title: Bronchiectasis diagnosed after renal transplantation: a retrospective multicenter study.
abstract: BACKGROUND
  Bronchiectasis is characterized by abnormal, permanent and irreversible dilatation of the bronchi, usually responsible for daily symptoms and frequent respiratory complications. Many causes have been identified, but only limited data are available concerning the association between bronchiectasis and renal transplantation.
  
  
  METHODS
  We conducted a retrospective multicenter study of cases of bronchiectasis diagnosed after renal transplantation in 14 renal transplantation departments (French SPIESSER group). Demographic, clinical, laboratory and CT scan data were collected.
  
  
  RESULTS
  Forty-six patients were included (mean age 58.2 years, 52.2 % men). Autosomal dominant polycystic kidney disease (32.6 %) was the main underlying renal disease. Chronic cough and sputum (50.0 %) were the major symptoms leading to chest CT scan. Mean duration of symptoms before diagnosis was 1.5 years [0-12.1 years]. Microorganisms were identified in 22 patients, predominantly Haemophilus influenzae. Hypogammaglobulinemia was observed in 46.9 % patients. Bronchiectasis was usually extensive (84.8 %). The total bronchiectasis score was 7.4 ± 5.5 with a significant gradient from apex to bases. Many patients remained symptomatic (43.5 %) and/or presented recurrent respiratory tract infections (37.0 %) during follow-up. Six deaths (13 %) occurred during follow-up, but none were attributable to bronchiectasis.
  
  
  CONCLUSIONS
  These results highlight that the diagnosis of bronchiectasis should be considered in patients with de novo respiratory symptoms after renal transplantation. Further studies are needed to more clearly understand the mechanisms underlying bronchiectasis in this setting.
authors.affiliation: Service des Maladies Respiratoires, Hôpital Maison Blanche, CHU, 45, rue de Cognacq-Jay, 51092, Reims, Cedex, France. sdury@chu-reims.fr.|EA 4683 Université de Médecine et de Pharmacie, Reims, France. sdury@chu-reims.fr.
authors.forename: Sandra
authors.initials: S
authors.lastname: Dury
authors.affiliation: Service de Néphrologie, Hôpital Maison Blanche, CHU, Reims, France. ccolosio@chu-reims.fr.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Colosio
authors.affiliation: Service de Néphrologie, Rouen University Hospital, Rouen, France. Isabelle.Etienne@chu-rouen.fr.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Etienne
authors.affiliation: Service de Néphrologie, Hôpital Necker, APHP, Paris, France. dany.anglicheau@nck.aphp.fr.
authors.forename: Dany
authors.initials: D
authors.lastname: Anglicheau
authors.affiliation: Service de Néphrologie, CHU, Tours, France. e.merieau@chu-tours.fr.
authors.forename: Elodie
authors.initials: E
authors.lastname: Merieau
authors.affiliation: Service de Néphrologie, Hôpitaux Universitaires, Strasbourg, France. sophie.caillard@chru-strasbourg.fr.
authors.forename: Sophie
authors.initials: S
authors.lastname: Caillard
authors.affiliation: Service de Néphrologie, CHU, Rennes, France. joseph.rivalan@chu-rennes.fr.
authors.forename: Joseph
authors.initials: J
authors.lastname: Rivalan
authors.affiliation: Service de Néphrologie, Hôpital Européen Georges Pompidou, APHP, Paris, France. eric.thervet@egp.aphp.fr.
authors.forename: Eric
authors.initials: E
authors.lastname: Thervet
authors.affiliation: Service de Néphrologie, CHU, Limoges, France. marie.essig@chu-limoges.fr.
authors.forename: Marie
authors.initials: M
authors.lastname: Essig
authors.affiliation: Néphrologie-Dialyse ECHO - Pôle Santé Sud, Le Mans, France. fbabinet@echo.sante.com.
authors.forename: François
authors.initials: F
authors.lastname: Babinet
authors.affiliation: Service de Néphrologie, CHU, Angers, France. jfsubra@chu-angers.fr.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Subra
authors.affiliation: Service de Radiologie, Hôpital Maison Blanche, CHU, Reims, France. otoubas@chu-reims.fr.
authors.forename: Olivier
authors.initials: O
authors.lastname: Toubas
authors.affiliation: Service de Néphrologie, Hôpital Maison Blanche, CHU, Reims, France. prieu@chu-reims.fr.
authors.forename: Philippe
authors.initials: P
authors.lastname: Rieu
authors.affiliation: Service des Maladies Respiratoires, Hôpital Maison Blanche, CHU, 45, rue de Cognacq-Jay, 51092, Reims, Cedex, France. claunois@chu-reims.fr.
authors.forename: Claire
authors.initials: C
authors.lastname: Launois
authors.affiliation: Service des Maladies Respiratoires, Hôpital Maison Blanche, CHU, 45, rue de Cognacq-Jay, 51092, Reims, Cedex, France. jmperotin-collard@chu-reims.fr.|Unité 903 Inserm, Reims, France. jmperotin-collard@chu-reims.fr.
authors.forename: Jeanne-Marie
authors.initials: JM
authors.lastname: Perotin-Collard
authors.affiliation: Service des Maladies Respiratoires, Hôpital Maison Blanche, CHU, 45, rue de Cognacq-Jay, 51092, Reims, Cedex, France. flebargy@chu-reims.fr.|EA 4683 Université de Médecine et de Pharmacie, Reims, France. flebargy@chu-reims.fr.
authors.forename: François
authors.initials: F
authors.lastname: Lebargy
authors.affiliation: Service des Maladies Respiratoires, Hôpital Maison Blanche, CHU, 45, rue de Cognacq-Jay, 51092, Reims, Cedex, France. gdeslee@chu-reims.fr.|Unité 903 Inserm, Reims, France. gdeslee@chu-reims.fr.
authors.forename: Gaëtan
authors.initials: G
authors.lastname: Deslée
mesh_terms: D000328:Adult; D000361:Agammaglobulinemia / Q000453:epidemiology*; D000368:Aged; D000369:Aged, 80 and over; D001379:Azathioprine / Q000627:therapeutic use; D001987:Bronchiectasis / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D002908:Chronic Disease; D003371:Cough / Q000209:etiology; D016572:Cyclosporine / Q000627:therapeutic use; D000068338:Everolimus / Q000627:therapeutic use; D005260:Female; D005541:Forced Expiratory Volume; D006084:Graft Rejection / Q000517:prevention & control*; D006192:Haemophilus Infections / Q000453:epidemiology*; D006193:Haemophilus influenzae; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000601:surgery*; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016891:Polycystic Kidney, Autosomal Dominant / Q000150:complications / Q000601:surgery; D012141:Respiratory Tract Infections / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D000069283:Rituximab / Q000627:therapeutic use; D020123:Sirolimus / Q000627:therapeutic use; D016559:Tacrolimus / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D014797:Vital Capacity; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D000069283:Rituximab; D016572:Cyclosporine; D000068338:Everolimus; D009173:Mycophenolic Acid; D001379:Azathioprine; D020123:Sirolimus; D016559:Tacrolimus