Higher Risk of Acute Cellular Rejection in Lung Transplant Recipients with Cystic Fibrosis

Fiorella Calabrese; Francesca Lunardi; Nazarena Nannini; Elisabetta Balestro; Monica Loy; Giuseppe Marulli; Francesca Calabrese; Stefania Edith Vuljan; Marco Schiavon; Egle Perissinotto; Federico Rea

doi:10.12659/aot.894785

Higher Risk of Acute Cellular Rejection in Lung Transplant Recipients with Cystic Fibrosis

Ann Transplant. 2015 Dec 31:20:769-76. doi: 10.12659/aot.894785.

Affiliations

¹ Pneumology Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.
² Thoracic Surgery Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.
³ Pathology Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.
⁴ Biostatistics, Epidemiology and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.

PMID: 26718747
DOI: 10.12659/aot.894785

Abstract

BACKGROUND Acute cellular rejection (ACR) affects up to 40% of recipients within the first year after lung transplant (LTx). The aim of this study was to determine the frequency of ACR and associated major risk factors in cystic fibrosis (CF) recipients. Bronchiolitis obliterans syndrome (BOS) and 1-year/long-term survival were also evaluated. MATERIAL AND METHODS ACR was reviewed in 643 scheduled biopsies from 44 CF (Group 1) versus 89 other recipients (Group 2). We performed univariate/multivariate analyses of risk factors for ACR and BOS, and survival analysis. RESULTS Group 1 showed higher ACR frequency, especially for ACR ≥ A2. Multivariable generalized linear models considering both native lung disease and age showed that higher values of ACR index were significantly related to the pretransplant diagnosis of CF. BOS and long-term survival were not influenced by the increased incidence of ACR. Poorer long-term survival was observed in Group 2. CONCLUSIONS CF recipients have a higher ACR risk, which may be due to enhanced immune activation related to a genetic disorder, and younger age.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Acute Disease
Adolescent
Adult
Age Factors
Biopsy, Needle
Bronchiolitis Obliterans / epidemiology
Bronchiolitis Obliterans / pathology*
Bronchoscopy / methods
Cystic Fibrosis / diagnosis
Cystic Fibrosis / mortality*
Cystic Fibrosis / surgery*
Female
Graft Rejection / epidemiology
Graft Rejection / pathology*
Humans
Immunohistochemistry
Italy
Longitudinal Studies
Lung Transplantation / adverse effects*
Lung Transplantation / methods
Male
Multivariate Analysis
Necrosis / pathology
Postoperative Complications / epidemiology
Postoperative Complications / pathology
Proportional Hazards Models
Retrospective Studies
Risk Assessment
Severity of Illness Index
Sex Factors
Statistics, Nonparametric
Survival Analysis
Transplant Recipients
Treatment Outcome
Young Adult