Colonization with small conidia Aspergillus species is associated with bronchiolitis obliterans syndrome: a two-center validation study.
Journal Article (Journal Article;Multicenter Study)
Aspergillus colonization after lung transplantation may increase the risk for bronchiolitis obliterans syndrome (BOS), a disease of small airways. We hypothesized that colonization with small conidia Aspergillus species would be associated with a greater risk of BOS, based upon an increased likelihood of deposition in small airways. We studied adult primary lung recipients from two large centers; 298 recipients at University of California, Los Angeles and 482 recipients at Duke University Medical Center. We grouped Aspergillus species by conidia diameter≤3.5 μm. We assessed the relationship of colonization with outcomes in Cox models. Pre-BOS colonization with small conidia Aspergillus species, but not large, was a risk factor for BOS (p=0.002, HR 1.44, 95% CI 1.14-1.82), along with acute rejection, single lung and Pseudomonas. Colonization with small conidia species also associated with risk of death (p=0.03, HR 1.30, 95% CI 1.03-1.64). Although other virulence traits besides conidia size may be important, we have demonstrated in two large independent cohorts that colonization with small conidia Aspergillus species increases the risk of BOS and death. Prospective evaluation of strategies to prevent Aspergillus colonization of small airways is warranted, with the goal of preserving lung allograft function as long as possible.
Full Text
Duke Authors
Cited Authors
- Weigt, SS; Copeland, CAF; Derhovanessian, A; Shino, MY; Davis, WA; Snyder, LD; Gregson, AL; Saggar, R; Lynch, JP; Ross, DJ; Ardehali, A; Elashoff, RM; Palmer, SM; Belperio, JA
Published Date
- April 2013
Published In
Volume / Issue
- 13 / 4
Start / End Page
- 919 - 927
PubMed ID
- 23398785
Pubmed Central ID
- PMC3618528
Electronic International Standard Serial Number (EISSN)
- 1600-6143
Digital Object Identifier (DOI)
- 10.1111/ajt.12131
Language
- eng
Conference Location
- United States