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Respiratory viral infections are a distinct risk for bronchiolitis obliterans syndrome and death.
Am J Respir Crit Care Med. 2004 Jul 15; 170(2):181-7.AJ

Abstract

Bronchiolitis obliterans syndrome (BOS) is the major obstacle to long-term survival after lung transplantation, in part because its pathogenesis is poorly understood and treatment options are limited. To identify unique risk factors for BOS and death, we performed a retrospective cohort study on 259 consecutive adult lung transplant recipients over a 5-year period. The demographic and clinical characteristics of this population were analyzed for an association between BOS or death and potential risk factors, including community-acquired respiratory viral (CARV) infections, acute rejection, and cytomegalovirus pneumonitis. Respiratory syncytial virus, parainfluenza, influenza, and adenovirus accounted for 21 CARV infections. Univariate and multivariate time-dependent Cox regression analyses demonstrated that this CARV group was more likely to develop BOS, death, and death from BOS. Furthermore, these trends were more pronounced in patients with evidence of lower respiratory tract-CARV (lower-CARV) infections. Notably, the CARV and lower-CARV infections were risk factors for BOS, death, and death from BOS distinct from the risk attributable to acute rejection. Identification of CARV and lower-CARV infections as BOS and mortality risk factors has important clinical implications and may provide insight into disease pathogenesis and accelerate the development of novel treatment strategies to modify post-CARV BOS.

Authors+Show Affiliations

Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St Louis, MO 63110, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15130908

Citation

Khalifah, Anthony P., et al. "Respiratory Viral Infections Are a Distinct Risk for Bronchiolitis Obliterans Syndrome and Death." American Journal of Respiratory and Critical Care Medicine, vol. 170, no. 2, 2004, pp. 181-7.
Khalifah AP, Hachem RR, Chakinala MM, et al. Respiratory viral infections are a distinct risk for bronchiolitis obliterans syndrome and death. Am J Respir Crit Care Med. 2004;170(2):181-7.
Khalifah, A. P., Hachem, R. R., Chakinala, M. M., Schechtman, K. B., Patterson, G. A., Schuster, D. P., Mohanakumar, T., Trulock, E. P., & Walter, M. J. (2004). Respiratory viral infections are a distinct risk for bronchiolitis obliterans syndrome and death. American Journal of Respiratory and Critical Care Medicine, 170(2), 181-7.
Khalifah AP, et al. Respiratory Viral Infections Are a Distinct Risk for Bronchiolitis Obliterans Syndrome and Death. Am J Respir Crit Care Med. 2004 Jul 15;170(2):181-7. PubMed PMID: 15130908.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Respiratory viral infections are a distinct risk for bronchiolitis obliterans syndrome and death. AU - Khalifah,Anthony P, AU - Hachem,Ramsey R, AU - Chakinala,Murali M, AU - Schechtman,Kenneth B, AU - Patterson,G Alexander, AU - Schuster,Daniel P, AU - Mohanakumar,Thalachallour, AU - Trulock,Elbert P, AU - Walter,Michael J, Y1 - 2004/05/06/ PY - 2004/5/8/pubmed PY - 2004/8/20/medline PY - 2004/5/8/entrez SP - 181 EP - 7 JF - American journal of respiratory and critical care medicine JO - Am. J. Respir. Crit. Care Med. VL - 170 IS - 2 N2 - Bronchiolitis obliterans syndrome (BOS) is the major obstacle to long-term survival after lung transplantation, in part because its pathogenesis is poorly understood and treatment options are limited. To identify unique risk factors for BOS and death, we performed a retrospective cohort study on 259 consecutive adult lung transplant recipients over a 5-year period. The demographic and clinical characteristics of this population were analyzed for an association between BOS or death and potential risk factors, including community-acquired respiratory viral (CARV) infections, acute rejection, and cytomegalovirus pneumonitis. Respiratory syncytial virus, parainfluenza, influenza, and adenovirus accounted for 21 CARV infections. Univariate and multivariate time-dependent Cox regression analyses demonstrated that this CARV group was more likely to develop BOS, death, and death from BOS. Furthermore, these trends were more pronounced in patients with evidence of lower respiratory tract-CARV (lower-CARV) infections. Notably, the CARV and lower-CARV infections were risk factors for BOS, death, and death from BOS distinct from the risk attributable to acute rejection. Identification of CARV and lower-CARV infections as BOS and mortality risk factors has important clinical implications and may provide insight into disease pathogenesis and accelerate the development of novel treatment strategies to modify post-CARV BOS. SN - 1073-449X UR - https://www.unboundmedicine.com/medline/citation/15130908/Respiratory_viral_infections_are_a_distinct_risk_for_bronchiolitis_obliterans_syndrome_and_death_ L2 - http://www.atsjournals.org/doi/full/10.1164/rccm.200310-1359OC?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -