Clinical Characteristics, Outcomes, and Distribution Patterns of Pathogens Causing Respiratory Infections in Lung...

Area of Science:

• Medicine
• Transplantation Surgery
• Infectious Diseases

Background:

• Lung retransplantation is an option for graft failure but has inferior outcomes.
• Infection is a major cause of morbidity and mortality in lung retransplant recipients.

Purpose of the Study:

• To examine clinical characteristics, outcomes, and microbial spectra of respiratory infections in lung retransplant recipients.
• To compare these factors between lung retransplant and primary lung transplant patients.

Main Methods:

• Retrospective case-control study at two tertiary care centers.
• Included 10 lung retransplant and 20 matched primary lung transplant patients.
• Compared respiratory pathogens identified via bronchoalveolar lavage (BAL) over two years post-transplantation.

Main Results:

• Retransplant recipients had higher prevalence of pulmonary hypertension, 5-year mortality, infection-related mortality, and longer hospital/ICU stays.
• Distinct temporal pathogen patterns observed: Elizabethkingia predominated early in retransplant group (31.6% within 1 month), while primary transplant group showed heterogeneous distribution.
• Pseudomonas increased gradually in retransplant group; Acinetobacter, Pseudomonas, and Enterococcus were detected early in primary transplant group.

Conclusions:

• Lung retransplant recipients experience worse clinical outcomes and distinct respiratory pathogen temporal distributions.
• High incidence of Elizabethkingia in lung retransplant recipients requires specific infection surveillance.
• Tailored preventive strategies are crucial to enhance lung retransplantation outcomes.