scholarly journals Upper and Lower Respiratory Tract Viral Infections and Acute Graft Rejection in Lung Transplant Recipients

2010 ◽  
Vol 51 (2) ◽  
pp. 163-170 ◽  
Author(s):  
P. M. Soccal ◽  
J.‐D. Aubert ◽  
P.‐O. Bridevaux ◽  
J. Garbino ◽  
Y. Thomas ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Graft Rejection ◽  
Lower Respiratory Tract ◽  
Lung Transplant ◽  
Viral Infections ◽  
Transplant Recipients ◽  
Acute Graft Rejection ◽  
Lung Transplant Recipients ◽  
Acute Graft

The Etiology and Prognosis of Delayed Postoperative Leukocytosis in Lung Transplant Recipients

2020 ◽  
Vol 30 (2) ◽  
pp. 111-116
Author(s):  
Shimon Izhakian ◽  
Walter G. Wasser ◽  
Baruch Vainshelboim ◽  
Avraham Unterman ◽  
Moshe Heching ◽  
...  
Keyword(s):  
Graft Rejection ◽  
Lung Transplant ◽  
Unknown Etiology ◽  
Transplant Recipients ◽  
Primary Graft Dysfunction ◽  
Graft Dysfunction ◽  
Acute Graft Rejection ◽  
Second Surgery ◽  
Lung Transplant Recipients ◽  
Acute Graft

Background: Leukocytosis (white blood cell count >12 000/µL) in the delayed postoperative period (4-7 days) after lung transplantation is due to diverse etiologies. We aimed to describe the etiologies of delayed postoperative leukocytosis in lung transplant recipients and to evaluate the association of leukocytosis causes with short-term survival. Methods: A retrospective chart review of 274 lung transplantations performed in our institution during 2006 to 2013. Results: Delayed postoperative leukocytosis was seen in 159 (58.0%) of lung transplant recipients. In 57 (35.8%) of them, the etiology of the leukocytosis was not identified. The etiologies of leukocytosis that were identified were infection (n = 39), second surgery, acute rejection (n = 12), primary graft dysfunction (n = 3), multiple etiologies (n = 17), and other causes (n = 10). On multivariate analysis, delayed postoperative leukocytosis was one of the variables that most significantly associated with decreased survival in the entire sample (hazard ratio [HR] = 1.52, 95% confidence interval [CI]: 1.01-2.29, P = .040). On additional analysis for mortality assessing each leukocytosis subgroup, the data were acute graft rejection (HR = 8.21, 95% CI: 4.09-16.49, P < .001), second surgery (HR = 2.05, 95% CI: 1.08-3.90, P = .020), primary graft dysfunction (HR = 2.72, 95% CI: 0.65-11.33, P = .169), other causes (HR = 1.30, 95% CI: 0.47-3.62, P = .620), and unknown etiology (HR = 0.94, 95% CI: 0.54-1.62, P = .800). Conclusions: Delayed post-lung transplant leukocytosis is a poor prognostic sign, especially when attributed to acute graft rejection, infection, and multiple etiologies. In the absence of an identifiable etiology, it can be attributed to postoperative reactive stress, is not associated with increased mortality, and likely does not warrant further diagnostic investigation.

scholarly journals Community-acquired Respiratory Viruses Are a Risk Factor for Chronic Lung Allograft Dysfunction

2018 ◽  
Vol 69 (7) ◽  
pp. 1192-1197 ◽  
Author(s):  
Maddalena Peghin ◽  
Ibai Los-Arcos ◽  
Hans H Hirsch ◽  
Gemma Codina ◽  
Víctor Monforte ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Risk Factors ◽  
Acute Rejection ◽  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Lung Transplant ◽  
Respiratory Viruses ◽  
Transplant Recipients ◽  
Independent Risk Factors ◽  
Lung Transplant Recipients

Abstract Background The relationship between community-acquired respiratory viruses (CARVs) and chronic lung allograft dysfunction (CLAD) in lung transplant recipients is still controversial. Methods We performed a prospective cohort study (2009–2014) in all consecutive adult patients (≥18 years) undergoing lung transplantation in the Hospital Universitari Vall d’Hebron (Barcelona, Spain). We systematically collected nasopharyngeal swabs from asymptomatic patients during seasonal changes, from patients with upper respiratory tract infectious disease, lower respiratory tract infectious disease (LRTID), or acute rejection. Nasopharyngeal swabs were analyzed by multiplex polymerase chain reaction. Primary outcome was to evaluate the potential association of CARVs and development of CLAD. Time-dependent Cox regression models were performed to identify the independent risk factors for CLAD. Results Overall, 98 patients (67 bilateral lung transplant recipients; 63.3% male; mean age, 49.9 years) were included. Mean postoperative follow-up was 3.4 years (interquartile range [IQR], 2.5–4.0 years). Thirty-eight lung transplant recipients (38.8%) developed CLAD, in a median time of 20.4 months (IQR, 12–30.4 months). In time-controlled multivariate analysis, CARV-LRTID (hazard ratio [HR], 3.00 [95% confidence interval {CI}, 1.52–5.91]; P = .002), acute rejection (HR, 2.97 [95% CI, 1.51–5.83]; P = .002), and cytomegalovirus pneumonitis (HR, 3.76 [95% CI, 1.23–11.49]; P = .02) were independent risk factors associated with developing CLAD. Conclusions Lung transplant recipients with CARVs in the lower respiratory tract are at increased risk to develop CLAD.

scholarly journals Cytokine levels in pleural fluid as markers of acute rejection after lung transplantation

2014 ◽  
Vol 40 (4) ◽  
pp. 425-428
Author(s):  
Priscila Cilene León Bueno de Camargo ◽  
José Eduardo Afonso Jr ◽  
Marcos Naoyuki Samano ◽  
Milena Marques Pagliarelli Acencio ◽  
Leila Antonangelo ◽  
...  
Keyword(s):  
Pleural Fluid ◽  
Lung Transplant ◽  
Transplant Recipients ◽  
Time Points ◽  
Cell Counts ◽  
Acute Graft Rejection ◽  
Cytokine Levels ◽  
Differential Cell ◽  
Lung Transplant Recipients ◽  
Acute Graft

Our objective was to determine the levels of lactate dehydrogenase, IL-6, IL-8, and VEGF, as well as the total and differential cell counts, in the pleural fluid of lung transplant recipients, correlating those levels with the occurrence and severity of rejection. We analyzed pleural fluid samples collected from 18 patients at various time points (up to postoperative day 4). The levels of IL-6, IL-8, and VEGF tended to elevate in parallel with increases in the severity of rejection. Our results suggest that these levels are markers of acute graft rejection in lung transplant recipients.

scholarly journals Assessment of Pulmonary Function before and after Sinus Surgery in Lung Transplant Recipients

2017 ◽  
Vol 22 (02) ◽  
pp. 157-160
Author(s):  
Bernardo Ramos ◽  
Fábio Pinna ◽  
Silvia Campos ◽  
José Afonso Júnior ◽  
Ricardo Teixeira ◽  
...  
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Pulmonary Function ◽  
Chronic Rhinosinusitis ◽  
Lower Respiratory Tract ◽  
Lung Transplant ◽  
Sinus Surgery ◽  
Transplant Recipients ◽  
Inpatient Hospitalization ◽  
Lung Transplant Recipients

Introduction The association between sinus and lung diseases is well known. However, there are scarce studies regarding the effects of sinus surgery on pulmonary function in lung transplant recipients. The present study describes our experience with sinus surgery in lung transplant recipients with chronic rhinosinusitis. Objectives To assess the impact of sinus surgery for chronic rhinosinusitis on pulmonary function and on inpatient hospitalization days due to lower respiratory tract infection in lung transplant recipients. Methods A retrospective study conducted between 2006 and 2012 on a sample of lung transplant recipients undergoing sinus surgery for chronic rhinosinusitis. Pulmonary function, measured by forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1), as well as inpatient hospitalization days due to lower respiratory tract infection, were compared 6 months before and 6 months after sinus surgery. Results The FEV1 values increased significantly, and the inpatient hospitalization days due to bronchopneumonia decreased significantly 6 months after sinus surgery. The preoperative and postoperative median FEV1 values were 2.35 and 2.68 respectively (p = 0.0056). The median number of inpatient hospitalization days due to bronchopneumonia 6 months before and 6 months after surgery were 32.82 and 5.41 respectively (p = 0.0013). Conclusion In this sample of lung transplant recipients with chronic rhinosinusitis, sinus surgery led to an improvement in pulmonary function and a decrease in inpatient hospitalization days due to bronchopneumonia.

scholarly journals Clinical Characteristics and Outcome of Lung Transplant Recipients with Respiratory Isolation ofCorynebacteriumspp.

2018 ◽  
Vol 56 (8) ◽  
Author(s):  
Ibai Los-Arcos ◽  
Oscar Len ◽  
María Teresa Martín-Gómez ◽  
Aída Baroja ◽  
Cristina Berastegui ◽  
...  
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Stent Implantation ◽  
Lower Respiratory Tract ◽  
Clinical Characteristics ◽  
Lung Transplant ◽  
Transplant Recipients ◽  
Content Type ◽  
Bronchial Stent ◽  
Lung Transplant Recipients

ABSTRACTAlthough chronic respiratory disease and immunosuppression are risk factors forCorynebacteriumspecies respiratory infection, data are scarce regarding this disease in lung transplantation. Our aim was to describe the clinical characteristics and outcomes of lung transplant recipients (LTR) with respiratory isolation ofCorynebacteriumspp. This was a retrospective observational study performed at a referral center in Barcelona, Spain (2014 to 2016). We included all LTR in whomCorynebacteriumspp. were isolated in at least one good-quality lower respiratory tract specimen. Overall, 24 of 527 (4.6%) LTR at risk during the study period were included. The main epidemiological, clinical, and microbiological data were analyzed. The most frequently isolated species wereC. striatum(11/24),C. pseudodiphtheriticum(3/24), andC. amycolatum(3/24). All 19 (76%) patients who underwent bronchoscopy showed abnormalities, mainly mucosal plaques at the bronchial suture and purulent secretions. Clinical cure was achieved in 8/12 (67%) patients who fulfilled the CDC definition of lower respiratory tract infection (LRTI). To assess the clinical relevance ofCorynebacteriumspp., only patients with monomicrobial isolation (n= 18) were evaluated. LRTI was diagnosed in 9, and a nonsignificant association was found with a significant number ofCorynebacteriumsp. CFU/ml (7/9 LRTI versus 2/9 non-LRTI,P= 0.057). Persistent infection was associated with metallic bronchial stent implantation (4/4 versus 2/14,P= 0.005). The isolation ofCorynebacteriumspp. in respiratory specimens of lung transplant recipients may herald a respiratory tract infection or bronchial suture damage. Bronchial stent implantation is a risk factor for the persistence ofCorynebacteriumspecies infection.

scholarly journals Detection of human rhinoviruses in the lower respiratory tract of lung transplant recipients

2011 ◽  
Vol 156 (8) ◽  
pp. 1439-1443 ◽  
Author(s):  
Cristina Costa ◽  
Massimiliano Bergallo ◽  
Sara Astegiano ◽  
Francesca Sidoti ◽  
Maria Elena Terlizzi ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Lung Transplant ◽  
Transplant Recipients ◽  
Lung Transplant Recipients
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