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- Title
Fatal Infections Differentially Involve Allograft and Native Lungs in Single Lung Transplant Recipients.
- Authors
Villalba, Julian A.; Cheek-Norgan, Heidi; Johnson, Tucker F.; Yi, Eunhee S.; Boland, Jennifer M.; Aubry, Marie-Christine; Pennington, Kelly M.; Scott, John P.; Roden, Anja C.
- Abstract
Context.--Respiratory infections complicate lung transplantation and increase the risk of allograft dysfunction. Allograft lungs may have different susceptibilities to infection than native lungs, potentially leading to different disease severity in lungs of single lung transplant recipients (SLTRs). Objective.--To study whether infections affect allograft and native lungs differently in SLTRs but similarly in double LTRs (DLTRs). Design.--Using an institutional database of LTRs, medical records were searched, chest computed tomography studies were systematically reviewed, and histopathologic features were recorded per lung lobe and graded semiquantitatively. A multilobar-histopathology score (MLHS) including histopathologic data from each lung and a bilateral ratio (MLHSratio) comparing histopathologies between both lungs were calculated in SLTRs and compared to DLTRs. Results.--Six SLTRs died of infection involving the lungs. All allografts showed multifocal histopathologic evidence of infection, but at least 1 lobe of the native lung was uninvolved. In 4 of 5 DLTRs, histopathologic evidence of infection was seen in all lung lobes. On computed tomography, multifocal ground-glass and/or nodular opacities were found in a bilateral distribution in all DLTRs but in only 2 of 6 SLTRs. In SLTRs, the MLHSAllograft was higher than MLHSNative (P ¼ .02). The MLHSratio values of SLTR and DLTR were significantly different (P, .001). Conclusions.--Allograft and native lungs appear to harbor different susceptibilities to infections. The results are important for the management of LTRs.
- Subjects
LUNG microbiology; LUNG radiography; LUNG transplantation; PATIENTS; TRANSPLANTATION of organs, tissues, etc.; RESPIRATORY infections; COMPUTED tomography; TREATMENT effectiveness; HOMOGRAFTS; LUNGS; CHEST X rays; DESCRIPTIVE statistics; RETROSPECTIVE studies; DISEASE complications; MEDICAL records; ACQUISITION of data; HISTOLOGICAL techniques; COMPARATIVE studies; DISEASE risk factors
- Publication
Archives of Pathology & Laboratory Medicine, 2024, Vol 148, Issue 7, p784
- ISSN
0003-9985
- Publication type
Article
- DOI
10.5858/arpa.2023-0227-OA