title: Higher Risk of Acute Cellular Rejection in Lung Transplant Recipients with Cystic Fibrosis.
abstract: BACKGROUND Acute cellular rejection (ACR) affects up to 40% of recipients within the first year after lung transplant (LTx). The aim of this study was to determine the frequency of ACR and associated major risk factors in cystic fibrosis (CF) recipients. Bronchiolitis obliterans syndrome (BOS) and 1-year/long-term survival were also evaluated. MATERIAL AND METHODS ACR was reviewed in 643 scheduled biopsies from 44 CF (Group 1) versus 89 other recipients (Group 2). We performed univariate/multivariate analyses of risk factors for ACR and BOS, and survival analysis. RESULTS Group 1 showed higher ACR frequency, especially for ACR ≥ A2. Multivariable generalized linear models considering both native lung disease and age showed that higher values of ACR index were significantly related to the pretransplant diagnosis of CF. BOS and long-term survival were not influenced by the increased incidence of ACR. Poorer long-term survival was observed in Group 2. CONCLUSIONS CF recipients have a higher ACR risk, which may be due to enhanced immune activation related to a genetic disorder, and younger age.
authors.affiliation: Pneumology Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.
authors.forename: Fiorella
authors.initials: F
authors.lastname: Calabrese
authors.affiliation: Pneumology Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Lunardi
authors.affiliation: Pneumology Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.
authors.forename: Nazarena
authors.initials: N
authors.lastname: Nannini
authors.affiliation: Pneumology Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Balestro
authors.affiliation: Thoracic Surgery Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Loy
authors.affiliation: Thoracic Surgery Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Marulli
authors.affiliation: Thoracic Surgery Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Calabrese
authors.affiliation: Pathology Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.
authors.forename: Stefania Edith
authors.initials: SE
authors.lastname: Vuljan
authors.affiliation: Thoracic Surgery Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Schiavon
authors.affiliation: Biostatistics, Epidemiology and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.
authors.forename: Egle
authors.initials: E
authors.lastname: Perissinotto
authors.affiliation: Thoracic Surgery Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Rea
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001707:Biopsy, Needle; D001989:Bronchiolitis Obliterans / Q000453:epidemiology / Q000473:pathology*; D001999:Bronchoscopy / Q000379:methods; D003550:Cystic Fibrosis / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D007558:Italy; D008137:Longitudinal Studies; D016040:Lung Transplantation / Q000009:adverse effects* / Q000379:methods; D008297:Male; D015999:Multivariate Analysis; D009336:Necrosis / Q000473:pathology; D011183:Postoperative Complications / Q000453:epidemiology / Q000473:pathology; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D066027:Transplant Recipients; D016896:Treatment Outcome; D055815:Young Adult