Having Cystic Fibrosis Appears to Increase Chance of Lung Transplant Rejection

Having Cystic Fibrosis Appears to Increase Chance of Lung Transplant Rejection

Lung transplants are rejected in about 40 percent of those who receive them, but the incidence of rejection is even higher among people with cystic fibrosis (CF), according to a new study from Italy.

The research paper, titled Higher Risk of Acute Cellular Rejection in Lung Transplant Recipients with Cystic Fibrosis, appeared in the medical journal Annals of Transplantation.

CF is one of the most common chronic lung diseases in children and young adults, and can be a life-threatening disorder. Breathing is often difficult due to a sticky mucus that builds up in the lungs and causes serious bacterial lung infections.

Treatments are now available for CF, and have greatly prolonged survival in people suffering from the disease. However, respiratory problems can still ultimately develop in those with CF, leading to respiratory failure and death. In some cases, a lung transplant may be necessary to extend survival and improve quality of life.

In those who receive a lung transplant, acute cellular rejection (ACR) is always a possibility.

The study, led by Fiorella Calabrese of the Pathology Unit in Department of Cardiac, Thoracic and Vascular Sciences at the University of Padua, Italy, was designed to measured how often ACR occurs in those with CF who had a lung transplant, and also to predict risk factors for ACR in these individuals.

The study included 44 people with CF who underwent a lung transplant compared to 89 people who had a lung transplant for a different reason. Both groups showed rates of ACR, with a slightly higher rate of 75 percent in the CF group and 67 percent in the comparison group. However, there was a trend toward a more severe transplant rejection in the CF group.

The scientists also noted that rejection was more common in younger individuals, and that the group with CF was younger overall than the group that had a lung transplant but did not have CF.

In their research report, the study authors said, “CF recipients have a higher frequency of ACR, particularly of severe ACR. Careful post-transplant management using scheduled (transbronchial biopsies) are mandatory for sensitive ACR detection and prompt treatment.”

The team also observed that younger age as well as characteristics specific to CF could account for the greater tendency toward rejection in the CF group. “CF recipients have a higher ACR risk, which may be due to enhanced immune activation related to a genetic disorder, and younger age,” they wrote.

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