Rationale: Non-cystic fibrosis bronchiectasis (NCFB) is a common disease and lung transplantation (LT) is an established treatment for end-stage disease. However, data on outcomes of LT for NCFB are scarce. We aimed to assess the 3-year outcomes of LT for NCFB.

Methods: Retrospective study of all LT for NCFB (2008-2019) in two high-volume centers. The primary outcome was 3-year survival; Secondary outcomes were the occurrence of early postoperative complications, infectious complications, Chronic Lung Allograft Dysfunction (CLAD) and other long-term complications.

Results: We included 41 LT recipients for NCFB (3.9% of all LT), 21 men (51.2%), median age at LT 47yrs [37-55.5]. Main etiologies of NCFB were idiopathic (41.5%), post-infectious (22%) and primary ciliary dyskinesia (17%). Venoarterial-ECMO was necessary for 39% of patients and revision surgery was needed in 7 patients (17.1%). Thirty patients were alive at 3 years (3-yr survival 73.9%). Causes of death were early postoperative complications for 8 patients and CLAD for 2 patients. 3-year mortality was significantly associated with revision surgery due to early postoperative complications (p=0.01) and NCFB etiology (p=0.04). Among patients who survived the first year, 13 (40.6%) developed CLAD and 11 (34.4%) had a P.aeruginosa colonization after LT. Few patients presented long-term complications, such as chronic kidney failure (34%) or cardiovascular disease (22%).

Discussion: In this bicentric series, the 3-year outcome of LT for NCFB is affected by the etiology of NCFB and the occurrence of early postoperative complications. Comparison between LT for NCFB and double LT for other indications remains to be performed.