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 finding that AR is a risk factor for CLAD development is uncontroversial, and the effect of the choice of calcineurin inhibition on CLAD development has been previously published. 27 At our center in general there is a selection bias toward Tacrolimus instead of CSA, for younger patients and CF patients. Also if a patient is retransplanted, TAC is selected more often (S7 http://links.lww.com/TXD/A117). The high HR for CLAD development associated with CSA treatment is somewhat unexpected, but our study was not designed for comparing the impact of different types of immunosuppression and the result must be interpreted witch caution. We did not find any association between VRTI and time until graft loss; however, the majority of the CLAD population with previous VRTI exposure suffered from a relatively slowly progressing BOS compared with those in the CLAD population with no previous VRTI exposure. This could suggest that the CLAD phenotype triggered by VRTI is less aggressive than CLAD triggered by other causes.