Abstract
To evaluate incidence of and risk factors for respiratory bacterial colonization and infections within 30 days from lung transplantation (LT). We retrospectively analyzed microbiological and clinical data from 94 patients transplanted for indications other than cystic fibrosis, focusing on the occurrence of bacterial respiratory colonization or infection during 1 month of follow-up after LT. Thirty-three percent of patients developed lower respiratory bacterial colonization. Bilateral LT and chronic heart diseases were independently associated to a higher risk of overall bacterial colonization. Peptic diseases conferred a higher risk of multi-drug resistant (MDR) colonization, while longer duration of aerosol prophylaxis was associated with a lower risk. Overall, 35% of lung recipients developed bacterial pneumonia. COPD (when compared to idiopathic pulmonary fibrosis, IPF) and higher BMI were associated to a lower risk of bacterial infection. A higher risk of MDR infection was observed in IPF and in patients with pre-transplant colonization and infections. The risk of post-LT respiratory infections could be stratified by considering several factors (indication for LT, type of LT, presence of certain comorbidities, and microbiologic assessment before LT). A wider use of early nebulized therapies could be useful to prevent MDR colonization, thus potentially lowering infectious risk.
Highlights
Lung transplant (LT) is considered a reasonable treatment option for selected patients with chronic respiratory endstage diseases
Thirty-one (19.5%) subjects were excluded since they were transplanted for cystic fibrosis, 36 (22.3%) were excluded for missing or incomplete clinical and/or microbiological data
The studied population was mainly constituted by male (n = 59; 68.2%) patients with a median age of 56.5 years (IQR 49.8–61) and a median pre-transplant body mass index (BMI) of 24 kg/m2 (IQR 20–29)
Summary
Lung transplant (LT) is considered a reasonable treatment option for selected patients with chronic respiratory endstage diseases. The most frequent indications for adult LT are chronic obstructive pulmonary diseases (COPD) with or without α1-antitrypsin deficiency, interstitial lung diseases, cystic fibrosis, and idiopathic pulmonary arterial hypertension [1, 2]. Each one of these diseases has its own peculiar features in term of transplant list waiting, mortality, and post-transplant survival [3, 4]. Despite post-LT survival rate has increased over the last years, risk of early and late post-surgical complications remains high for transplanted patients [2, 5]. Infectious complications represent the most frequent cause of death after graft failure within the first 30 days from transplant, and the first cause within the first year [2]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
