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• W2337647516 abstract "In the NIAID-sponsored Clinical Trials in Organ Transplantation in Children study of pediatric lung transplant recipients (PTLR), we explored the association between respiratory viral infection (RVI) and rejection in the first year following transplant. Prospective serial nasopharyngeal (NP) and bronchoalveolar lavage (BAL) specimens from the first year post-transplant were interrogated by multiplex PCR (Luminex xTAG®) that identifies 17 viruses. To differentiate picornaviruses, sequencing of 5’ non-translated region was performed. Descriptive statistics include medians/ranges for continuous variables, and percentages for categorical variables. Exact chi-square tests were used to determine association between viral episodes and rejection. 61 subjects (41% male) a median of 14.2 years (0.7-19.1) had 331 BAL (median 6/pt) and 369 NP specimens (median 7/pt) including 293 paired samples. 94 viral events were detected in 43 PTLRs (70% of subjects, range 1-5 events), of which 69 (73%) were picornaviruses, exclusively rhinovirus by sequencing. Other viruses included: coronaviruses (4); parainfluenza viruses (5); respiratory syncytial virus (4); human metapneumovirus (3); influenza viruses (3); and adenovirus (3). Two patients expired from RVI, both adenovirus. 74 (79%) events were asymptomatic. Of 331 BAL specimens, 31 (9%) were virus-positive compared to 75 of 369 NP specimens (20%). Of 293 paired specimens, concordance for positivity was 27% (k=0.33) (BAL+/NP- 13; BAL-/NP+41). Rhinovirus sequencing results revealed persistent infections with one serotype (9-408 days) and reinfection with different serotypes. There was no association between viral episodes, whether symptomatic or not, and ISHLT A or B grade rejection when concurrent transbronchial biopsies were obtained. RVI occurred commonly and RVI mortality was rare except with adenovirus. Concordance between NP and BAL was weak. Rhinovirus was recovered most frequently and was persistent for months in a substantial number of patients. No association between RVI and A or B grade rejection was identified. Analysis of the impact of RVI on long term PLTR outcomes (i.e.death, retransplant, BOS and OB), including interrogation of potential humoral and cellular auto and alloimmune mechanisms, is in progress." @default.
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• W2337647516 date "2016-04-01" @default.
• W2337647516 modified "2023-10-17" @default.
• W2337647516 title "Respiratory Viral Infections Are Common in the First Year After Pediatric Lung Transplantation: A Multi-Center Prospective Study" @default.
• W2337647516 doi "https://doi.org/10.1016/j.healun.2016.01.094" @default.
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