Community-acquired Respiratory Viruses Are a Risk Factor for Chronic Lung Allograft Dysfunction

Peghin, Maddalena; Los‐Arcos, Ibai; Hirsch, Hans H.; Codina, Gemma; Monforte, Vı́ctor; Bravo, Carles; Berastegui, Cristina; Jáuregui, Alberto; Romero, Laura; Cabral, Evelyn; Ferrer, Ricard; Sacanell, Judit; Román, Antonio; Len, Óscar; Gavaldá, Joan

doi:10.1093/cid/ciy1047

Cited by 59 publications

(62 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Both prospective 21,44,45 and retrospective studies 46 support a link between CARVs and chronic rejection, particularly when the infection involves the lower respiratory tract and/or is associated with clinical symptoms. 46,47 anti-donor HLA antibodies, 39,40 as well as ColV and Kα1T autoantibodies as risk factors for CLAD. 8,48 Similarly, we did not find a correlation between donor-specific alloreactive T cells responsiveness (as assessed by cytokine ELISPOT) in contrast to studies in kidney transplant recipients where ELISPOT reactivity strongly correlates with long-term renal graft function.…”

Section: Discussionmentioning

confidence: 99%

Absence of evidence that respiratory viral infections influence pediatric lung transplantation outcomes: Results of the CTOTC-03 study

Sweet

Chin

Conrad

et al. 2019

American Journal of Transplantation

View full text Add to dashboard Cite

Based on reports in adult lung transplant recipients, we hypothesized that community-acquired respiratory viral infections (CARVs) would be a risk factor for poor outcome after pediatric lung transplant. We followed 61 pediatric lung transplant recipients for 2+ years or until they met a composite primary endpoint including bronchiolitis obliterans syndrome/obliterative bronchiolitis, retransplant, or death. Blood, bronchoalveolar lavage, and nasopharyngeal specimens were obtained with standard of care visits. Nasopharyngeal specimens were obtained from recipients with respiratory viral symptoms. Respiratory specimens were interrogated for respiratory viruses by using multiplex polymerase chain reaction. Donor-specific HLA antibodies, self-antigens, and ELISPOT reactivity were also evaluated. Survival was 84% (1 year) and 68% (3 years). Bronchiolitis obliterans syndrome incidence was 20% (1 year) and 38% (3 years). The primary endpoint was met in 46% of patients. CARV was detected in 156 patient visits (74% enterovirus/rhinovirus). We did not find a relationship | 3285 SWEET ET al.

show abstract

Section: Discussionmentioning

confidence: 99%

Absence of evidence that respiratory viral infections influence pediatric lung transplantation outcomes: Results of the CTOTC-03 study

Sweet

Chin

Conrad

et al. 2019

American Journal of Transplantation

View full text Add to dashboard Cite

show abstract

“…Among a total of 1,007 patients, sole HMPV infection was identified in 57 cases, of which 35% were associated with acute rejection within 3 months, followed by CLAD/BOS (151). However, in other studies, reactivation of cytomegalovirus has been identified as an important cofactor that is not exclusive to HMPV (61).…”

Section: Human Pneumo-and Paramyxoviridaementioning

confidence: 97%

“…In a prospective cohort study from 2009 to 2014 enrolling 98 lung transplant recipients, CLAD was diagnosed in 38% at a median time of 20.4 months (IQR, 12 to 30.4) (61). In the time-controlled multivariate analysis, CLAD was associated with CARV-LRTID (HR, 3.00; 95% CI, 1.52 to 5.91; P ϭ 0.002), acute rejection (HR, 2.97; 95% CI, 1.51 to 5.83; P ϭ 0.002), and CMV pneumonitis (HR, 3.76; 95% CI, 1.23 to 11.49; P ϭ 0.02) (61).…”

Section: General Aspects Of Carvs In the Transplant Populationmentioning

confidence: 99%

See 1 more Smart Citation

Community-Acquired Respiratory Viruses in Transplant Patients: Diversity, Impact, Unmet Clinical Needs

2019

View full text Add to dashboard Cite

SUMMARY Patients undergoing solid-organ transplantation (SOT) or allogeneic hematopoietic cell transplantation (HCT) are at increased risk for infectious complications. Community-acquired respiratory viruses (CARVs) pose a particular challenge due to the frequent exposure pre-, peri-, and posttransplantation. Although influenza A and B viruses have a top priority regarding prevention and treatment, recent molecular diagnostic tests detecting an array of other CARVs in real time have dramatically expanded our knowledge about the epidemiology, diversity, and impact of CARV infections in the general population and in allogeneic HCT and SOT patients. These data have demonstrated that non-influenza CARVs independently contribute to morbidity and mortality of transplant patients. However, effective vaccination and antiviral treatment is only emerging for non-influenza CARVs, placing emphasis on infection control and supportive measures. Here, we review the current knowledge about CARVs in SOT and allogeneic HCT patients to better define the magnitude of this unmet clinical need and to discuss some of the lessons learned from human influenza virus, respiratory syncytial virus, parainfluenzavirus, rhinovirus, coronavirus, adenovirus, and bocavirus regarding diagnosis, prevention, and treatment.

show abstract

“…As we have previously reported, permanent discontinuation of the antimetabolite in KT patients with a severe viral infection such as CMV and BK virus is safe and effective [ 76 , 77 ]. However, there are less data about the safety of the prolonged cessation of antimetabolites in other organ transplants, particularly for viruses in whom the disease severity is characterized by a hyperactive immune response, or for conditions such as in thoracic transplant where respiratory viral infections have been shown to trigger immune responses that induce chronic allograft dysfunction [ 78 – 81 ].…”

Section: Outpatient Management For Transplant Recipientsmentioning

confidence: 99%

General Approach to the Clinical Care of Solid Organ Transplant Recipients with COVID-19 Infection

2020

View full text Add to dashboard Cite

Purpose of Review Insufficient knowledge about COVID-19 and the potential risks of COVID-19 are limiting organ transplantation in wait-listed candidates and deferring essential health care in solid organ transplant recipients. In this review, we expand the understanding and present an overview of the optimized management of COVID-19 in solid organ transplant recipients. Recent Findings Transplant recipients are at an increased risk of severe COVID-19. The unique characteristics of transplant recipients can make it more difficult to identify COVID-19 . Based on the COVID-19 data to date and our experience, we present testing, management, and prevention methods for COVID-19. Comprehensive diagnostic tests should be performed to determine disease severity, phase of illness, and identify other comorbidities in transplant recipients diagnosed with COVID-19. Outpatients should receive education for preventative measures and optimal health care delivery minimizing potential infectious exposures. Multidisciplinary interventions should be provided to hospitalized transplant recipients for COVID-19 because of the complexity of caring for transplant recipients. Summary Transplant recipients should strictly adhere to infection prevention measures. Understanding of the transplant specific pathophysiology and development of effective treatment strategies for COVID-19 should be prioritized.

show abstract

Community-acquired Respiratory Viruses Are a Risk Factor for Chronic Lung Allograft Dysfunction

Cited by 59 publications

References 42 publications

Absence of evidence that respiratory viral infections influence pediatric lung transplantation outcomes: Results of the CTOTC-03 study

Absence of evidence that respiratory viral infections influence pediatric lung transplantation outcomes: Results of the CTOTC-03 study

Community-Acquired Respiratory Viruses in Transplant Patients: Diversity, Impact, Unmet Clinical Needs

General Approach to the Clinical Care of Solid Organ Transplant Recipients with COVID-19 Infection

Contact Info

Product

Resources

About