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Infectious complications of bronchial stenosis in lung transplant recipients
Author(s) -
Fallis Rebecca J.,
Jablonski Lindsay,
Moss Sean,
Axelrod Peter,
Clauss Heather
Publication year - 2019
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.13100
Subject(s) - medicine , lung , stenosis , lung transplantation , intensive care medicine
Background Bronchial stenosis is a known complication of lung transplantation, but there are limited data regarding whether transplant recipients with bronchial stenosis develop more infectious complications than those without bronchial stenosis. Methods We conducted a retrospective single‐center observational cohort study between January 1, 2011 and September 29, 2016 of 35 lung transplant recipients diagnosed with bronchial stenosis and a random sample of 35 lung transplant recipients without bronchial stenosis. Data collected included donor/recipient demographic and anatomic information, respiratory cultures, episodes of respiratory infections diagnosed using CDC‐NNIS criteria, hospitalizations, and 1‐year all‐cause mortality. Patients were followed up to 1 year after transplant. Results Bronchial stenosis occurred at a median of 54 days post‐transplant (range 5‐365 days). Bronchial stenosis patients spent more time in the hospital (87.4 vs 46.8 days, P = 0.011) and had more total hospitalizations (4.54 vs 2.37, P < 0.01) than their counterparts. The relative risk of pneumonia among cases vs controls was 4.0 (95% CI 2.2‐7.3, P < 0.01); for purulent tracheobronchitis the relative risk was 3.1 (95% CI 1.6‐6.1, P < 0.01). Patients with bronchial stenosis were significantly more likely to have respiratory cultures growing Staphylococcus aureus (RR 5.0; P = 0.001) and Pseudomonas aeruginosa (RR 2.1, P = 0.026). Mortality within the first year following transplant was equal in both the groups (14.3% vs 14.3%). Conclusions There was no significant increase in 1‐year mortality for lung transplant patients who developed bronchial stenosis. However, bronchial stenosis patients had significantly higher risks of pneumonia and tracheobronchitis, and spent more days in the hospital than those without bronchial stenosis.