Prognostic implications of and clinical risk factors for acute lung injury and organizing pneumonia after lung transplantation: Data from a multicenter prospective cohort study.

Journal Article (Multicenter Study;Journal Article)

We determined prognostic implications of acute lung injury (ALI) and organizing pneumonia (OP), including timing relative to transplantation, in a multicenter lung recipient cohort. We sought to understand clinical risks that contribute to development of ALI/OP. We analyzed prospective, histologic diagnoses of ALI and OP in 4786 lung biopsies from 803 adult lung recipients. Univariable Cox regression was used to evaluate the impact of early (≤90 days) or late (>90 days) posttransplant ALI or OP on risk for chronic lung allograft dysfunction (CLAD) or death/retransplantation. These analyses demonstrated late ALI/OP conferred a two- to threefold increase in the hazards of CLAD or death/retransplantation; there was no association between early ALI/OP and these outcomes. To determine risk factors for late ALI/OP, we used univariable Cox models considering donor/recipient characteristics and posttransplant events as candidate risks. Grade 3 primary graft dysfunction, higher degree of donor/recipient human leukocyte antigen mismatch, bacterial or viral respiratory infection, and an early ALI/OP event were significantly associated with increased late ALI/OP risk. These data from a contemporary, multicenter cohort underscore the prognostic implications of ALI/OP on lung recipient outcomes, clarify the importance of the timing of these events, and identify clinical risks to target for ALI/OP prevention.

Full Text

Duke Authors

Cited Authors

  • Pavlisko, EN; Neely, ML; Kopetskie, H; Hwang, DM; Farver, CF; Wallace, WD; Arrossi, A; Illei, P; Sever, ML; Kirchner, J; Frankel, CW; Snyder, LD; Martinu, T; Shino, MY; Zaffiri, L; Williams, N; Robien, MA; Singer, LG; Budev, M; Tsuang, W; Shah, PD; Reynolds, JM; Weigt, SS; Belperio, JA; Palmer, SM; Todd, JL

Published Date

  • December 2022

Published In

Volume / Issue

  • 22 / 12

Start / End Page

  • 3002 - 3011

PubMed ID

  • 36031951

Pubmed Central ID

  • PMC9925227

Electronic International Standard Serial Number (EISSN)

  • 1600-6143

Digital Object Identifier (DOI)

  • 10.1111/ajt.17183


  • eng

Conference Location

  • United States