title: The impact of viral respiratory tract infections on long-term morbidity and mortality following lung transplantation: a retrospective cohort study using a multiplex PCR panel.
abstract: BACKGROUND
  The major factor affecting morbidity and mortality after lung transplantation (LTX) is bronchiolitis obliterans syndrome. Earlier studies have suggested a connection between the presence of viral agents and morbidity in this patient group, but data are somewhat conflicting. The objective of this study was to investigate the development of bronchiolitis obliterans syndrome and graft loss after LTX in relation to the presence of respiratory viruses during the first year after LTX.
  
  
  METHODS
  The study is a retrospective cohort study of 39 LTX recipients 11Y13 years after surgery. Patients were operated between January 1, 1998 and December 31, 2000 at Sahlgrenska University Hospital. The presence of virus in bronchoalveolar lavage (BAL) fluids from patients during the first year after surgery was analyzed retrospectively using a multiplex polymerase chain reaction test capable of detecting 15 respiratory agents. The time to BOS or graft loss was analyzed in relation to the positive findings in BAL during the first year after LTX.
  
  
  RESULTS
  Patients with one or more viruses detected in BAL during the first year after transplantation demonstrated a significantly faster development of BOS (P=0.005) compared with patients with no virus detected. No significant difference in graft survival was found.
  
  
  CONCLUSIONS
  Our results suggest that the long-term prognosis after LTX may be negatively affected by viral respiratory tract infections during the first year after LTX.
authors: Department of Internal Medicine/Respiratory Medicine and Allergology, Institute of Medicine, Sahlgrenska University Hospital, Göteborg, Sweden. jesper.magnusson@vgregion.se
authors: Jesper
authors: J
authors: Magnusson
authors: Johan
authors: J
authors: Westin
authors: Lars-Magnus
authors: LM
authors: Andersson
authors: Robin
authors: R
authors: Brittain-Long
authors: Gerdt C
authors: GC
authors: Riise
mesh_terms: D000328:Adult; D001989:Bronchiolitis Obliterans / Q000401:mortality / Q000821:virology; D001992:Bronchoalveolar Lavage Fluid / Q000821:virology; D016009:Chi-Square Distribution; D004279:DNA, Viral / Q000032:analysis*; D018572:Disease-Free Survival; D005260:Female; D006084:Graft Rejection / Q000401:mortality / Q000821:virology; D006085:Graft Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D016040:Lung Transplantation / Q000009:adverse effects* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D060885:Multiplex Polymerase Chain Reaction; D011237:Predictive Value of Tests; D015995:Prevalence; D012141:Respiratory Tract Infections / Q000175:diagnosis* / Q000401:mortality* / Q000821:virology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D004279:DNA, Viral