Bronchiolitis obliterans with organizing pneumonia: possible association with human herpes virus-7 infection after lung transplantation

Abstract

transplant database of the centre was carried out. All single lung (SL), double lung (DL) and heart-lung block (HL) transplant patients who survived over 2 years post transplant were included in the study group. They were grouped as follows: A 5 D-/R(n5102), B 5 D-/R1 (n570), C 5 D1/R(n533) and E 5 D1/R1 (n592). The respective incidence of BOS in the different groups was 43.1%, 45.7%, 51.5% and 47.8% (p50.32). The 3-year BOS free survival was 65%, 56%, 58% and 67% respectively (p.0.05). In group A, the significant risk factors for developing BOS were three or more episodes of acute rejection (p50.02) and non-CMV pulmonary infection (p50.03). The mean number of acute rejection episodes per 100 patients days within the first six months were 1.28 (group A), 1.06 (group B), 0.50 (group C) and 1.11 (group E) [p,0.05]. Conclusion: Although CMV has been shown to be a risk factor for BOS, its absence did not preclude lung transplant patients from developing BOS. Moreover, absence of CMV was associated with an increase in the number of acute rejection episodes within the first transplant year. However, this could be accounted for by changes in frequency of acute rejection over time. Moreover, this may also reflect the non-uniformity of the pathological processes that are grouped as BOS.