Abstract
<b>Introduction:</b> Azithromycin (AZI) has proved beneficial immunomodulatory effect in lung transplant (LT) recipients, and apparently, it could prevent chronic lung allograft dysfunction (CLAD), which is the main cause of mortality from the first year after LT. <b>Objectives:</b> To assess the influence of AZI and the timing of its onset on the development of CLAD in a cohort of LT recipients. <b>Methods:</b> Single center retrospective study, including LT recipients from 01/01/2011 to 30/06/2020. Four groups were established: those who received AZI from the 3rd week after LT (group A), those with AZI beyond the 3rd week post-transplant without a decline in FEV1 (B), those who did not receive AZI (C) and those who received AZI due to a decline in FEV1 (D). CLAD was defined and graduated according to the 2019 ISHLT criteria. <b>Results:</b> We included 358 LT recipients, 64.2% of whom were male, with a median age of 58.26 years (ICR 51.81 – 62.28). Interstitial lung disease (46.1%) and COPD (34.1%) were the most frequent diseases. 50.6% received induction with basiliximab. There was a significant reduction in the development of CLAD in the group of patients who were given AZI at 1st year (p = 0.01), 3 years (p <0.001) and 5 years (p < 0.001) (Figure 1). <b>Conclusions:</b> Early onset of azithromycin in LT recipients significantly decreases development of CLAD. Our results suggest that the use of AZI right after transplantation may have a protective role in the development of CLAD.
Published Version
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