Post-Transplant Diarrhea is Associated with Increased Rejection in Lung Transplant Recipients: A Retrospective Review
Abstract Background Diarrhea causes significant morbidity among solid organ transplant recipients. It is described in liver and kidney transplant recipients, but not in lung transplant (LTx) recipients. The primary aim of this study was to characterize diarrhea in LTx recipients. Methods Retrospective review was performed for all patients undergoing LTx at our tertiary care hospital between 01/2011 and 02/2019. Electronic medical records were reviewed for the development of diarrhea. Results A total of 564 patients (66.3% male, mean age 64.4 ± 8.8 years) underwent LTx during the 8-year study period, with 289 patients (51.2%) experiencing post-LTx diarrhea. The most common etiologies of diarrhea were medication-induced (33.6%) and CDI (15.6%). Mycophenolate mofetil (MMF) was the most common cause of medication induced diarrhea (33.3%). Diarrhea and age were significantly associated with increased LTx rejection rates in multivariate analysis (Diarrhea OR = 2.26, 95% CI = 1.48–3.45; Age OR = 0.98, 95% CI = 0.95-1.0). Conclusions Diarrhea is common in LTx recipients, with medication-induced diarrhea being the most common etiology. Diarrhea and younger age were associated with an increased risk of LTx rejection. Recognizing the causes of diarrhea in LTx recipients is important for early diagnosis and treatment, leading to greater quality of life and improved graft function.