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.

In total, 26 patients suffered an AR during the first year, 3 of these patients suffered more than 1 AR before developing CLAD. Bacterial infections affected 41 patients and consisted of Pseudomonas aeruginosa in 20 cases, and the remainder were other bacteria. Fungal infections affected 13 patients with 2 cases of Candida glabrata, 1 case of Candida krusei and the rest consisted of Aspergillus species. A total of 14 patients showed CMV antibody mismatch; 46 patients had at least 1 episode of CMV viremia during the first year, but only 4 patients developed CMV disease during the follow-up period. Repeated elevated EBV-DNA was common, with 29 patients suffering from more than 1 episode of Epstein-Barr viremia. Three patients developed posttransplant lymphoproliferative disease during follow-up, all responded favorably to treatment. Acute rejection and infectious events are outlined in Table 2 . No case of positive PCR for Legionella pneumophila, Pneumocystis jirovecii, Chlamydophila pneumoniae, or Mycoplasma pneumoniae was detected.