Upper and lower respiratory tract viral infections and acute graft rejection in lung transplant recipients.

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Serval ID
serval:BIB_A52EA738A55D
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Upper and lower respiratory tract viral infections and acute graft rejection in lung transplant recipients.
Journal
Clinical Infectious Diseases
Author(s)
Soccal P.M., Aubert J.D., Bridevaux P.O., Garbino J., Thomas Y., Rochat T., Rochat T.S., Meylan P., Tapparel C., Kaiser L.
ISSN
1537-6591[electronic], 1058-4838[linking]
Publication state
Published
Issued date
2010
Volume
51
Number
2
Pages
163-170
Language
english
Abstract
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.
Result: 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 (). We observed a significant association P < .001 between the presence of respiratory symptoms and positive viral detection in the lower respiratory tract (Pp. 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.
Keywords
Human Metapneumovirus Infection, Parainfluenza Virus-Infection, Bronchiolitis Obliterans, Clinical Impact, Bronchoalveolar Lavage, Syncytial Virus, Epidemiology, Influenza, Diagnosis, Etiology
Pubmed
Web of science
Open Access
Yes
Create date
06/07/2010 11:15
Last modification date
25/09/2019 7:10
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