Risk Factors for Recalcitrant Chronic Rhinosinusitis in Non-Solid and Solid Transplant Recipients

Area of Science:

• Otolaryngology
• Transplant Surgery
• Immunology

Background:

• Transplant recipients are immunocompromised, increasing surgical risks.
• Evidence comparing chronic rhinosinusitis (CRS) incidence in solid vs. non-solid organ transplants is limited.
• CRS is a common complication impacting quality of life in transplant patients.

Purpose of the Study:

• To compare the incidence of CRS requiring endoscopic sinus surgery (ESS) between solid and non-solid organ transplant recipients.
• To identify risk factors associated with recalcitrant CRS in these populations.
• To analyze differences in ESS incidence based on transplant type.

Main Methods:

• Retrospective cohort study at a multisite tertiary academic center.
• Chart review of 1303 transplant recipients with CRS between 2017-2022.
• Analysis of 224 patients who underwent ESS, with subgroup analysis for solid vs. non-solid transplants.

Main Results:

• 17.19% of all transplant recipients required ESS.
• Solid organ transplant recipients had a higher incidence of ESS (57%) compared to non-solid (28.2%).
• The risk of recalcitrant CRS requiring ESS was 1.78 times greater in solid transplant recipients (p=0.0005).
• Immunotherapy, pancytopenia, and rejection correlated with ESS risk in both groups.

Conclusions:

• Solid organ transplant recipients have a significantly higher risk of developing CRS requiring ESS compared to non-solid organ transplant recipients.
• Specific risk factors like immunotherapy, pancytopenia, and rejection warrant further investigation in transplant-related CRS.