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Lung Transplants May Not Help Most Cystic Fibrosis Children
Date:11/21/2007

Study found little improvement, but procedures have also changed since analysis was made

WEDNESDAY, Nov. 21 (HealthDay News) -- Hardly any of the children who receive lung transplants because of severe damage caused by cystic fibrosis benefit from the risky operation, a study concludes.

It is a controversial conclusion, made more controversial because the transplant rules have been changed since the study was done, said Dr. Theodore G. Liou, associate professor of internal medicine at the University of Utah, and lead author of a report in the Nov. 22 New England Journal of Medicine.

CF is a hereditary disease in which the lungs and digestive tract become clogged with mucus. People with CF die at a relatively young age. Previous studies have shown some survival benefit for adult cystic fibrosis sufferers who received lung transplants as a last resort, Liou said.

The new report is one of very few looking at such transplants in children, he said. "In 2005, we published one [study] showing no difference in outcome between patients who were transplanted and those who were not, although they were equally sick as far as we could tell," Liou said. "That got us into a lot of trouble, because people didn't like the results."

The new study looked at 514 children with cystic fibrosis who were on the waiting list for lung transplants from 1992 to 2002. A total of 248 of the children did undergo the procedure during the study period.

The researchers found a significant estimated benefit for only five of those who had transplants, with "a significant risk of harm" associated with lung transplantation for 315 of the young patients, meaning that other treatment would have benefited them more.

The process has changed since the study was conducted, partly in ways that work against transplantation, Liou noted. Children selected for lung transplants now are first put on an intensive course of treat
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