2318. Incidence of Infection Following Transplantation in Single- vs. Double- Lung Transplant Recipients
Session: Poster Abstract Session: Transplants: Infection Epidemiology and Outcome in Solid Organ Transplantation
Saturday, October 29, 2016
Room: Poster Hall
Background: Single- and double-lung transplantation are therapeutic options for patients with advanced lung disease. Pneumonia (PNA) is a major cause of morbidity and mortality in lung transplant recipients but there is sparse literature regarding the rates of infection in single lung transplant (SLT) vs double lung transplant (DLT) recipients. The limited data that exists suggests outcomes may be better in DLT recipients, and we hypothesize that SLT recipients may have a higher incidence of PNA due to the retention of a structurally abnormal lung colonized with bacteria or fungi. We aim to compare the incidence of post-transplant pneumonia between SLT and DLT recipients.

Methods: This is a retrospective cohort study in patients who underwent SLT and DLT at Columbia University Medical Center from 2013-2014. Patients whose indication for transplant made them ineligible for SLT (cystic fibrosis) and those who underwent multi-organ transplantation or re-transplantation of the lung were excluded. The primary outcome was the incidence of bacterial PNA in the first year post transplant. PNA was defined by the National Healthcare Safety Network criteria. Additional outcomes were the incidence of fungal PNA in the first post-transplant year and respiratory culture data.

Results: 77 lung transplant patients met inclusion criteria. Mean age was 62; 56% male. 59 underwent SLT and 18 underwent DLT. 26 SLT and 7 DLT recipients had PNA in the first year, and the incidence rates of PNA were 0.057 (26/460 person-months) and 0.046 (7/161 person-months), respectively. There were 33 episodes of PNA in the SLT group and 12 in the DLT group. The relative risk of PNA in SLT vs DLT was 1.22 (95% confidence interval 0.54-2.27). Common pathogens in SLT recipients were Pseudomonas aeruginosa (21%) and Klebsiella pneumoniae (21%), and Klebsiella pneumoniae (58%) in DLT recipients. The incidence of fungal PNA was 17% in both groups.

Conclusion:There was a slightly increased incidence of PNA in SLT compared to DLT, but this did not reach statistical significance. Further research is needed to quantify the incidence of post-transplant pneumonia in these populations. Such results may assist clinicians in their decision to pursue SLT vs. DLT based on patient-specific risks for infection, or may alter decisions regarding post-transplant antimicrobial prophylaxis.

Rosy Priya Kodiyanplakkal, M.D.1, Olivia Kates, MD2, Benjamin Miko, MD, MS1, Mary Ann Chiasson, DrPH3, Christine Kubin, PharmD1, Selim Arcasoy, MD4 and Marcus R. Pereira, MD, MPH1, (1)Division of Infectious Diseases, Columbia University Medical Center, New York, NY, (2)Medicine, Columbia University Medical Center, New York, NY, (3)Epidemiology, Mailman School of Public Health, New York, NY, (4)Pulmonary & Critical Care, Columbia University Medical Center, New York, NY

Disclosures:

R. P. Kodiyanplakkal, None

O. Kates, None

B. Miko, None

M. A. Chiasson, None

C. Kubin, None

S. Arcasoy, None

M. R. Pereira, None

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