Adenovirus infection in the lung results in graft failure after lung transplantation

N. D. Bridges, T. L. Spray, M. H. Collins, N. E. Bowles, Jeffrey Towbin

Research output: Contribution to journalArticle

118 Citations (Scopus)

Abstract

Objectives: Our goal was to examine the relationship between viral pneumonia and outcome in pediatric patients undergoing lung or heart-lung transplantation. Methods: Prospective surveillance for common respiratory viruses of childhood was performed in all patients undergoing lung or heart- lung transplantation. Specimens were examined for the presence of replicating virus (by culture), viral genome (by polymerase chain reaction), and viral antigen (by immunofluorescence and immunohistochemical staining). The relationship between viral infection and outcome was examined. Results: Sixteen patients underwent 19 transplants during the study period, with follow-up of I to 26 months. Virus was identified in the transplanted lung in 29 instances; adenovirus was identified most commonly (8/16 patients) and had the greatest impact on outcome. In 2 patients with early, fulminant infection, adenovirus was also identified in the donor. Adenovirus was significantly associated with respiratory failure leading to death or graft loss and with the histologic diagnosis of obliterative bronchiolitis (P ≤ .002 in each case). Conclusions: Adenovirus infection in the transplanted lung is significantly associated with graft failure, histologic obliterative bronchiolitis, and death. Health care personnel and families must be vigilant in preventing exposure of transplant recipients to this virus. Availability of a rapid and reliable test for adenovirus in donors and recipients would have an impact on management and could improve outcome for pediatric lung recipients.

Original languageEnglish (US)
Pages (from-to)617-623
Number of pages7
JournalJournal of Thoracic and Cardiovascular Surgery
Volume116
Issue number4
DOIs
StatePublished - Jan 1 1998
Externally publishedYes

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Adenoviridae Infections
Lung Transplantation
Transplants
Lung
Adenoviridae
Heart-Lung Transplantation
Viruses
Bronchiolitis
Viral Pneumonia
Tissue Donors
Pediatrics
Viral Antigens
Viral Genome
Virus Diseases
Respiratory Insufficiency
Health Personnel
Fluorescent Antibody Technique
Staining and Labeling
Delivery of Health Care
Polymerase Chain Reaction

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Adenovirus infection in the lung results in graft failure after lung transplantation. / Bridges, N. D.; Spray, T. L.; Collins, M. H.; Bowles, N. E.; Towbin, Jeffrey.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 116, No. 4, 01.01.1998, p. 617-623.

Research output: Contribution to journalArticle

Bridges, N. D. ; Spray, T. L. ; Collins, M. H. ; Bowles, N. E. ; Towbin, Jeffrey. / Adenovirus infection in the lung results in graft failure after lung transplantation. In: Journal of Thoracic and Cardiovascular Surgery. 1998 ; Vol. 116, No. 4. pp. 617-623.
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