%0 Journal Article %A Benedicte De Muynck %A Anke Van Herck %A Annelore Sacreas %A Tobias Heigl %A Janne Kaes %A Arno Vanstapel %A Stijn E. Verleden %A Arne P. Neyrinck %A Laurens J. Ceulemans %A Dirk E. Van Raemdonck %A Katrien Lagrou %A Bart M. Vanaudenaerde %A Geert M. Verleden %A Robin Vos %A , %T Successful Pseudomonas aeruginosa eradication improves outcomes after lung transplantation: a retrospective cohort analysis %D 2020 %R 10.1183/13993003.01720-2020 %J European Respiratory Journal %P 2001720 %V 56 %N 4 %X Long-term survival after lung transplantation (LTx) is hampered by development of chronic lung allograft dysfunction (CLAD). Pseudomonas aeruginosa is an established risk factor for CLAD. Therefore, we investigated the effect of P. aeruginosa eradication on CLAD-free and graft survival.Patients who underwent first LTx between July, 1991, and February, 2016, and were free from CLAD, were retrospectively classified according to P. aeruginosa presence in respiratory samples between September, 2011, and September, 2016. P. aeruginosa-positive patients were subsequently stratified according to success of P. aeruginosa eradication following targeted antibiotic treatment. CLAD-free and graft survival were compared between P. aeruginosa-positive and P. aeruginosa-negative patients; and between patients with or without successful P. aeruginosa eradication. In addition, pulmonary function was assessed during the first year following P. aeruginosa isolation in both groups.CLAD-free survival of P. aeruginosa-negative patients (n=443) was longer compared with P. aeruginosa-positive patients (n=95) (p=0.045). Graft survival of P. aeruginosa-negative patients (n=443, 82%) was better compared with P. aeruginosa-positive patients (n=95, 18%) (p<0.0001). Similarly, P. aeruginosa-eradicated patients demonstrated longer CLAD-free and graft survival compared with patients with persistent P. aeruginosa. Pulmonary function was higher in successfully P. aeruginosa-eradicated patients compared with unsuccessfully eradicated patients (p=0.035).P. aeruginosa eradication after LTx improves CLAD-free and graft survival and maintains pulmonary function. Therefore, early P. aeruginosa detection and eradication should be pursued.Presence of P. aeruginosa in respiratory samples after lung transplantation is associated with worse outcomes. Successful eradication improves outcomes and pulmonary function. Therefore, early treatment of P. aeruginosa should be pursued. https://bit.ly/2XuDPG2 %U https://erj.ersjournals.com/content/erj/56/4/2001720.full.pdf