Risk factors for infection after pediatric lung transplantation

Abstract

Although infection is the leading cause of death in the first year following pediatric lung transplantation, there are limited data on risk factors for early infection. Sepsis remains under-recognized and under-reported in the early post-operative period for lung transplant recipients (LTR). We evaluated the incidence of infection and sepsis, and identified risk factors for infection in the early post-operative period in pediatric LTRs. A retrospective review of medical records of LTRs at a large quaternary-care hospital from January 2009 to March 2016 was conducted. Microbiology results on days 0-7 after transplant were obtained. Sepsis was defined using the 2005 International Pediatric Consensus Conferencecriteria. Risk factors included history of recipient and donor infection, history of multi-drug resistant (MDR) infection, nutritional status, and surgical times. Among the 98 LTRs, there were 22 (22%) with post-operative infection. Prolonged donor ischemic time ≥7 hours, cardiopulmonary bypass(CPB) time ≥340 minutes, history of MDR infection and diagnosis of cystic fibrosis were significantly associated with infection. With multivariable regression analysis, only prolonged donor ischemic time remained significant (OR 4.4, 95% CI: 1.34-14.48). Further research is needed to determine whether processes to reduce donor ischemic time could result in decreased post-transplant morbidity.

Pediatric lung transplantation in the largest lung transplantation center of China: embarking on a long road

“…Infection is a common complication especially in pediatric LT cases 14 , and is one of the important risk factors leading to early death after transplantation with the infection rate of 69–90% 15 . Onyearugbulem et al retrospectively analyzed 98 lung transplant recipients in their center, 22 of whom developed infection after surgery 16 . Given the use of immunosuppressive agents, the treatment for post-LT infection can be challenging.…”

Challenges in the Diagnosis and Management of Bacterial Lung Infections in Solid Organ Recipients: A Narrative Review

“…[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41]. Main studies addressing the etiology of lung infections in solid organ transplant recipients.…”