A prospective molecular surveillance study evaluating the clinical impact of community-acquired respiratory viruses in lung transplant recipients
Community-acquired respiratory viral infections (RVIs) are common in lung transplant patients and may be associated with acute rejection and bronchiolitis obliterans syndrome (BOS). The use of sensitive molecular methods that can simultaneously detect a large panel of respiratory viruses may help be...
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Veröffentlicht in: | Transplantation 2010-04, Vol.89 (8), p.1028-1033 |
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creator | Kumar, Deepali Husain, Shahid Chen, Maggie Hong Moussa, George Himsworth, David Manuel, Oriol Studer, Sean Pakstis, Diana McCurry, Kenneth Doucette, Karen Pilewski, Joseph Janeczko, Richard Humar, Atul |
description | Community-acquired respiratory viral infections (RVIs) are common in lung transplant patients and may be associated with acute rejection and bronchiolitis obliterans syndrome (BOS). The use of sensitive molecular methods that can simultaneously detect a large panel of respiratory viruses may help better define their effects.
Lung transplant recipients undergoing serial surveillance and diagnostic bronchoalveolar lavages (BALs) during a period of 3 years were enrolled. BAL samples underwent multiplex testing for a panel of 19 respiratory viral types/subtypes using the Luminex xTAG respiratory virus panel assay.
Demographics, symptoms, and forced expiratory volume in 1 sec were prospectively collected for 93 lung transplant recipients enrolled. Mean number of BAL samples was 6.2+/-3.1 per patient. A respiratory virus was isolated in 48 of 93 (51.6%) patients on at least one BAL sample. Of 81 positive samples, the viruses isolated included rhinovirus (n=46), parainfluenza 1 to 4 (n=17), coronavirus (n=11), influenza (n=4), metapneumovirus (n=4), and respiratory syncytial virus (n=2). Biopsy-proven acute rejection (> or =grade 2) or decline in forced expiratory volume in 1 sec > or =20% occurred in 16 of 48 (33.3%) patients within 3 months of RVI when compared with 3 of 45 (6.7%) RVI-negative patients within a comparable time frame (P=0.001). No significant difference was seen in incidence of acute rejection between symptomatic and asymptomatic patients. Biopsy-proven obliterative bronchiolitis or BOS was diagnosed in 10 of 16 (62.5%) patients within 1 year of infection.
Community-acquired RVIs are frequently detected in BAL samples from lung transplant patients. In a significant percentage of patients, symptomatic or asymptomatic viral infection is a trigger for acute rejection and obliterative bronchiolitis/BOS. |
doi_str_mv | 10.1097/TP.0b013e3181d05a71 |
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Lung transplant recipients undergoing serial surveillance and diagnostic bronchoalveolar lavages (BALs) during a period of 3 years were enrolled. BAL samples underwent multiplex testing for a panel of 19 respiratory viral types/subtypes using the Luminex xTAG respiratory virus panel assay.
Demographics, symptoms, and forced expiratory volume in 1 sec were prospectively collected for 93 lung transplant recipients enrolled. Mean number of BAL samples was 6.2+/-3.1 per patient. A respiratory virus was isolated in 48 of 93 (51.6%) patients on at least one BAL sample. Of 81 positive samples, the viruses isolated included rhinovirus (n=46), parainfluenza 1 to 4 (n=17), coronavirus (n=11), influenza (n=4), metapneumovirus (n=4), and respiratory syncytial virus (n=2). Biopsy-proven acute rejection (> or =grade 2) or decline in forced expiratory volume in 1 sec > or =20% occurred in 16 of 48 (33.3%) patients within 3 months of RVI when compared with 3 of 45 (6.7%) RVI-negative patients within a comparable time frame (P=0.001). No significant difference was seen in incidence of acute rejection between symptomatic and asymptomatic patients. Biopsy-proven obliterative bronchiolitis or BOS was diagnosed in 10 of 16 (62.5%) patients within 1 year of infection.
Community-acquired RVIs are frequently detected in BAL samples from lung transplant patients. In a significant percentage of patients, symptomatic or asymptomatic viral infection is a trigger for acute rejection and obliterative bronchiolitis/BOS.</description><identifier>ISSN: 0041-1337</identifier><identifier>EISSN: 1534-6080</identifier><identifier>DOI: 10.1097/TP.0b013e3181d05a71</identifier><identifier>PMID: 20075787</identifier><language>eng</language><publisher>United States</publisher><subject>Acute Disease ; Adult ; Biopsy ; Bronchiolitis Obliterans - epidemiology ; Bronchiolitis Obliterans - pathology ; Bronchiolitis Obliterans - physiopathology ; Bronchiolitis Obliterans - virology ; Bronchoalveolar Lavage ; Bronchoalveolar Lavage Fluid - virology ; Community-Acquired Infections - epidemiology ; Community-Acquired Infections - pathology ; Community-Acquired Infections - physiopathology ; Community-Acquired Infections - virology ; Female ; Forced Expiratory Volume ; Graft Rejection - epidemiology ; Graft Rejection - pathology ; Graft Rejection - physiopathology ; Graft Rejection - virology ; Humans ; Immunosuppressive Agents - therapeutic use ; Incidence ; Lung Transplantation - adverse effects ; Male ; Middle Aged ; Pennsylvania - epidemiology ; Population Surveillance ; Prospective Studies ; Respiratory syncytial virus ; Respiratory Tract Infections - epidemiology ; Respiratory Tract Infections - pathology ; Respiratory Tract Infections - physiopathology ; Respiratory Tract Infections - virology ; Rhinovirus ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome</subject><ispartof>Transplantation, 2010-04, Vol.89 (8), p.1028-1033</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c381t-7adb496aabeab0fc6e2dabbff6570615a291522ff69b94bc1701ae42f007537a3</citedby><cites>FETCH-LOGICAL-c381t-7adb496aabeab0fc6e2dabbff6570615a291522ff69b94bc1701ae42f007537a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,27926,27927</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20075787$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kumar, Deepali</creatorcontrib><creatorcontrib>Husain, Shahid</creatorcontrib><creatorcontrib>Chen, Maggie Hong</creatorcontrib><creatorcontrib>Moussa, George</creatorcontrib><creatorcontrib>Himsworth, David</creatorcontrib><creatorcontrib>Manuel, Oriol</creatorcontrib><creatorcontrib>Studer, Sean</creatorcontrib><creatorcontrib>Pakstis, Diana</creatorcontrib><creatorcontrib>McCurry, Kenneth</creatorcontrib><creatorcontrib>Doucette, Karen</creatorcontrib><creatorcontrib>Pilewski, Joseph</creatorcontrib><creatorcontrib>Janeczko, Richard</creatorcontrib><creatorcontrib>Humar, Atul</creatorcontrib><title>A prospective molecular surveillance study evaluating the clinical impact of community-acquired respiratory viruses in lung transplant recipients</title><title>Transplantation</title><addtitle>Transplantation</addtitle><description>Community-acquired respiratory viral infections (RVIs) are common in lung transplant patients and may be associated with acute rejection and bronchiolitis obliterans syndrome (BOS). The use of sensitive molecular methods that can simultaneously detect a large panel of respiratory viruses may help better define their effects.
Lung transplant recipients undergoing serial surveillance and diagnostic bronchoalveolar lavages (BALs) during a period of 3 years were enrolled. BAL samples underwent multiplex testing for a panel of 19 respiratory viral types/subtypes using the Luminex xTAG respiratory virus panel assay.
Demographics, symptoms, and forced expiratory volume in 1 sec were prospectively collected for 93 lung transplant recipients enrolled. Mean number of BAL samples was 6.2+/-3.1 per patient. A respiratory virus was isolated in 48 of 93 (51.6%) patients on at least one BAL sample. Of 81 positive samples, the viruses isolated included rhinovirus (n=46), parainfluenza 1 to 4 (n=17), coronavirus (n=11), influenza (n=4), metapneumovirus (n=4), and respiratory syncytial virus (n=2). Biopsy-proven acute rejection (> or =grade 2) or decline in forced expiratory volume in 1 sec > or =20% occurred in 16 of 48 (33.3%) patients within 3 months of RVI when compared with 3 of 45 (6.7%) RVI-negative patients within a comparable time frame (P=0.001). No significant difference was seen in incidence of acute rejection between symptomatic and asymptomatic patients. Biopsy-proven obliterative bronchiolitis or BOS was diagnosed in 10 of 16 (62.5%) patients within 1 year of infection.
Community-acquired RVIs are frequently detected in BAL samples from lung transplant patients. In a significant percentage of patients, symptomatic or asymptomatic viral infection is a trigger for acute rejection and obliterative bronchiolitis/BOS.</description><subject>Acute Disease</subject><subject>Adult</subject><subject>Biopsy</subject><subject>Bronchiolitis Obliterans - epidemiology</subject><subject>Bronchiolitis Obliterans - pathology</subject><subject>Bronchiolitis Obliterans - physiopathology</subject><subject>Bronchiolitis Obliterans - virology</subject><subject>Bronchoalveolar Lavage</subject><subject>Bronchoalveolar Lavage Fluid - virology</subject><subject>Community-Acquired Infections - epidemiology</subject><subject>Community-Acquired Infections - pathology</subject><subject>Community-Acquired Infections - physiopathology</subject><subject>Community-Acquired Infections - virology</subject><subject>Female</subject><subject>Forced Expiratory Volume</subject><subject>Graft Rejection - epidemiology</subject><subject>Graft Rejection - pathology</subject><subject>Graft Rejection - physiopathology</subject><subject>Graft Rejection - virology</subject><subject>Humans</subject><subject>Immunosuppressive Agents - therapeutic use</subject><subject>Incidence</subject><subject>Lung Transplantation - adverse effects</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pennsylvania - epidemiology</subject><subject>Population Surveillance</subject><subject>Prospective Studies</subject><subject>Respiratory syncytial virus</subject><subject>Respiratory Tract Infections - epidemiology</subject><subject>Respiratory Tract Infections - pathology</subject><subject>Respiratory Tract Infections - physiopathology</subject><subject>Respiratory Tract Infections - virology</subject><subject>Rhinovirus</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>0041-1337</issn><issn>1534-6080</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUtr3TAQhUVpaG5v8gsKRbuunI4sy7KXIeRRCDSLm7UZyeNWQX5Ejwv3Z_Qf15ckXWTT1TDwnTOcOYx9EXAhoNXfdw8XYEBIkqIRPSjU4gPbCCWrooYGPrINQCUKIaU-ZZ9jfAIAJbX-xE5LAK10ozfszyVfwhwXssntiY-zJ5s9Bh5z2JPzHidLPKbcHzjt0WdMbvrF02_i1rvJWfTcjQvaxOeB23kc8-TSoUD7nF2gngeKiwuY5nDgexdypMjdxH0-ugSc4rKeSCtm3eJoSvGMnQzoI52_zi17vLneXd0V9z9vf1xd3hdWNiIVGntTtTWiITQw2JrKHo0ZhlppqIXCshWqLNe9NW1lrNAgkKpyOEaXGuWWfXvxXfM_Z4qpG120dExMc46dVpWSsqya_5NSNq1YwZWUL6RdfxoDDd0S3Ijh0AnojqV1u4fufWmr6uurfzYj9f80by3Jv5POmLI</recordid><startdate>20100427</startdate><enddate>20100427</enddate><creator>Kumar, Deepali</creator><creator>Husain, Shahid</creator><creator>Chen, Maggie Hong</creator><creator>Moussa, George</creator><creator>Himsworth, David</creator><creator>Manuel, Oriol</creator><creator>Studer, Sean</creator><creator>Pakstis, Diana</creator><creator>McCurry, Kenneth</creator><creator>Doucette, Karen</creator><creator>Pilewski, Joseph</creator><creator>Janeczko, Richard</creator><creator>Humar, Atul</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope></search><sort><creationdate>20100427</creationdate><title>A prospective molecular surveillance study evaluating the clinical impact of community-acquired respiratory viruses in lung transplant recipients</title><author>Kumar, Deepali ; Husain, Shahid ; Chen, Maggie Hong ; Moussa, George ; Himsworth, David ; Manuel, Oriol ; Studer, Sean ; Pakstis, Diana ; McCurry, Kenneth ; Doucette, Karen ; Pilewski, Joseph ; Janeczko, Richard ; Humar, Atul</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c381t-7adb496aabeab0fc6e2dabbff6570615a291522ff69b94bc1701ae42f007537a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Acute Disease</topic><topic>Adult</topic><topic>Biopsy</topic><topic>Bronchiolitis Obliterans - epidemiology</topic><topic>Bronchiolitis Obliterans - pathology</topic><topic>Bronchiolitis Obliterans - physiopathology</topic><topic>Bronchiolitis Obliterans - virology</topic><topic>Bronchoalveolar Lavage</topic><topic>Bronchoalveolar Lavage Fluid - virology</topic><topic>Community-Acquired Infections - epidemiology</topic><topic>Community-Acquired Infections - pathology</topic><topic>Community-Acquired Infections - physiopathology</topic><topic>Community-Acquired Infections - virology</topic><topic>Female</topic><topic>Forced Expiratory Volume</topic><topic>Graft Rejection - epidemiology</topic><topic>Graft Rejection - pathology</topic><topic>Graft Rejection - physiopathology</topic><topic>Graft Rejection - virology</topic><topic>Humans</topic><topic>Immunosuppressive Agents - therapeutic use</topic><topic>Incidence</topic><topic>Lung Transplantation - adverse effects</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pennsylvania - epidemiology</topic><topic>Population Surveillance</topic><topic>Prospective Studies</topic><topic>Respiratory syncytial virus</topic><topic>Respiratory Tract Infections - epidemiology</topic><topic>Respiratory Tract Infections - pathology</topic><topic>Respiratory Tract Infections - physiopathology</topic><topic>Respiratory Tract Infections - virology</topic><topic>Rhinovirus</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kumar, Deepali</creatorcontrib><creatorcontrib>Husain, Shahid</creatorcontrib><creatorcontrib>Chen, Maggie Hong</creatorcontrib><creatorcontrib>Moussa, George</creatorcontrib><creatorcontrib>Himsworth, David</creatorcontrib><creatorcontrib>Manuel, Oriol</creatorcontrib><creatorcontrib>Studer, Sean</creatorcontrib><creatorcontrib>Pakstis, Diana</creatorcontrib><creatorcontrib>McCurry, Kenneth</creatorcontrib><creatorcontrib>Doucette, Karen</creatorcontrib><creatorcontrib>Pilewski, Joseph</creatorcontrib><creatorcontrib>Janeczko, Richard</creatorcontrib><creatorcontrib>Humar, Atul</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>Transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kumar, Deepali</au><au>Husain, Shahid</au><au>Chen, Maggie Hong</au><au>Moussa, George</au><au>Himsworth, David</au><au>Manuel, Oriol</au><au>Studer, Sean</au><au>Pakstis, Diana</au><au>McCurry, Kenneth</au><au>Doucette, Karen</au><au>Pilewski, Joseph</au><au>Janeczko, Richard</au><au>Humar, Atul</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A prospective molecular surveillance study evaluating the clinical impact of community-acquired respiratory viruses in lung transplant recipients</atitle><jtitle>Transplantation</jtitle><addtitle>Transplantation</addtitle><date>2010-04-27</date><risdate>2010</risdate><volume>89</volume><issue>8</issue><spage>1028</spage><epage>1033</epage><pages>1028-1033</pages><issn>0041-1337</issn><eissn>1534-6080</eissn><abstract>Community-acquired respiratory viral infections (RVIs) are common in lung transplant patients and may be associated with acute rejection and bronchiolitis obliterans syndrome (BOS). The use of sensitive molecular methods that can simultaneously detect a large panel of respiratory viruses may help better define their effects.
Lung transplant recipients undergoing serial surveillance and diagnostic bronchoalveolar lavages (BALs) during a period of 3 years were enrolled. BAL samples underwent multiplex testing for a panel of 19 respiratory viral types/subtypes using the Luminex xTAG respiratory virus panel assay.
Demographics, symptoms, and forced expiratory volume in 1 sec were prospectively collected for 93 lung transplant recipients enrolled. Mean number of BAL samples was 6.2+/-3.1 per patient. A respiratory virus was isolated in 48 of 93 (51.6%) patients on at least one BAL sample. Of 81 positive samples, the viruses isolated included rhinovirus (n=46), parainfluenza 1 to 4 (n=17), coronavirus (n=11), influenza (n=4), metapneumovirus (n=4), and respiratory syncytial virus (n=2). Biopsy-proven acute rejection (> or =grade 2) or decline in forced expiratory volume in 1 sec > or =20% occurred in 16 of 48 (33.3%) patients within 3 months of RVI when compared with 3 of 45 (6.7%) RVI-negative patients within a comparable time frame (P=0.001). No significant difference was seen in incidence of acute rejection between symptomatic and asymptomatic patients. Biopsy-proven obliterative bronchiolitis or BOS was diagnosed in 10 of 16 (62.5%) patients within 1 year of infection.
Community-acquired RVIs are frequently detected in BAL samples from lung transplant patients. In a significant percentage of patients, symptomatic or asymptomatic viral infection is a trigger for acute rejection and obliterative bronchiolitis/BOS.</abstract><cop>United States</cop><pmid>20075787</pmid><doi>10.1097/TP.0b013e3181d05a71</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Acute Disease Adult Biopsy Bronchiolitis Obliterans - epidemiology Bronchiolitis Obliterans - pathology Bronchiolitis Obliterans - physiopathology Bronchiolitis Obliterans - virology Bronchoalveolar Lavage Bronchoalveolar Lavage Fluid - virology Community-Acquired Infections - epidemiology Community-Acquired Infections - pathology Community-Acquired Infections - physiopathology Community-Acquired Infections - virology Female Forced Expiratory Volume Graft Rejection - epidemiology Graft Rejection - pathology Graft Rejection - physiopathology Graft Rejection - virology Humans Immunosuppressive Agents - therapeutic use Incidence Lung Transplantation - adverse effects Male Middle Aged Pennsylvania - epidemiology Population Surveillance Prospective Studies Respiratory syncytial virus Respiratory Tract Infections - epidemiology Respiratory Tract Infections - pathology Respiratory Tract Infections - physiopathology Respiratory Tract Infections - virology Rhinovirus Risk Assessment Risk Factors Time Factors Treatment Outcome |
title | A prospective molecular surveillance study evaluating the clinical impact of community-acquired respiratory viruses in lung transplant recipients |
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