Related Experiment Video
Updated: Mar 7, 2026
Author Spotlight: Investigating the Key Factors of Obliterative Bronchiolitis After Lung Transplantation
Published on: November 10, 2023
Impact of Doxycycline Prophylaxis on Reducing Ureaplasma and Mycoplasma-Related Complications in Lung Transplant
Lara Jones1, Byeong Choi2, Maria Velez1
1Department of Pulmonary Diseases and Critical Care, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA.
Background:
Ureaplasma and Mycoplasma species (spp.) infections have been associated with increased morbidity and mortality in lung transplant (LTx) recipients due to their association with hyperammonemia syndrome (HS) and wound dehiscence. This study aims to assess the clinical outcomes in LTx recipients treated with preventative doxycycline.
Methods:
We conducted a single-center retrospective review of LTx recipients from January 2020 to February 2024. In November 2023, our center began administering doxycycline prophylaxis (ppx) postoperatively until bronchoalveolar lavage PCR results for Mycoplasma and Ureaplasma spp. were available. Doxycycline was discontinued if the PCR was negative and continued for 14 days if positive.
Results:
A total of 98 LTx recipients were reviewed, with 3 excluded due to death before surveillance. Of these, 70 tested negative for Mycoplasma and Ureaplasma spp., 8 were not tested, and among the 17 positives, 11 received doxycycline ppx. The incidence of HS was lower in the ppx group (0% vs. 50%). The ppx group had shorter median duration of mechanical ventilation (MV) (3 vs. 20 days), ICU stay (9 vs. 22 days), and hospital stay (24 vs. 30 days). No significant difference was found in the rates of anastomotic dehiscence (18% vs. 17%).
Conclusions:
Doxycycline ppx was associated with a lower incidence of HS, decreased duration of MV, and shorter ICU and hospital length of stay in this cohort of LTx recipients. These findings suggest that doxycycline, an inexpensive and relatively well-tolerated intervention, may prevent HS after LTx.
Insights
Preventative doxycycline reduced hyperammonemia syndrome (HS) and shortened recovery times in lung transplant (LTx) recipients. This inexpensive treatment may prevent HS after LTx.
Area of Science:
- Transplantation immunology
- Infectious diseases in immunocompromised patients
- Pharmacological interventions in critical care
Background:
- Ureaplasma and Mycoplasma species infections are linked to severe complications like hyperammonemia syndrome (HS) and wound dehiscence in lung transplant (LTx) recipients.
- These infections contribute to increased morbidity and mortality in the LTx population.
Purpose of the Study:
- To evaluate the clinical outcomes of LTx recipients receiving prophylactic doxycycline to prevent Ureaplasma and Mycoplasma infections.
- To assess the impact of doxycycline prophylaxis on the incidence of HS and other post-transplant complications.
Main Methods:
- A retrospective review of 98 LTx recipients from January 2020 to February 2024 at a single center.
- Implementation of doxycycline prophylaxis (ppx) postoperatively until PCR results for Mycoplasma and Ureaplasma spp. were available, starting in November 2023.
- Doxycycline was continued for 14 days if PCR was positive and discontinued if negative.
Main Results:
- Doxycycline prophylaxis was administered to 11 out of 17 patients who tested positive for Mycoplasma/Ureaplasma.
- The incidence of HS was significantly lower in the doxycycline ppx group (0%) compared to the non-ppx group (50%).
- Patients receiving doxycycline ppx experienced shorter durations of mechanical ventilation (3 vs. 20 days), ICU stay (9 vs. 22 days), and hospital stay (24 vs. 30 days).
Conclusions:
- Prophylactic doxycycline administration in LTx recipients is associated with a reduced incidence of HS.
- Doxycycline ppx led to decreased duration of mechanical ventilation and shorter ICU and hospital lengths of stay.
- Doxycycline represents a cost-effective and well-tolerated intervention that may prevent HS post-lung transplantation.
Related Concept Videos
01:26Kidney Transplant II: Surgical Procedure
01:25Transmission-based Precautions II: Airborne and Protective Environment
Airborne precautions:
Use airborne precautions when treating patients known or suspected to have diseases that spread through the air—for example, tuberculosis or measles. These organisms are present in smaller droplets expelled by an infected person and...
01:29Pulmonary Tuberculosis I
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
01:16Kidney Transplant III: Nursing Management
01:28Kidney Transplant I: Introduction
01:26COPD: Management Using Bronchodilators and Corticosteroids