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.

Data were collected prospectively. A standardized followup protocol was used for all patient visits, as outlined in Figure 1 . Induction therapy consisted of rabbit antithymocyte globulin which was given for 1 to 3 consecutive days together with methylprednisolone IV. Posttransplantation immunosuppression included prednisone, 0.3 mg/kg/day and mycophenolate mofetil, 2 g/d. The patients then received either oral cyclosporine (CSA) (1-2 mg/kg) adjusted to maintain a serum level of 300 to 350 ng/mL or tacrolimus (TAC), 0.075 mg/kg given orally divided in 2 doses daily adjusted to maintain a serum level of 14 to 16 ng/mL. The dosage of immunosuppression was gradually lowered during FU. Further changes in immunosuppressive therapy were based on clinical presentation. Antimicrobial prophylaxis is detailed in the supplementary material (S1 http://links.lww.com/TXD/A117). Extra follow-up visits and additional bronchoscopies were carried out upon suspicion of respiratory infections or AR based on clinical presentation.