Pseudomonas aeruginosa colonization of the allograft after lung transplantation and the risk of bronchiolitis obliterans syndrome

Transplantation. 2008 Mar 15;85(5):771-4. doi: 10.1097/TP.0b013e31816651de.


Long-term survival after lung transplantation remains limited by the development of bronchiolitis obliterans syndrome (BOS). Allograft colonization with Pseudomonas aeruginosa is common particularly in recipients with BOS, but a possible etiological relationship remains unexplored. In 155 consecutive lung transplants, the development of allograft colonization with Pseudomonas was strongly associated with the development of BOS within 2 years of transplant (23.4% vs. 7.7% in those colonized and not colonized, respectively, P=0.006). Freedom from BOS was significantly shorter in those patients without any pretransplant bacterial reservoir developing de novo allograft pseudomonal colonization as compared with those remaining free of colonization (Kaplan-Meier log-rank P=0.014). The isolation of Pseudomonas preceded the diagnosis of BOS in 14 of 18 (78%) and by a median of 204 days (95% confidence interval 115-492) in patients developing both these complications. We conclude that de novo colonization of the lung allograft by Pseudomonas is strongly associated with the subsequent development of BOS.

MeSH terms

  • Adult
  • Bronchiolitis Obliterans / epidemiology*
  • Bronchiolitis Obliterans / microbiology
  • Female
  • Humans
  • Lung Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Pseudomonas Infections / epidemiology
  • Pseudomonas aeruginosa / isolation & purification*
  • Pulmonary Disease, Chronic Obstructive / epidemiology
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Transplantation, Homologous