Lung donor bronchoalveolar lavage positivity: Incidence, risk factors, and lung transplant recipients' outcome.
J Heart Lung Transplant
; 43(8): 1288-1297, 2024 Aug.
Article
in En
| MEDLINE
| ID: mdl-38677352
ABSTRACT
BACKGROUND:
Inconsistent data exists regarding the risk factors for bronchoalveolar lavage (BAL) positivity in lung donors, the incidence of donor-derived infections (DDI), and the effect of BAL positivity on lung transplant (LuTx) recipients' outcome.METHODS:
A retrospective analysis was conducted on consecutive LuTx at a single center from January 2016 to December 2022. Donors' data, including characteristics, graft function and BAL samples were collected pre-procurement. Recipients underwent BAL before LuTx and about the 3rd, 7th and 14th day after LuTx. A DDI was defined as BAL positivity (bacterial growth ≥104 colony forming units) for identical bacterial species between donor and recipient. Recipients' pre-operative characteristics, intra-operative management, and post-operative outcomes were assessed. Two recipient cohorts were identified based on lung colonization status before undergoing LuTx.RESULTS:
Out of 188 LuTx procedures performed, 169 were analyzed. Thirty-six percent of donors' BAL tested positive. Donors' characteristics and graft function at procurement were not associated with BAL positivity. Fourteen DDI were detected accounting for 23% of recipients receiving a graft with a positive BAL. Only among uncolonized recipients, receiving a graft with positive BAL is associated with higher likelihood of requiring invasive ventilation at 72 hours after LuTx on higher positive end-expiratory pressure levels having lower PaO2/FiO2, prolonged duration of mechanical ventilation and longer ICU stay. No difference in hospital length of stay was observed.CONCLUSIONS:
Receiving a graft with a positive BAL, which is poorly predicted by donors' characteristics, carries the risk of developing a DDI and is associated to a worse early graft function among uncolonized recipients.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Tissue Donors
/
Bronchoalveolar Lavage Fluid
/
Lung Transplantation
Limits:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
J Heart Lung Transplant
/
J. heart lung transplant
/
Journal of heart and lung transplantation
Journal subject:
CARDIOLOGIA
/
TRANSPLANTE
Year:
2024
Document type:
Article
Country of publication:
United States