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.
R. P. Kodiyanplakkal,
B. Miko, None
M. A. Chiasson, None
C. Kubin, None
S. Arcasoy, None
M. R. Pereira, None
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