Pseudomonas aeruginosa colonization of the allograft after lung transplantation and the risk of bronchiolitis obliterans syndrome.

Abstract

Long-term survival after lung transplantation remains limited by the development of bronchiolitis obliterans syndrome (BOS). Allograft colonization with Pseudomonas aeruginosa is common particularly in recipients with BOS, but a possible etiological relationship remains unexplored. In 155 consecutive lung transplants, the development of allograft colonization with Pseudomonas was strongly associated with the development of BOS within 2 years of transplant (23.4% vs. 7.7% in those colonized and not colonized, respectively, P=0.006). Freedom from BOS was significantly shorter in those patients without any pretransplant bacterial reservoir developing de novo allograft pseudomonal colonization as compared with those remaining free of colonization (Kaplan-Meier log-rank P=0.014). The isolation of Pseudomonas preceded the diagnosis of BOS in 14 of 18 (78%) and by a median of 204 days (95% confidence interval 115-492) in patients developing both these complications. We conclude that de novo colonization of the lung allograft by Pseudomonas is strongly associated with the subsequent development of BOS.

• Authors: Phil Botha, Lynda Archer, Rachel L Anderson, Jim Lordan, John H Dark, Paul A Corris, Kate Gould, Andrew J Fisher
• Journal: Transplantation (Transplantation) Vol. 85 Issue 5 Pg. 771-4 (Mar 15 2008) ISSN: 0041-1337 [Print] United States
• PMID: 18337673 (Publication Type: Journal Article)

Topics

• Adult
• Bronchiolitis Obliterans (epidemiology, microbiology)
• Female
• Humans
• Lung Transplantation (adverse effects)
• Male
• Middle Aged
• Pseudomonas Infections (epidemiology)
• Pseudomonas aeruginosa (isolation & purification)
• Pulmonary Disease, Chronic Obstructive (epidemiology)
• Retrospective Studies
• Risk Factors
• Time Factors
• Transplantation, Homologous