Pseudomonal airway colonization: a risk factor for BOS after lung transplantation?

¹ Laboratory of Pneumology, Katholieke Universiteit Leuven
² Center for Gastroenterological Research, Katholieke Universiteit Leuven, Belgium and
³ Laboratory of Pneumology, Katholieke Universiteit Leuven; Lung Transplantation Unit; and Dept of Respiratory Disease
⁴ Center for Gastroenterological Research, Katholieke Universiteit Leuven, Belgium and; Lung Transplantation Unit; and Dept of Thoracic Surgery, University Hospital Gasthuisberg, 49 Herestraat, B 3000 Leuven, Belgium

^* To whom correspondence should be addressed. E-mail: geert.verleden{at}uz.kuleuven.ac.be.

	Abstract

Airway colonization with Pseudomonads, especially Pseudomonas aeruginosa (P. aeruginosa), is common in lung transplant (LTx) recipients. We investigated whether pseudomonal colonization affects the prevalence of Bronchiolitis Obliterans Syndrome (BOS) after lung transplantation.

In this retrospective study, 92 double (SS) LTx recipients (26 Cystic Fibrosis (CF) and 66 non-CF patients), with at least 2 consecutive postoperative broncho-alveolar lavage (BAL) or sputum cultures evaluated for Pseudomonads, were included. Freedom of BOS was investigated in post-operatively colonized and noncolonized patients.

Post-operative airway colonization demonstrated to be an independent risk factor for BOS 1 and was associated with a worse BOS 1-free survival in univariate analysis, especially in CF SSLTx recipients. Multivariate analysis only demonstrated a trend for colonization as an independent risk factor for BOS (p=0.061), however, pointing to a possible role in the development of BOS.

Pseudomonal airway colonization after LTx may be associated with an increased prevalence of BOS, especially in CF patients. Its possible pathophysiological mechanisms in the development of BOS need further investigation, yet induction of neutrophilic airway inflammation seems to be the main characteristic.

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