Abstract
BackgroundRespiratory infections are a major threat for lung recipients. We aimed to compare with a monocentric study the impact of late viral and bacterial respiratory infections on the graft function.MethodsPatients, who survived 6 months or more following lung transplantation that took place between 2009 and 2014, were classified into three groups: a viral infection group (VIG) (without any respiratory bacteria), a bacterial infection group (BIG) (with or without any respiratory viruses), and a control group (CG) (no documented infection). Chronic lung allograft dysfunction (CLAD) and acute rejection were analysed 6 months after the inclusion in the study.ResultsAmong 99 included lung recipients, 57 (58%) had at least one positive virological respiratory sample during the study period. Patients were classified as follows: 38 in the VIG, 25 in the BIG (among which 19 co-infections with a virus) and 36 in the CG. The BIG presented a higher initial deterioration in lung function (p = 0.05) than the VIG. But 6 months after the infection, only the VIG presented a median decrease of forced expiratory volume in 1 s; − 35 mL (IQR; − 340; + 80) in the VIG, + 140 mL (+ 60;+ 330) in the BIG and + 10 (− 84;+ 160) in the CG, p < 0.01. Acute rejection was more frequent in the VIG (n = 12 (32%)), than the BIG (n = 6 (24%)) and CG (n = 3 (8%)), p < 0.05, despite presenting no more CLAD (p = 0.21).ConclusionsDespite a less severe initial presentation, single viral respiratory infections seem to lead to a greater deterioration in lung function, and to more acute rejection, than bacterial infections.
Highlights
IntroductionWe aimed to compare with a monocentric study the impact of late viral and bacterial respiratory infections on the graft function
Respiratory infections are a major threat for lung recipients
Patients were divided into three groups according to the criteria described above: 38 (38%) in the viral infection group (VIG), 25 (25%) in the bacterial infection group (BIG) (6 patients mono-infected by bacteria and 19 co-infected patients) and 36 (36%) in the control group (CG)
Summary
We aimed to compare with a monocentric study the impact of late viral and bacterial respiratory infections on the graft function. Bacterial infections are the leading cause of respiratory infections in LTRs [7, 11, 13] Their association with the occurrence of CLAD is well established [2, 14]. Many authors admit that viral respiratory tract infections (VRTI) may be associated with CLAD [3, 15,16,17,18,19,20,21,22,23,24], but this remains controversial, depending on the definition of respiratory infection, the virus panel studied, the time limit between VRTI and spirometric analysis, and the consideration of intercurrent events possibly influencing the respiratory function [25]. While some studies have identified an association between these two events [17, 26, 27] some others, including a recent meta-analysis, have not found any link between them [21, 25, 28]
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