Pseudomonas aeruginosa colonization of the allograft after lung transplantation and the risk of bronchiolitis obliterans syndrome
Pseudomonas aeruginosa colonization of the allograft after lung transplantation and the risk of bronchiolitis obliterans syndrome
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DOI：
10.1097/tp.0b013e31816651de
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发表时间：
2008-03-15
期刊：
影响因子：
6.2
通讯作者：
Fisher, Andrew J.
中科院分区：
文献类型：
--
作者：
Botha, Phil;Archer, Lynda;Fisher, Andrew J.
肺移植后的长期生存仍然受到闭塞性细支气管炎综合征（BOS）的限制。铜绿假单胞菌在同种异体移植物中的定植很常见，尤其是在BOS受者中，但可能的病因学关系尚未探讨。在155例连续肺移植中，假单胞菌的同种异体移植物定植的发展与移植后2年内BOS的发展密切相关（定植和未定植者分别为23.4%和7.7%，P=0.006）。与未发生定植的患者相比，未发生BOS的患者在移植前无任何细菌储库发生新发同种异体移植物假单胞菌定植的患者中显著更短（Kaplan-Meier对数秩P=0.014）。18例中有14例（78%）假单胞菌的分离先于BOS的诊断，在发生这两种并发症的患者中，中位时间为204天（95%置信区间115-492）。我们的结论是假单胞菌在同种异体肺移植物中的重新定植与随后的BOS发展密切相关。
Long-term survival after lung transplantation remains limited by the development of bronchiolitis obliterans syndrome (BOS). Allograft colonization with Pseudomonas aeruginosa is common particularly in recipients with BOS, but a possible etiological relationship remains unexplored. In 155 consecutive lung transplants, the development of allograft colonization with Pseudomonas was strongly associated with the development of BOS within 2 years of transplant (23.4% vs. 7.7% in those colonized and not colonized, respectively, P=0.006). Freedom from BOS was significantly shorter in those patients without any pretransplant bacterial reservoir developing de novo allograft pseudomonal colonization as compared with those remaining free of colonization (Kaplan-Meier log-rank P=0.014). The isolation of Pseudomonas preceded the diagnosis of BOS in 14 of 18 (78%) and by a median of 204 days (95% confidence interval 115-492) in patients developing both these complications. We conclude that de novo colonization of the lung allograft by Pseudomonas is strongly associated with the subsequent development of BOS.