Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Jacksonville, FL, USA.
Biology Department, Jacksonville University, Jacksonville, FL, USA.
Am J Rhinol Allergy. 2023 Sep;37(5):550-557. doi: 10.1177/19458924231177855. Epub 2023 Jun 1.
Transplant patients are high risk for surgery due to their immunocompromised state. There is a paucity of evidence concerning the differences in incidence of chronic rhinosinusitis (CRS) in solid versus non-solid organ transplant. Our aim is to analyze the difference in incidence of CRS requiring endoscopic sinus surgery (ESS) between non-solid and solid transplant populations and determine if certain risk factors are associated with increased incidence of recalcitrant CRS in non-solid versus solid transplants.
Retrospective cohort.
Multisite tertiary academic center.
This is a retrospective chart review of 1303 transplant recipients who were seen in our rhinologic clinic for CRS between 2017 and 2022. A total of 224 patients underwent ESS and were further analyzed for risk factors associated with recalcitrant disease requiring sinus surgery. Subgroup analysis based on solid and non-solid organ transplant was performed.
Of the 224 patients in the study, 171/224 (76.3%) had solid transplants while 53/224 (23.6%) had non-solid transplants. 17.19% of all transplant recipients required ESS. The incidence of ESS in non-solid transplants was 28.2% versus 57% in solid transplant. The risk of recalcitrant CRS in solid transplant recipients was almost 1.78 times greater than those with non-solid organ transplant (95% CI, 1.27-2.54, p = 0.0005). Individual factors such as certain immunotherapy drugs, pancytopenia, and rejection appear to correlate with the risk of ESS in both non-solid and solid organ transplant.
Risk of ESS was greater in the solid transplant recipients compared to those who received non-solid organ transplant.
由于移植患者免疫功能低下，因此他们进行手术的风险较高。有关实体器官与非实体器官移植患者慢性鼻-鼻窦炎（CRS）发生率差异的证据很少。我们的目的是分析实体器官与非实体器官移植患者行内镜鼻窦手术（ESS）治疗的 CRS 发病率差异，并确定某些危险因素是否与非实体器官移植患者中难治性 CRS 的发病率增加相关。
回顾性队列研究。
多地点三级学术中心。
这是对 2017 年至 2022 年在我们鼻科诊所因 CRS 就诊的 1303 例移植受者进行的回顾性图表审查。共有 224 例患者接受了 ESS，并进一步分析了与需要鼻窦手术的难治性疾病相关的危险因素。根据实体器官和非实体器官移植进行了亚组分析。
在研究的 224 例患者中，171/224（76.3%）例患者接受了实体器官移植，53/224（23.6%）例患者接受了非实体器官移植。所有移植受者中有 17.19%需要 ESS。非实体器官移植患者 ESS 的发生率为 28.2%，而实体器官移植患者的发生率为 57%。实体器官移植受者发生难治性 CRS 的风险是非实体器官移植患者的近 1.78 倍（95%CI，1.27-2.54，p = 0.0005）。某些免疫治疗药物、全血细胞减少症和排斥等个体因素似乎与非实体器官和实体器官移植患者行 ESS 的风险相关。
与接受非实体器官移植的患者相比，实体器官移植受者行 ESS 的风险更高。
