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Infections Within the First Month After Pediatric Lung Transplantation: Epidemiology and Impact on Outcomes.

Abstract：

BACKGROUND:Despite successes in lung transplantation, with infection as the leading cause of death in the first year following lung transplantation, there remains a lag in survival compared with other solid organ transplants. Infections that occur early after transplantation may impact short- and long-term outcomes in pediatric lung transplant recipients (LTRs). METHODS:We performed a retrospective review of pediatric LTRs at a large quaternary-care hospital from January 2009 to March 2016 to evaluate both epidemiologic features of infection in the first 30 days post-transplantation and mortality outcomes. The 30 days were divided into early (0-7 days) and late (8-30 days) periods. RESULTS:Among the 98 LTRs, there were 51 episodes of infections. Cystic fibrosis (CF) was associated with early bacterial infections (P = .004) while non-CF was associated with late viral (P = .02) infections. Infection after transplantation was associated with worse survival by Kaplan-Meier analysis (P value log rank test = .007). Viral infection in the late period was significantly associated with 3-year mortality after multivariable analysis (P = .02). CONCLUSIONS:Infections in pediatric LTRs were frequent in the first 30 days after transplant, despite perioperative antimicrobial coverage. The association of 3-year mortality with late viral infections suggests a possible important role in post-transplant lung physiology and graft function. Understanding the epidemiology of early post-lung transplant infections can help guide post-operative management and interventions to reduce their incidence and the early- and long-term impact in this population.

journal_name

J Pediatric Infect Dis Soc

journal_title

Journal of the Pediatric Infectious Diseases Society

authors

Onyearugbulem C,Coss-Bu J,Gazzaneo MC,Melicoff E,Das S,Lam F,Mallory GB,Munoz FM

doi

10.1093/jpids/piaa050

subject

Has Abstract

pub_date

2020-06-13 00:00:00

eissn

2048-7193

issn

2048-7207

pii

5857121

pub_type

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