Lung Transplant Program, Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Division of Infectious Disease and Geographic Medicine, Department of Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Clin Transplant. 2021 Jan;35(1):e14140. doi: 10.1111/ctr.14140. Epub 2020 Nov 20.
The current study describes the spectrum of community-acquired respiratory infections (CARV) during the first year after lung transplantation (LT). Additionally, we elucidate variables associated with CARV, management strategies utilized, and impact on early and late outcomes.
This was a retrospective study among patients transplanted between 2012 and 2015 (n = 255, mean age 55.6 ± 13.5 years, M: F 152:103). The diagnosis of CARV was based on the multiplex PCR on nasopharyngeal swab samples. Baseline characteristics, post-transplant variables, and outcomes were compared among patients with and without CARV.
Eighty CARV infections developed among a quarter of the study group (n = 62, 24.3%). Rhinovirus/enterovirus was the most commonly isolated CARV (n = 24) followed by coronavirus (n = 17) and RSV (n = 9). A significant proportion of episodes (43.8%) required hospitalization. The use of nasal corticosteroids and left single LT was independently associated with an increased risk of CARV. CARV infections did not impact the lung functions during the first year or the CLAD-free survival at 3 years.
There is a significant burden of CARV infections during the first year after LT. The use of nasal corticosteroids may increase the risk of CARV infection. CARV infections did not impact outcomes.
本研究描述了肺移植(LT)后第一年社区获得性呼吸道感染(CARV)的谱。此外,我们阐明了与 CARV 相关的变量、使用的管理策略以及对早期和晚期结果的影响。
这是一项回顾性研究,纳入了 2012 年至 2015 年间接受移植的患者(n=255,平均年龄 55.6±13.5 岁,M:F 152:103)。CARV 的诊断基于鼻咽拭子样本的多重 PCR。比较了有和无 CARV 患者的基线特征、移植后变量和结局。
四分之一的研究组(n=62,24.3%)发生了 80 例 CARV 感染。鼻病毒/肠道病毒是最常见的 CARV(n=24),其次是冠状病毒(n=17)和 RSV(n=9)。相当一部分(43.8%)需要住院治疗。鼻用皮质类固醇和左单肺 LT 的使用与 CARV 风险增加独立相关。CARV 感染不会影响第一年的肺功能或 3 年的无 CLAD 生存率。
LT 后第一年 CARV 感染负担很大。鼻用皮质类固醇的使用可能会增加 CARV 感染的风险。CARV 感染不会影响结局。