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Thorac Cardiovasc Surg 2013; 61(03): 240-245
DOI: 10.1055/s-0032-1322619
Original Thoracic
Georg Thieme Verlag KG Stuttgart · New York

Gram-Negative Infection and Bronchiectasis in Lung Transplant Recipients with Bronchiolitis Obliterans Syndrome

Don Hayes Jr.
1   Departments of Pediatrics and Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, United States
,
Aaron Weiland
1   Departments of Pediatrics and Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, United States
,
Stephen Kirkby
1   Departments of Pediatrics and Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, United States
,
Mark Galantowicz
2   Department of Surgery, The Ohio State University College of Medicine, Columbus, Ohio, United States
,
Patrick I. McConnell
2   Department of Surgery, The Ohio State University College of Medicine, Columbus, Ohio, United States
,
Joseph D. Tobias
1   Departments of Pediatrics and Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, United States
› Author Affiliations
Further Information

Publication History

14 March 2012

10 April 2012

Publication Date:
06 December 2012 (online)

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Abstract

Background Bronchiolitis obliterans syndrome (BOS) after lung transplantation manifests as a gradual decline in forced expiratory volume in 1 second. Bronchiectasis is often seen but occurs at variable rates with the underlying pathogenesis being unclear.

Objective We completed a study to determine whether lower airway infection with gram-negative bacilli was associated with the development of bronchiectasis in lung transplant recipients with BOS.

Methods A retrospective review of 17 lung transplant recipients (age: 28 ± 7 years, range: 13 to 40 years) in a patient population transplanted for cystic fibrosis (CF) 82% (14/17), bronchiolitis obliterans 12% (2/17), and sarcoidosis 6% (1/17) was completed. Each patient completed pulmonary function testing and underwent annual computed tomographic imaging of the chest for surveillance posttransplant at a single transplant center.

Results Bronchiectasis was present in 70% (12/17) of patients whereas 94% (16/17) of patients had varying severity of BOS: 1 (n = 7), 2 (n = 3), and 3 (n = 6). All 12 patients with bronchiectasis had an allograft gram-negative rod infection and 92% (11/12) of them had BOS.

Conclusions The presence of bronchiectasis in lung transplant recipients with BOS was associated with a gram-negative bacterial airway infection of the allograft in a small cohort of predominately lung transplant recipients with CF.

Keywords

bronchiectasis - allograft - chronic rejection - gram-negative rod infection - bronchiolitis obliterans syndrome - lung transplantation
 

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