Upper and lower respiratory tract viral infections and acute graft rejection in lung transplant recipients
| Autor: | John-David Aubert, Laurent Kaiser, Caroline Tapparel, Thierry Rochat, Pierre-Olivier Bridevaux, Jorge Garbino, T. Rochat, Paola M. Soccal, Pascal Meylan, Yves Thomas |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Graft Rejection
Male Pathology medicine.medical_treatment 030230 surgery Gastroenterology Graft Rejection/*complications Pulmonary function testing Cohort Studies 0302 clinical medicine Nasopharynx 030212 general & internal medicine Respiratory system Child Articles and Commentaries Respiratory Tract Infections ddc:616 medicine.diagnostic_test Respiratory disease Middle Aged respiratory system Transplantation 3. Good health Infectious Diseases medicine.anatomical_structure Virus Diseases Viruses Respiratory virus Female Bronchoalveolar Lavage Fluid Lung Transplantation Adult Microbiology (medical) medicine.medical_specialty Adolescent Bronchoalveolar Lavage Fluid/virology Major Articles Young Adult 03 medical and health sciences Internal medicine medicine Humans Nasopharynx/virology Lung transplantation Respiratory Tract Infections/*complications/virology Aged Lung business.industry Virus Diseases/*complications medicine.disease Human Metapneumovirus Infection Parainfluenza Virus-Infection Bronchiolitis Obliterans Clinical Impact Bronchoalveolar Lavage Syncytial Virus Epidemiology Influenza Diagnosis Etiology respiratory tract diseases Bronchoalveolar lavage business Viruses/isolation & purification Respiratory tract |
| Zdroj: | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America Clinical Infectious Diseases, Vol. 51, No 2 (2010) pp. 163-170 Clinical Infectious Diseases, vol. 51, no. 2, pp. 163-170 Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America |
| ISSN: | 1058-4838 |
| DOI: | 10.1086/653529 |
| Popis: | Background. Lung transplant recipients are frequently exposed to respiratory viruses and are particularly at risk for severe complications. The aim of this study was to assess the association among the presence of a respiratory virus detected by molecular assays in bronchoalveolar lavage (BAL) fluid, respiratory symptoms, and acute rejection in adult lung transplant recipients. Methods. Upper (nasopharyngeal swab) and lower (BAL) respiratory tract specimens from 77 lung transplant recipients enrolled in a cohort study and undergoing bronchoscopy with BAL and transbronchial biopsies were screened using 17 different polymerase chain reaction—based assays. Results. BAL fluid and biopsy specimens from 343 bronchoscopic procedures performed in 77 patients were analyzed. We also compared paired nasopharyngeal and BAL fluid specimens collected in a subgroup of 283 cases. The overall viral positivity rate was 29.3% in the upper respiratory tract specimens and 17.2% in the BAL samples (P < .001). We observed a significant association between the presence of respiratory symptoms and positive viral detection in the lower respiratory tract (P = .012). Conversely, acute rejection was not associated with the presence of viral infection (odds ratio, 0.41; 95% confidence interval, 0.20–0.88). The recovery of lung function was significantly slower when acute rejection and viral infection were both present. Conclusions. A temporal relationship exists between acute respiratory symptoms and positive viral nucleic acid detection in BAL fluid from lung transplant recipients. We provide evidence suggesting that respiratory viruses are not associated with acute graft rejection during the acute phase of infection. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|