Outcome of minimal acute rejection (grade A1) in lung transplant recipients: the need for careful observation

2002 ◽  
Vol 21 (1) ◽  
pp. 107 ◽  
Author(s):  
P.M Hopkins ◽  
C.L Aboyoun ◽  
P.N Chhajed ◽  
M.L Plit ◽  
S.P Rainer ◽  
...  
Keyword(s):  
Acute Rejection ◽  
Lung Transplant ◽  
Transplant Recipients ◽  
Careful Observation ◽  
Lung Transplant Recipients

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.

Perioperative desensitization therapy decreases acute rejection in sensitized lung transplant recipients

2004 ◽  
Vol 65 (9-10) ◽  
pp. S5
Author(s):  
James Z. Appel ◽  
Barbara O. Burgess ◽  
Walter F. Herczyk ◽  
Ed Cantu ◽  
Matthew G. Hartwig ◽  
...  
Keyword(s):  
Acute Rejection ◽  
Lung Transplant ◽  
Transplant Recipients ◽  
Desensitization Therapy ◽  
Lung Transplant Recipients

scholarly journals The Airway Microbiota Signatures of Infection and Rejection in Lung Transplant Recipients

2021 ◽  
Author(s):  
Jin Su ◽  
Chun-xi Li ◽  
Hai-yue Liu ◽  
Ao Chen ◽  
Zhi-xuan You ◽  
...  
Keyword(s):  
Acute Rejection ◽  
T Lymphocyte ◽  
Lung Transplant ◽  
Clinical Manifestations ◽  
Transplant Recipients ◽  
Linear Discriminant ◽  
Alpha And Beta Diversity ◽  
Infection Event ◽  
Lung Transplant Recipients ◽  
Diagnosis Of Infection

Abstract BackgroundInfection and rejection are the two most common complications after lung transplantation (LT) and are associated with increased morbidity and mortality. The differential diagnosis of infection and rejection is sometimes difficult due to similar clinical manifestations. However, few studies have investigated the airway microbiota between lung transplant recipients (LTRs) with infection and rejection. ResultsA total of 181 sputum samples (event-free, n=47; infection, n=103; rejection, n=31) were collected from 59 LTRs. A distinct airway microbiota was observed among clinically stable (or event-free) recipients and those with infection or acute rejection after LT. Alpha and beta diversity were significantly different between event-free and rejection recipients and between infection and rejection recipients. Ten differential genera were identified by linear discriminant analysis effect size (LEfSe), with Corynebacterium, unclassified Enterococcaceae and unclassified Lactobacillales enriched in recipients with infection, and Rothia, Granulicatella, Neisseria, Actinomyces, Leptotrichia, Lactobacillus and unclassified Aerococcaceae more abundant in LTRs with acute rejection. Random forest analyses indicated that the combination of the 10 microbiota constituents and procalcitonin (PCT) and T-lymphocyte levels showed AUCs of 0.894, 0.955 and 0.913 to differentiate between event-free and infection, event-free and rejection, and infection and rejection recipients, respectively. ConclusionsOur study is the first to compare the airway microbiota between LTRs with infection and acute rejection. The airway microbiota, especially combined with PCT and T-lymphocyte levels, showed satisfactory predictive efficiency in discriminating among clinically stable recipients and those with infection and acute rejection, suggesting that the airway microbiota was an indicator to differentiate between infection and acute rejection after LT.

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