Presentation and outcomes of chronic rhinosinusitis following liver and kidney transplant

Spillinger, Aviv; Low, Christopher M.; Smith, Brenda; Stokken, Janalee K.; O’Brien, Erin; Choby, Garret

doi:10.1016/j.wjorl.2020.05.001

Cited by 7 publications

(9 citation statements)

References 27 publications

(52 reference statements)

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“…Some studies suggest that certain combinations of immunosuppressive therapy and low-dose prednisone may actually be protective for rhinologic disease. 7,15,16 Our findings are consistent with the majority of studies, as we noted that the certain immunosuppressant drugs appear to be a factor associated with recalcitrant disease. 3,7,10,24,25…”

Section: Discussionsupporting

confidence: 91%

“…The frequency of ESS in solid transplant recipients in our study was 36% which coincides with estimates described in the literature. 15 Based on our results as well as other smaller studies, CRS patients with liver transplants were consistently documented as having recalcitrant CRS. 15 In fact, our univariate analysis found that patients with liver transplants had a higher risk of developing recalcitrant CRS and requiring surgery compared to all other solid organ transplant patients.…”

Section: Discussionsupporting

confidence: 83%

“…There is a lack of robust studies evaluating CRS in both nonsolid and solid transplant populations. 7,[14][15][16][17][18][19][20] One of the major gaps in the literature is a clear estimate of the incidence of recalcitrant CRS requiring surgery in transplant patients. To our knowledge, previous studies have not determined if specific risk factors lead to similar rates of developing recalcitrant CRS in both solid and non-solid organ transplants.…”

Section: Discussionmentioning

confidence: 99%

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Risk Factors for Recalcitrant Chronic Rhinosinusitis in Non-Solid and Solid Transplant Recipients

Candelo

Darakjian

Avila-Castano

et al. 2023

Am J Rhinol�Allergy

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Objectives Transplant patients are high risk for surgery due to their immunocompromised state. There is a paucity of evidence concerning the differences in incidence of chronic rhinosinusitis (CRS) in solid versus non-solid organ transplant. Our aim is to analyze the difference in incidence of CRS requiring endoscopic sinus surgery (ESS) between non-solid and solid transplant populations and determine if certain risk factors are associated with increased incidence of recalcitrant CRS in non-solid versus solid transplants. Study Design Retrospective cohort. Setting Multisite tertiary academic center. Methods This is a retrospective chart review of 1303 transplant recipients who were seen in our rhinologic clinic for CRS between 2017 and 2022. A total of 224 patients underwent ESS and were further analyzed for risk factors associated with recalcitrant disease requiring sinus surgery. Subgroup analysis based on solid and non-solid organ transplant was performed. Results Of the 224 patients in the study, 171/224 (76.3%) had solid transplants while 53/224 (23.6%) had non-solid transplants. 17.19% of all transplant recipients required ESS. The incidence of ESS in non-solid transplants was 28.2% versus 57% in solid transplant. The risk of recalcitrant CRS in solid transplant recipients was almost 1.78 times greater than those with non-solid organ transplant (95% CI, 1.27-2.54, p = 0.0005). Individual factors such as certain immunotherapy drugs, pancytopenia, and rejection appear to correlate with the risk of ESS in both non-solid and solid organ transplant. Conclusion Risk of ESS was greater in the solid transplant recipients compared to those who received non-solid organ transplant.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

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Risk Factors for Recalcitrant Chronic Rhinosinusitis in Non-Solid and Solid Transplant Recipients

Candelo

Darakjian

Avila-Castano

et al. 2023

Am J Rhinol�Allergy

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“…None of the 10 patients diagnosed with sinusitis or neoplasm in the screening had a complicated course after HTx. Similar observations have been reported in literature: in a cohort of liver and kidney transplant recipients no complicated sinusitis was witnessed [17], and the presence of pretransplant chronic rhinosinusitis does not contribute to mortality after liver transplant [18].…”

Section: Post-transplant Evaluationsupporting

confidence: 89%

Evaluation of Routine Ear, Nose, and Throat Screening in Heart Transplant Candidates: A Retrospective Cohort Study

Vroonhof

Roest

Datema

et al. 2023

Transplantation Proceedings

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“…In our study, chronic hepatitis was detected in 1 case (9.1%), chronic glomerulonephritis -in 1 case (9.1%), chronic pyelonephritis -in 1 case (9.1%). Dysfunction of these organs is accompanied by intoxication, immune disorders, which can cause the development of bacterial-fungal chronic rhinosinusitis [44].…”

Section: Discussionmentioning

confidence: 99%

Rhinosinusitis in Patients in Post-Covid-19 Period: Etiology, Clinical and Morphological Characteristics

Myroshnychenko

Kalashnyk-Vakulenko

Kapustnyk³

et al. 2022

Wiad Lek

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The aim is to identify the etiology, clinical and morphological features of rhinosinusitis in patients in post-COVID-19 period. Materials and methods: In the present study, it was carried out the analysis of 11 cases of rhinosinusitis, which developed after COVID-19 infection. The diagnosis of rhi¬nosinusitis was established on the basis of anamnesis, clinical and laboratory examination, specialized instrumental examination (rhinoendoscopy, X-ray, magnetic resonance imaging, spiral and 3D computed tomography). All patients underwent endoscopic sanitation of the nasal cavity, expansion of the maxillary anastomosis, maxillary sinusotomy, sanitation of the maxillary sinuses and removal of pathologically altered tissues. Microbiological examination of the swab from the nasal cavity was carried out in all patients. Histological and morphometric research methods were used during the morphological study of surgical material. The nonparametric Mann-Whitney U test was used to compare the means in the groups. Results: The conducted comprehensive study made it possible to identify chronic atrophic rhinosinusitis at the stage of exacerbation caused by associations of bacteria and fungi in patients in post-COVID-19 period. Among bacteria, the authors most often noted Staphylococcus aureus, Staphylococcus epidermidis, Klebsiella pneumonia, Streptococcus pneumonia and Enterococcus faecalis. Among fungi, there were Aspergillus, Candida, Mucor and Coccidioides. Fungal infection was characterized by invasion into the mucous membrane of the nose and paranasal sinuses. In patients in post-COVID-19 period the invasive bacterial-fungal chronic atrophic rhinosinusitis at the stage of exacerbation was predominantly bilateral, characterized by the involvement of several or all paranasal sinuses in the process. Patients with such pathology complained of periodic fever, headaches and malaise; nasal congestion and constant difficulty in nasal breathing; yellowish-greenish-reddish discharge from the nasal cavity, sometimes with a fetid odor; discomfort and pain in the area of paranasal sinuses; immobility of the eyeball, hyposmia or anosmia; reduction or complete loss of vision. Frequent risk factors for the development of invasive bacterial-fungal chronic atrophic rhinosinusitis at the stage of exacerbation in patients in post-COVID-19 period were the information about moderate or severe course of this infection in anamnesis; comorbidities (predominantly diabetes mellitus, hypertensive disease and ischemic heart disease). Conclusions: The study conducted by the authors made it possible to identify the etiological, clinical and morphological features, as well as risk factors of rhinosinusitis in patients in post-COVID-19 period. This information will contribute to a better understanding of such pathology by the doctors and improve the diagnostic and treatment process.

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Presentation and outcomes of chronic rhinosinusitis following liver and kidney transplant

Cited by 7 publications

References 27 publications

Risk Factors for Recalcitrant Chronic Rhinosinusitis in Non-Solid and Solid Transplant Recipients

Risk Factors for Recalcitrant Chronic Rhinosinusitis in Non-Solid and Solid Transplant Recipients

Evaluation of Routine Ear, Nose, and Throat Screening in Heart Transplant Candidates: A Retrospective Cohort Study

Rhinosinusitis in Patients in Post-Covid-19 Period: Etiology, Clinical and Morphological Characteristics

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