Key result
Non-rhinovirus community-acquired respiratory virus infections were associated with a significant decline in lung allograft function at 1-2.5 months, whereas rhinovirus infections were not.
Why the study?
Does community acquired respiratory virus infection increase acute rejection or decline allograft function in lung transplant recipients?
Cohort (n=59)
Does community acquired respiratory virus infection increase acute rejection or decline allograft function in lung transplant recipients?
Non-rhinovirus respiratory infections are associated with short-term allograft dysfunction in lung transplant recipients, independent of acute rejection.
May warrant closer surveillance after non-rhinovirus infections in lung recipients; hypothesis-generating for virus-specific allograft effects.
BACKGROUND: Community acquired respiratory virus (CARV) infections in lung transplant recipients (LTR) have been associated with adverse outcomes, including acute rejection (AR) and decline in allograft function, in some but not in all studies. METHODS: Spirometry and transbronchial biopsy results of LTR diagnosed with CARV infection over a two-yr period were extracted from clinical records. Primary outcomes, studied at 1-2.5 months postinfection, were as follows: (i) incidence of biopsy-proven AR (grade >A0) and (ii) allograft function, defined by forced expiratory volume in one s (FEV(1)). A reference group of biopsies (n = 526) collected during the study period established the baseline incidence of AR. Rhinovirus (RV) and non-rhinovirus (non-RV) infections were analyzed as subgroups. RESULTS: Eighty-seven cases of CARV infection were identified in 59 subjects. Incidences of AR were similar in the post-CARV and reference groups and did not differ significantly after RV vs. non-RV infection. Allograft function declined significantly after non-RV infection, but not after RV infection. CONCLUSIONS: In LTR, CARV infections other than RV are associated with allograft dysfunction at 1-2.5 months after infection. However, CARVs do not appear associated with AR at this time point. The impact of specific CARVs on lung allografts, including the development of chronic allograft rejection, merits further study.
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Sayah et al. (2012) conducted a cohort in Community acquired respiratory virus infections in lung transplant recipients (n=59). Non-rhinovirus community acquired respiratory virus infections vs. Rhinovirus infections was evaluated on Incidence of biopsy-proven acute rejection (grade >A0) and allograft function (FEV1). Non-rhinovirus community-acquired respiratory virus infections were associated with a significant decline in lung allograft function at 1-2.5 months, whereas rhinovirus infections were not.
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