title: Long-term impact of respiratory viral infection after pediatric lung transplantation.
abstract: To evaluate the epidemiology and to investigate the impact of RVI on chronic allograft rejection after pediatric lung transplantation, a retrospective study of pediatric lung transplant recipients from 2002 to 2007 was conducted. Association between RVI and continuous and categorical risk factors was assessed using Wilcoxon rank-sum tests and Fisher's exact tests, respectively. Association between risk factors and outcomes were assessed using Cox proportional hazards models. Fifty-five subjects were followed for a mean of 674 days (range 14-1790). Twenty-eight (51%) developed 51 RVI at a median of 144 days post-transplant (mean 246; range 1-1276); 41% of infections were diagnosed within 90 days. Twenty-five subjects developed 39 LRI, and eight subjects had 11 URI. Organisms recovered included rhinovirus (n = 14), adenovirus (n = 10), parainfluenza (n = 10), influenza (n = 5), and RSV (n = 4). Three subjects expired secondary to their RVI (two adenovirus, one RSV). Younger age and prior CMV infection were risks for RVI (HR 2.4 95% CI 1.1-5.3 and 17.0; 3.0-96.2, respectively). RVI was not associated with the development of chronic allograft rejection (p = 0.25) or death during the study period. RVI occurs in the majority of pediatric lung transplant recipients, but was not associated with mortality or chronic allograft rejection.
authors.affiliation: The Children's Hospital at Cleveland Clinic, Cleveland, OH 44195, USA.
authors.forename: M
authors.initials: M
authors.lastname: Liu
authors.forename: G B
authors.initials: GB
authors.lastname: Mallory
authors.forename: M G
authors.initials: MG
authors.lastname: Schecter
authors.forename: S
authors.initials: S
authors.lastname: Worley
authors.forename: S
authors.initials: S
authors.lastname: Arrigain
authors.forename: J
authors.initials: J
authors.lastname: Robertson
authors.forename: O
authors.initials: O
authors.lastname: Elidemir
authors.forename: L A
authors.initials: LA
authors.lastname: Danziger-Isakov
mesh_terms: D000293:Adolescent; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D006084:Graft Rejection; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D007223:Infant; D008137:Longitudinal Studies; D016040:Lung Transplantation; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology*; D016016:Proportional Hazards Models; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology*; D012189:Retrospective Studies; D012307:Risk Factors; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents