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Cited by 177Burkholderia infections and melioidosisTransplantation: Methods and OutcomesInfections and bacterial resistance

Impact of Burkholderia Infection on Lung Transplantation in Cystic Fibrosis

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Murray, Susan, Charbeneau, Jeffery, Marshall, Bruce C., LiPuma, John J.·2008·American Journal of Respiratory and Critical Care Medicine
DOI 10.1164/rccm.200712-1834oc
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Abstract

Rationale: Lung transplantation offers the only survival option for patients with cystic fibrosis (CF) with end-stage pulmonary disease. Infection with Burkholderia species is typically considered a contraindication to transplantation in CF. However, the risks posed by different Burkholderia species on transplantation outcomes are poorly defined. Objectives: To quantify the risks of infection with Burkholderia species on survival before and after lung transplantation in patients with CF. Methods: Multivariate Cox survival models assessed hazard ratios of infection with Burkholderia species in 1,026 lung transplant candidates and 528 lung transplant recipients. Lung allocation scores, incorporating Burkholderia infection status, were calculated for transplant candidates. Measurements and Main Results: Transplant candidates infected with different Burkholderia species did not have statistically different mortality rates. Among transplant recipients infected with B. cenocepacia, only those infected with nonepidemic strains had significantly greater post-transplant mortality compared with uninfected patients (hazard ratio [HR], 2.52; 95% confidence interval [CI], 1.04–6.12; P = 0.04). Hazards were similar between uninfected transplant recipients and those infected with B. multivorans (HR, 0.66; 95% CI, 0.27–1.56; P = 0.34). Transplant recipients infected with B. gladioli had significantly greater post-transplant mortality than uninfected patients (HR, 2.23; 95% CI, 1.05–4.74; P = 0.04). Once hazards for species/strain were included, lung allocation scores of B. multivorans–infected transplant candidates were comparable to uninfected candidate scores, whereas those of candidates infected with nonepidemic B. cenocepacia or B. gladioli were lower. Conclusions: Post-transplant mortality among patients with CF infected with Burkholderia varies by infecting species. This variability should be taken into account in evaluating lung transplantation candidates.

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  • B. cenocepacia has been associated with post-transplant infections and increased mortality, especially within the first 6-12 months.

    “particularly B. cenocepacia has been associated with post-transplant infections and increased mortality especially within the first 6–12 months.(72, 73)”

    From Consensus document for the selection of lung transplant candidates: An update from the International Society for Heart and Lung Transplantation. (2021) · cites this paper as [73]

    The Discussion reports deaths within five months among recipients infected with B. cenocepacia, and the paper’s multivariate analysis finds increased post-transplant mortality for recipients infected with nonepidemic strains. But the Discussion says B. cenocepacia as a whole did not have a significantly increased mortality risk; the copy also does not establish a distinct 6–12-month risk period or specifically link B. cenocepacia to post-transplant infections. Page numbers are unavailable in the indexed passages. (LLM, conf=0.86)

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Research works printed but not linked: 2

  1. [9]9. Moore J, Murray S, Merion RM, Sweet SC, Sheraton TH. Addition of PaCO 2 as an allocation factor in lung transplantation. Am J Trans- plant 2007;7:244.
  2. [30]30. Mariencheck WI Jr, Palmer SM, Tapson VF, Davis RD, Durham NC. Survival following lung transplantation of cystic fibrosis patients colonized with Burkholderia cepacia [abstract]. Am J Respir Crit Care Med 2000;161:A720.

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Authors
Murray, S., Charbeneau, J., Marshall, B. C., & LiPuma, J. J.
Affiliations
  • University of Michigan (US)
  • Cystic Fibrosis Foundation (US)
ORCID
Venue
American Journal of Respiratory and Critical Care Medicine
Publisher
Oxford University Press (OUP)
Published
2008-08
Volume
178
Issue
4
Pages
363-371
ISSN
  • 1073-449X (ISSN-L)
  • 1535-4970
DOI
10.1164/rccm.200712-1834oc
OpenAlex
W2081925747
Semantic Scholar
68cf39ee60f9774eb35ae3f703478d0c836ebf29
Cited by
177
References
40
Citations by year
2026: 3 · 2025: 4 · 2024: 4 · 2023: 7 · 2022: 7 · 2021: 10 · 2020: 13 · 2019: 9 · 2018: 9 · 2017: 12 · 2016: 9 · 2015: 13 · 2014: 14 · 2013: 8 · 2012: 12
FWCI
10.54
Type
journal article
Language
en
Open access
Licence
academic.oup.com/pages/standard-publication-reuse-rights (vor)
Locations
  • American Journal of Respiratory and Critical Care Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Deep Blue (University of Michigan) (submittedVersion)
Funders
  • U.S. Department of Health and Human Services
  • Cystic Fibrosis Foundation
  • Health Resources and Services Administration
Topics
  • Health Sciences › Medicine › Epidemiology › Burkholderia infections and melioidosis
  • Health Sciences › Medicine › Surgery › Transplantation: Methods and Outcomes
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Endocrinology › Infections and bacterial resistance
Keywords
cystic fibrosis, lung transplantation, Burkholderia cenocepacia, Burkholderia multivorans, Burkholderia gladioli, post-transplant mortality, lung allocation score, transplant candidates
MeSH terms
Contraindications, Adult, Cystic Fibrosis, Female, Humans, Male, Postoperative Complications, Prognosis, Risk, United States, Cohort Studies, Survival Rate, Multivariate Analysis, Case-Control Studies, Lung Transplantation, Treatment Outcome, Pneumonia, Bacterial, Disease-Free Survival, Burkholderia Infections

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