The impact of chronic rhinosinusitis on long-term survival in lung transplantation recipients

Kariya, Shin; Okano, Mitsuhiro; Oto, Takahiro; Higaki, Toru; Tamano, Haruna; Noda, Yoichi; Nishizaki, Kazunori

doi:10.1080/00016489.2016.1247497

Cited by 6 publications

(5 citation statements)

References 19 publications

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“…11,12,25 In light of the excellent outcomes observed in these patients, a surgically oriented approach may be advocated earlier in the management course of these patients. This is further supported by a recent study 26 that compared survival rates among lung transplant recipient patients with CRS who underwent ESS with those who were managed conservatively. In that study, ESS correlated with increased survival rates.…”

Section: Chronic Rsmentioning

confidence: 61%

Rhinosinusitis in Solid Organ Transplant Recipients: Analysis of 4562 Transplanted Patients

Tzelnick

Soudry

2018

Am J Rhinol�Allergy

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Introduction Survival rates of solid organ transplant recipients are steadily increasing. Chronic immunosuppression is a key to sustain the transplanted organ. Thus, these patients are at a higher risk for fulminant disease and severe complications of rhinosinusitis (RS). Surprisingly, this has been scarcely discussed in the literature. Objective To analyze the characteristics and disease course of RS in solid organ transplant recipients. Materials and Methods Retrospective study. Medical records of all solid organ transplant recipients with a diagnosis RS treated at a national transplant center between the years 2001 and 2016 were reviewed. Results Of 4562 solid organ transplant recipients, a documented diagnosis of RS was identified only in 61 (1.3%) patients. Sixty-four patients presented with posttransplantation RS; of them, 54.5% had chronic RS (CRS) and the remaining 45.5% patients were diagnosed with acute RS. Microbial cultures grew almost exclusively bacterial pathogens. A documented invasive fungal infection was noted in only 2 patients. A total of 24 (40%) patients underwent endoscopic sinus surgery, the majority (22) for CRS. On subgroup analysis, surgical intervention was more frequent in lung transplant recipients ( P = .005). Neither specific disease nor surgical complications were found. Conclusions Interestingly, acute fulminant infection or sinusitis complications in solid organ transplant patients were much lower than expected. CRS in this patient group was less frequent than expected as well. Whether chronic immunosuppression minimizes the likelihood for CRS deserves further investigation. A more surgically oriented approach in CRS patients may be favored early in the management course of medically refractory patients in light of patients excellent outcomes.

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Section: Chronic Rsmentioning

confidence: 61%

Rhinosinusitis in Solid Organ Transplant Recipients: Analysis of 4562 Transplanted Patients

Tzelnick

Soudry

2018

Am J Rhinol�Allergy

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“…13 Looking at other solid organ transplant recipients, a lower mortality was found in lung transplant recipients with sinusitis who underwent FESS prior to transplantation compared to those who did not, while the presence of abnormalities on sinus CT was not associated with mortality. 20 In contrast, the prevalence of sinusitis was not increased in a large cohort of kidney transplant recipients, nor did asymptomatic patients show any deterioration of clinical course after transplantation. 21 Literature on the decision to treat sinusitis before solid organ transplantation is thus somewhat conflicting.…”

Section: Subgroupmentioning

confidence: 86%

“…A large Korean study in liver transplant recipients confirmed the absence of complicated infections but found better survival in sinusitis patients who were adequately treated before transplantation 13 . Looking at other solid organ transplant recipients, a lower mortality was found in lung transplant recipients with sinusitis who underwent FESS prior to transplantation compared to those who did not, while the presence of abnormalities on sinus CT was not associated with mortality 20 . In contrast, the prevalence of sinusitis was not increased in a large cohort of kidney transplant recipients, nor did asymptomatic patients show any deterioration of clinical course after transplantation 21 .…”

Section: Discussionmentioning

confidence: 98%

Evaluation of ear, nose, and throat‐screening in liver transplantation candidates: A retrospective cohort study

Beukman,

van der Meer,

Takkenberg

et al. 2023

Transplant Infectious Dis

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BackgroundPatients with end‐stage liver disease can be treated with a liver transplantation (LT). Before listing, candidates are subjected to a screening procedure according to the EASL Clinical Practice Guidelines for LT. In our hospital, this includes an ear, nose, and throat (ENT) examination, directed towards the identification of (asymptomatic) infections and head and neck malignancies.MethodsWe retrospectively reviewed all ENT screening examinations in LT candidates from 2007 to 2022. The screening consisted of a visit to the ENT outpatient clinic combined with sinus radiography.ResultsENT screening was performed in 1099 patients. Sixty‐one cases were identified, either diagnosed with an infection (n = 58, almost exclusively sinusitis) or a neoplasm (n = 3, of which two malignancies). With binary logistic regression, we could not identify significant risk factors for diagnosing sinusitis. 711 patients underwent LT. After LT, two patients developed a novel malignancy of the head and neck area, while 14 patients were diagnosed with sinusitis, two of the latter already showed opacification on sinus radiography during screening. Despite immunosuppressive drugs, no complicated sinusitis was observed.ConclusionSinusitis or a neoplasm was diagnosed in almost 6% in a large cohort of LT candidates. Although almost a third of sinusitis patients were not treated accordingly, we did not observe any complicated sinusitis after LT. A more conservative approach to sinusitis may therefore be justified in LT candidates, especially in asymptomatic cases. At our institution, we aim to refer only those patients with specific ENT complaints image.

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“…La rinosinusitis crónica es frecuente en pacientes con indicación de trasplante pulmonar, especialmente en aquellos pacientes con fibrosis quística (FQ), siendo más de la mitad de ellos sometidos a CEF previo al trasplante 14 . Esta asociación se ha explicado en base al concepto de vía aérea unificada y a que la descarga posterior puede inducir a la infección respiratoria baja, convirtiéndose en una fuente de infección durante la inmunosupresión postrasplante 15 . Distintos estudios demuestran que el tratamiento de la rinosinusitis tiene un efecto positivo en la prevención de infecciones postrasplante [16][17][18] , además se ha reportado que el drenaje crónico con patógenos en aloinjertos pulmonares es causado por el reservorio bacteriano de los senos paranasales 19 , siendo incluso genotípicamente idénticos 20 .…”

Section: Consideraciones En Pacientes Con Trasplante Pulmonarunclassified

“…En 148 pacientes que recibieron trasplante pulmonar debido a diversas indicaciones, aquellos receptores que presentaban RSC previa al trasplante y que no recibieron cirugía endoscó- pica funcional el porcentaje de sobrevida global fue significativamente menor que aquellos que sí fueron sometidos a CEF, en estos últimos la curva de sobrevida se compara a la de los pacientes sin RSC con un seguimiento mayor a 12 años. En este mismo estudio no existieron diferencias significativas en las curvas de sobrevida al analizar aquellos receptores con y sin anormalidades imagenológicas en la TC 15 .…”

Section: Consideraciones En Pacientes Con Trasplante Pulmonarunclassified

Evaluación pretrasplante en otorrinolaringología

2020

Rev. Otorrinolaringol. Cir. Cabeza Cuello

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The impact of chronic rhinosinusitis on long-term survival in lung transplantation recipients

Cited by 6 publications

References 19 publications

Rhinosinusitis in Solid Organ Transplant Recipients: Analysis of 4562 Transplanted Patients

Rhinosinusitis in Solid Organ Transplant Recipients: Analysis of 4562 Transplanted Patients

Evaluation of ear, nose, and throat‐screening in liver transplantation candidates: A retrospective cohort study

Evaluación pretrasplante en otorrinolaringología

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