Association between Cytomegalovirus (CMV) and Chronic Lung Allograft Dysfunction (CLAD) in Lung Transplant Recipients
نویسندگان
چکیده
PurposeBronchiolitis obliterans syndrome (BOS), restrictive allograft (RAS), and mixed are major phenotypes of CLAD. In previous, older studies, CMV viremia has been associated with reduced survival. We hypothesized that, in a more modern era prophylaxis, would remain death, but also represent risk factor for CLAD specifically RAS/mixed phenotype.MethodsThis is retrospective cohort study all consecutive adult, first, bilateral-/single-lung transplants performed 2010-2016 who had ≥4 pulmonary function tests ≥1 CMV-PCR measurement. levels were divided into 3 categories: undetectable, <1000 IU/mL, ≥1000 IU/mL. Risks CLAD, RAS/mixed, or death/re-transplantation assessed by Cox proportional hazards models using as time-dependent categorical variable, adjusting variables listed table.ResultsOf 645 patients, 257 developed (143 BOS, 44 66 undefined/unclassified) 388 CLAD-free at last follow-up. univariate analysis, CMV-PCR≥1000 IU/mL was significant (HR 1.33, p=0.05). multivariate not whereas serostatus mismatch (Table). (CMV-PCR<1000 IU/mL: HR 1.46, p=0.32. 1.43, p=0.33) analysis. Regarding time to death/re-transplantation, (Table).ConclusionCMV significantly death/re-transplantation. Conversely, strongly while was. may have an impact on through mechanisms independent viremia. light these paradoxical results, we further assessing the relationship between immunosuppression, immune function, CMV. Bronchiolitis phenotype. This table. Of
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ژورنال
عنوان ژورنال: Journal of Heart and Lung Transplantation
سال: 2021
ISSN: ['1053-2498', '1557-3117']
DOI: https://doi.org/10.1016/j.healun.2021.01.863