Viral Respiratory Tract Infection During the First Postoperative Year Is a Risk Factor for Chronic Rejection After Lung Transplantation

Magnusson, Jesper; Westin, Johan; Andersson, Lars-Magnus; Lindh, Magnus; Brittain-Long, Robin; Nordén, Rickard; Riise, Gerdt C.

Our data suggest that in particular coronaviruses might contribute to CLAD developing sooner after transplantation which has not been previously reported. Although hRV was the most commonly detected viral agent, it seemed to contribute less to CLAD development (S6 http://links.lww.com/TXD/ A117). The 4 coronavirus subtypes (229E, OC43, NL63, and HKU1) all usually replicate in NPH epithelial cells and generally cause mild symptoms in otherwise healthy patients, 23 but it is not clear if this is the case among immunocompromised hosts. 24 In our study, we found all the coronavirus subtypes in the lower airways. These findings fit with previous studies reporting CoV-HKU1 to have a preference for type 2 pneumocytes 25 and 229E for alveolar macrophages, 26 both known to trigger the innate immune system and a T cell mediated adaptive immune response. 25, 26 However, the number of each CoV subtype, as well as the number of viruses of other viral families were too few for subgroup analysis.