Key result
Community-acquired respiratory viruses in the lower respiratory tract were independently associated with an increased risk of developing chronic lung allograft dysfunction (HR 3.00; 95% CI 1.52-5.91; P=0.002).
Why the study?
The relationship between community-acquired respiratory viruses and chronic lung allograft dysfunction in lung transplant recipients remains controversial.
Does community-acquired respiratory virus lower respiratory tract infection increase the risk of chronic lung allograft dysfunction in lung transplant recipients?
Cohort (n=98)
No
Does community-acquired respiratory virus lower respiratory tract infection increase the risk of chronic lung allograft dysfunction in lung transplant recipients?
Hazard Ratio: 3 (95% CI 1.52–5.91)
p-value: p=0.002
Community-acquired respiratory viruses in the lower respiratory tract are an independent risk factor for chronic lung allograft dysfunction in lung transplant recipients.
May warrant viral surveillance in lung transplant recipients; leaves open whether prevention reduces CLAD incidence.
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.
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Peghin et al. (2018) conducted a cohort in Lung transplant recipients (n=98). Community-acquired respiratory viruses in the lower respiratory tract (CARV-LRTID) vs. No CARV-LRTID was evaluated on Development of chronic lung allograft dysfunction (CLAD) (HR 3.00, 95% CI 1.52-5.91, p=0.002). Community-acquired respiratory viruses in the lower respiratory tract were independently associated with an increased risk of developing chronic lung allograft dysfunction (HR 3.00; 95% CI 1.52-5.91; P=0.002).
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