Resistance to anti-viral drug may be more likely in cystic fibrosis patients
Following lung transplantation, resistance to the anti-viral drug ganciclovir may be more likely in cystic fibrosis patients, scientists report. Ganciclovir is given to lung transplant patients to protect against a life-threatening virus that is common after transplantation, and reduces mortality due to the virus from 34 percent to between 3 and 6 percent. But between 5 percent and 10 percent of patients infected with the virus have strains that are resistant to the drug.
Authors: Regard L, Martin C, Chassagnon G, Burgel PR Abstract Introduction Cystic fibrosis (CF) is a genetic disease that primarily affects the respiratory system and often leads to respiratory failure and premature death. Although pulmonary complications contribute to 85% of deaths, non-pulmonary complications are responsible for significant morbidity and mortality in adults with CF. Areas covered This review summarizes acute and chronic non-pulmonary complications in CF patients, with emphasis on emerging complications and in the context of the current growth and ageing of the CF adult population. It also address...
Conclusion: As for cardiac or hepatic transplantations, despite a strong immunosuppressive regimen, a high frequency of transient PF4/H Ab is observed in patients undergoing BLT. Their appareance is not related to thrombocytopenia and/or thrombotic events. However, they could be an early marker of a cellular reaction againts the graft.DisclosuresNo relevant conflicts of interest to declare.
Conclusion: There was 100% survival with all patients being discharged home within an average of 20.5 days post Tx. 100% were mobilised with physiotherapists within 12 hours of extubation, with an average increase in 6MWT on discharge of 360 mtrs. No patients required 02 therapy on discharge from MMUH.References:www.cfireland.ie/about-cf/living-with-cf (19.02.2108)Hirche et al., 2014 ‘Practice Guidelines: Lung Transplantatation in Patients with Cystic Fibrosis’ Pulm Med:621342
Conclusion: We identified production of IL-17A among populations of ILCs, gamma delta T cells and iNKT cells in different lung disease entities which suggests that these cell populations can contribute to IL-17A-dependent pathologies in end stage lung disease.
Background: 2017 NICE guidelines recommend use of a mucoactive agent [DNase, Mannitol, Hypertonic Saline] in patients with Cystic Fibrosis (CF) who have ‘clinical evidence of lung disease’ although a formal definition is not described. We speculated patients at our centre may have lung disease and not be treated according to guidelines.Aims: To use a pragmatic definition of ‘clinical evidence of lung disease’ to identify a patient cohort and assess NICE guideline adherence.Methods: Definition of lung disease used:·FEV1
Conclusion: Improvement of FEV1 one year after LT was lower in CF patients with preoperative chronic Bcc infection and severe surgical complications, and at a longer length of stay in hospital during a year after LT.
Conclusions: AAs after LT are common, with occurrence peaking 3 days after LT. Older age is associated with elevated risk. AAs-g had increased length of stay, although with no long-term survival impact.
Body: Fosfomycin (F) has a unique mechanism of action against P.aeruginosa (PA) and may be active in multidrug-resistant (MDR) pathogens. F was not licensed in Europe since long time so the experience of F use is limited.Aim: To evaluate safety and efficacy of F IV for pulmonary exacerbations (PEs) in adults cystic fibrosis (CF).Methods: We analyzed the F use from Apr15 to Dec17 in combination with other IV antibiotics to treat 28 PEs in 15 CF patients (pts) in our centre.Results: 15 pts, 9 female, mean age 40.2 yrs (25-74), mean FEV1%pred 45 (25-70), PA chronic respiratory infection in 14, severe lung disease (FEV1
Conclusions: Patients with CF after LT have a reduced maximal exercise capacity without ventilatory or cardiac limitations that persists despite the rehabilitative activity. Our findings showing a low work "efficiency" (low work/VO2 slope) suggest that the reduced exercise capacity could be attributable to muscle-related abnormality in oxygen metabolism in peripheral muscle