Lung transplant patients are more at risk for complicated respiratory infections

Dr. Joan Gavaldà, researcher at the Infectious Diseases group of Vall d'Hebron Research Institute (VHIR) and physician at the same service, and doctors Antonio Román and Joan Solé, coordinators of the Transplant Program at the Vall d'Hebron University Hospital, have published an epidemiological study concluding that lung transplant patients are more susceptible to respiratory infections. The study, published in the American Journal of Transplantation, is the first ever made prospectively evaluating the incidence, clinical characteristics and impact of respiratory virus infections in recipients of lung implant.

The research includes the epidemiology of respiratory virus infections in lung transplantation and its effects on acute rejection and other opportunistic infections such as cytomegalovirus infection and the one produced by P. aeruginosa. The clinical study was carried out for 5 years by collecting samples of asymptomatic nasopharyngeal receptors during seasonal changes or with respiratory infection. Samples were analyzed with multiple PCR able to detect 24 different types of respiratory viruses, and cohort patients were monitored weekly by phone to check their symptoms.

In total 1,094 samples were collected from 98 patients and a high incidence of these infections was documented with a global prevalence of 2.33 infections per patient/year, with the infection of the upper respiratory tract by Rhinovirus as the most common one. Also, showed that after tracheobronchitis and pneumonia patients had transient worsening of implant function, recovering after 3 months. Finally it was found that the risk of complications in the form of acute rejection or CMV superinfection or P. aeruginosa, was higher in those who had suffered an infection of the lower respiratory tract (tracheobronchitis or pneumonia) by a respiratory virus.

With this study, researchers have found a high incidence of respiratory infections in recipients of lung transplantation and immunomodulation capacity. According to Dr. Gavaldà, "lung transplant patients with respiratory viral infections are more susceptible to other complications that may worsen the prognosis of the implant." In this sense, the VHIR researcher says that "the study emphasizes the need for control of respiratory virus infections in this high-risk population, by vaccination (flu) and avoid, as far as possible, contact during times of greater risk."