Dr. Boussaud commented. "We showed that these colonizations didn't represent a special threat (except for cenocepacia) compared with other CF patients colonized with Pseudomonas."

While patients with cenocepacia colonization have an excess mortality in the early postoperative phase, Dr. Boussaud said, "transplantation may nevertheless still be discussed with these patients."

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Thank You for taking the time to read my blog. I am hoping that through this blog and my experiences that I can bring hope, faith and strength to all that may be living with Cystic Fibrosis, CF with Cepacia and Lung Transplant recipients. Information and blog entrees start Nov. 07. My Double Lung Transplant was on Dec. 10th 2007. Please feel free to read about my experience and ask me any questions! My email address is jamiebug77@gmail.com

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It's hard to put into words how I feel toward my Heavenly Father and the Savior. I have so many reasons to be thankful for what I have gone through & endured. Because of my trials in life I have gained a strong testimony of Faith. I have always had Faith in the Lord and in Prayer. As I faced the decision to get a double lung transplant I had to rely on faith to make the choice.....By listening to the spirit, I was guided to Pittsburgh where my life was saved. I believe prayers are answered. I have always tried to follow the philosophy of this: If I do what the Lord expects of me, he will give me what I want & need. That has always worked for me. I Believe in MIRACLES..........My life on this earth is a miracle- I prayed on my knees for years to be healed from my lung disease. I knew that through a priesthood blessing (if it was God's will) I could be healed. So many times I thought he would heal me instantly...my faith was tested as I continued to get sick and no cure was in my future. I turned to prayer....I talked to my Heavenly Father, I cried to him and he heard me and he healed me by guiding me to Pittsburgh and guiding the surgeons hands. I learned humility, and thankfulness. I realized that we need others to lean on and we are supposed to strengthen each others testimonies. I learned that the hardest things we'll do are usually the greatest blessings in our life. I was able to experience a lot of things during surgery and I know I had comforting angels in my ICU room. THe Lord knows each of us by name and he will never leave our side. We need to remember to stay close to him and have Faith that he is watching over us. I know this for a fact! I know that following the gospel will bring us true happiness- the world will tell us otherwise, but I know I am truely happy & living the gospel has brought me that. Amen