scholarly journals 444Incidence, Risk Factors and Outcomes of Delayed-Onset Cytomegalovirus Disease in a Large Retrospective Cohort of Lung Transplant Recipients

2014 ◽  
Vol 1 (suppl_1) ◽  
pp. S168-S168
Author(s):  
Carlos Santos ◽  
Daniel Brennan ◽  
Roger Yusen ◽  
Margaret Olsen
Keyword(s):  
Risk Factors ◽  
Retrospective Cohort ◽  
Lung Transplant ◽  
Transplant Recipients ◽  
Cytomegalovirus Disease ◽  
Delayed Onset ◽  
Lung Transplant Recipients

scholarly journals The Prediction and Prognosis of Fungal Infection in Lung Transplant Recipients—A Retrospective Cohort Study in South Korea

2021 ◽  
Vol 7 (8) ◽  
pp. 639
Author(s):  
Yae-Jee Baek ◽  
Yun-Suk Cho ◽  
Moo-Hyun Kim ◽  
Jong-Hoon Hyun ◽  
Yu-Jin Sohn ◽  
...  
Keyword(s):  
Cohort Study ◽  
South Korea ◽  
Fungal Infection ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Lung Transplant ◽  
Fungal Infections ◽  
Transplant Recipients ◽  
Tertiary Center ◽  
Lung Transplant Recipients

(1) Background: Lung transplant recipients (LTRs) are at substantial risk of invasive fungal disease (IFD), although no consensus has been reached on the use of antifungal agents (AFAs) after lung transplantation (LTx). This study aimed to assess the risk factors and prognosis of fungal infection after LTx in a single tertiary center in South Korea. (2) Methods: The study population included all patients who underwent LTx between January 2012 and July 2019 at a tertiary hospital. It was a retrospective cohort study. Culture, bronchoscopy, and laboratory findings were reviewed during episodes of infection. (3) Results: Fungus-positive respiratory samples were predominant in the first 90 days and the overall cumulative incidence of Candida spp. was approximately three times higher than that of Aspergillus spp. In the setting of itraconazole administration for 6 months post-LTx, C. glabrata accounted for 36.5% of all Candida-positive respiratory samples. Underlying connective tissue disease-associated interstitial lung disease, use of AFAs before LTx, a longer length of hospital stay after LTx, and old age were associated with developing a fungal infection after LTx. IFD and fungal infection treatment failure significantly increased overall mortality. Host factors, antifungal drug resistance, and misdiagnosis of non-Aspergillus molds could attribute to the breakthrough fungal infections. (4) Conclusions: Careful bronchoscopy, prompt fungus culture, and appropriate use of antifungal therapies are recommended during the first year after LTx.

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 Isavuconazole Is as Effective as and Better Tolerated Than Voriconazole for Antifungal Prophylaxis in Lung Transplant Recipients

2020 ◽  
Author(s):  
Palash Samanta ◽  
Cornelius J Clancy ◽  
Rachel V Marini ◽  
Ryan M Rivosecchi ◽  
Erin K McCreary ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lung Transplantation ◽  
Lung Transplant ◽  
Fungal Infections ◽  
Oral Intake ◽  
Antifungal Prophylaxis ◽  
Red Blood Cell Transfusion ◽  
Transplant Recipients ◽  
Independent Risk Factors ◽  
Lung Transplant Recipients

Abstract Background Invasive fungal infections (IFIs) are common following lung transplantation. Isavuconazole is unstudied as prophylaxis in organ transplant recipients. We compared effectiveness and tolerability of isavuconazole and voriconazole prophylaxis in lung transplant recipients. Methods A single-center, retrospective study of patients who received isavuconazole (September 2015–February 2018) or voriconazole (September 2013–September 2015) for antifungal prophylaxis. IFIs were defined by EORTC/MSG criteria. Results Patients received isavuconazole (n = 144) or voriconazole (n = 156) for median 3.4 and 3.1 months, respectively. Adjunctive inhaled amphotericin B (iAmB) was administered to 100% and 41% of patients in the respective groups. At 1 year, 8% of patients receiving isavuconazole or voriconazole developed IFIs. For both groups, 70% and 30% of IFIs were caused by molds and yeasts, respectively, and breakthrough IFI (bIFI) rate was 3%. Outcomes did not significantly differ for patients receiving or not receiving iAmB. Independent risk factors for bIFI and breakthrough invasive mold infection (bIMI) were mold-positive respiratory culture and red blood cell transfusion >7 units at transplant. Bronchial necrosis >2 cm from anastomosis and basiliximab induction were also independent risk factors for bIMI. Isavuconazole and voriconazole were discontinued prematurely due to adverse events in 11% and 36% of patients, respectively (P = .0001). Most common causes of voriconazole and isavuconazole discontinuation were hepatotoxicity and lack of oral intake, respectively. Patients receiving ≥90 days prophylaxis had fewer IFIs at 1 year (3% vs 9%, P = .02). IFIs were associated with increased mortality (P = .0001) and longer hospitalizations (P = .0005). Conclusions Isavuconazole was effective and well tolerated as antifungal prophylaxis following lung transplantation.

A Retrospective Cohort Study of Risk Factors for Surgical Site Infection Following Lung Transplant

2020 ◽  
Vol 30 (4) ◽  
pp. 329-334
Author(s):  
Josiane Luzia Sibioni Moraes ◽  
Ramon Antonio Oliveira ◽  
Marcos Naoyuki Samano ◽  
Vanessa de Brito Poveda
Keyword(s):  
Risk Factors ◽  
Retrospective Cohort ◽  
Lung Transplant ◽  
Smoking Status ◽  
High Body Mass Index ◽  
Surgical Site Infections ◽  
Tube Placement ◽  
Chest Drain ◽  
Related Risk ◽  
Lung Transplant Recipients

Background: Surgical site infections (SSIs) are among the leading health care–associated infections as well as a major problem in the postoperative period of lung transplant recipients. Little is known about the risk factors in this specific population. The objective of this study was to identify the incidence, risk factors, and outcomes of SSI following lung transplant. Methods: Digital medical records of adult recipients subjected to lung transplant from July 2011 and June 2016 in a large Brazilian referral teaching public center were analyzed in this retrospective cohort follow-up. Results: Among the 121 recipients analyzed, 19 (15.7%) had SSI; of these, 11 (57.8%) had superficial incisional infections, 1 (5.2%) had a deep incisional infection, and 7 (36.8%) had organ/space infection. Recipient-related risk factors for SSI were high body mass index ( P = .041), prolonged surgery time ( P = .043), and prolonged duration of chest drain placement ( P = .009). At the multiple logistic regression was found that each hour elapsed in the surgical time increased the odds of SSI by around 2 times (odds ratio 2.34; 95% CI, 1.46-4.53; P = .002). Donor-related risk factors included smoking status ( P = .05) and positive bronchoalveolar lavage ( P < .001). Having an SSI was associated with an increased length of stay in intensive care units ( P = .003), reoperation ( P = .014), and a higher 1-year mortality rate ( P = .02). Conclusions: The identified incidence rate was higher to that observed in the previous studies. The risk factors duration of chest tube placement and donor smoking status are different from those reported in the scientific literature.

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