Successful Pseudomonas aeruginosa eradication improves outcomes after lung transplantation: a retrospective cohort analysis
Successful Pseudomonas aeruginosa eradication improves outcomes after lung transplantation: a retrospective cohort analysis
复制标题
DOI：
10.1183/13993003.01720-2020
复制
发表时间：
2020-10-01
影响因子：
24.3
通讯作者：
Vos, Robin
中科院分区：
文献类型：
--
作者：
De Muynck, Benedicte;Van Herck, Anke;Vos, Robin
肺移植（LTx）后的长期生存受到慢性肺移植功能障碍（CLAD）的阻碍。铜绿假单胞菌是CLAD的既定危险因素。因此，我们研究了铜绿假单胞菌根除对无CLAD和移植物存活率的影响。根据2011年9月至2016年9月期间呼吸道样本中铜绿假单胞菌的存在，对1991年7月至2016年2月期间接受首次LTx且无CLAD的患者进行回顾性分类。随后根据靶向抗生素治疗后铜绿假单胞菌根除的成功率对铜绿假单胞菌阳性患者进行分层。比较了铜绿假单胞菌阳性和阴性患者以及铜绿假单胞菌成功根除或未成功根除患者的无CLAD和移植物存活率。铜绿假单胞菌阴性患者（n=443）的无CLAD生存期长于铜绿假单胞菌阳性患者（n=95）（p=0.045）。铜绿假单胞菌阴性患者（n=443，82%）的移植物存活率高于铜绿假单胞菌阳性患者（n=95，18%）（p
Long-term survival after lung transplantation (LTx) is hampered by development of chronic lung allograft dysfunction (CLAD). Pseudomonas aeruginosa is an established risk factor for CLAD. Therefore, we investigated the effect of P. aeruginosa eradication on CLAD-free and graft survival.Patients who underwent first LTx between July, 1991, and February, 2016, and were free from CLAD, were retrospectively classified according to P. aeruginosa presence in respiratory samples between September, 2011, and September, 2016. P. aeruginosa-positive patients were subsequently stratified according to success of P. aeruginosa eradication following targeted antibiotic treatment. CLAD-free and graft survival were compared between P. aeruginosa-positive and P. aeruginosa-negative patients; and between patients with or without successful P. aeruginosa eradication. In addition, pulmonary function was assessed during the first year following P. aeruginosa isolation in both groups.CLAD-free survival of P. aeruginosa-negative patients (n=443) was longer compared with P. aeruginosa-positive patients (n=95) (p=0.045). Graft survival of P. aeruginosa-negative patients (n=443, 82%) was better compared with P. aeruginosa-positive patients (n=95, 18%) (p