Pulmonary Infections in Intestinal Transplant Recipients With Preexisting Pulmonary Nodules |
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| Affiliation: | 1. Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida;2. Department of Medicine, Division of Infectious Disease, University of Miami Miller School of Medicine, Miami, Florida;3. Miami Transplant Institute, Jackson Health System, Miami, Florida;4. Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida;5. Department of Pediatrics, Division of Gastroenterology, University of Miami Miller School of Medicine, Miami, Florida;1. Clinic for Nephrology, Clinical Center of Montenegro, Podgorica, Montenegro;2. Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, Zagreb, Croatia;3. Department of Pathology and Cytology, University Hospital Centre Zagreb, Zagreb, Croatia;4. Clinic for Urology, University Hospital Center Zagreb, Zagreb, Croatia;1. Department of Medicine, Division of Pulmonary and Critical Care Medicine, Washington University, St Louis, Missouri;2. Department of Surgery, Division of Thoracic Surgery, Washington University, St Louis, Missouri;3. Mallinckrodt Institute of Radiology, Washington University, St Louis, Missouri;1. Amirou Boubacar Diallo National Hospital in Niamey, Niger;2. Faculty of Health Sciences, Abdou Moumouni University, Niamey, Niger;3. Niamey General Referral Hospital, Niger;4. Faculty of Health Sciences, University of Zinder, Niger;5. National Hospital of Zinder, Niger;6. Nephrology, Hemodialysis, Apheresis and Kidney Transplantation department, University Teaching, Hospital Grenoble-Alpes, Grenoble, France;7. University Grenoble Alpes, Grenoble, France;1. Ajmera Transplant Center, University Health Network, Toronto, Ontario, Canada;2. Center for Mental Health, University Health Network, Toronto, Ontario, Canada;3. Multi-Organ Transplant & Medical Specialties, The Hospital for Sick Children, Toronto, Ontario, Canada;4. Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada;1. Bahcesehir University Faculty of Medicine, Department of Nephrology, Goztepe Medicalpark Hospital, Istanbul, Turkey;2. Bahcesehir University Faculty of Medicine, Department of Public Health, Istanbul |
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| Abstract: | BackgroundPulmonary nodules in asymptomatic patients could represent latent pulmonary infections. Intestinal transplant (ITx) recipients with preexisting lung nodules might be at higher risk for pulmonary infections. However, data is scarce.MethodsThis retrospective study included adult patients who underwent ITx from May 2016 to May 2020. Chest computed tomography scans performed within 12 months before ITx were obtained to evaluate for preexisting pulmonary nodules. Screening for endemic mycoses, Aspergillus, Cryptococcus, and latent tuberculosis infection performed within 12 months before ITx was obtained. We assessed for worsening pulmonary nodules, and fungal and mycobacterial infections during the first year post-transplant. Survival and graft loss at 1-year post-transplant was also assessed.ResultsForty-four patients underwent ITx. Thirty-one had preexisting lung nodules. No invasive fungi were recorded in the pretransplant period and one individual had latent tuberculosis infection. In the post-transplant period, one individual developed probable invasive aspergillosis and had worsening nodular opacities, whereas one had disseminated histoplasmosis with stable lung nodules in chest computed tomography. No mycobacterial infections were documented. The cohort survival was 84% at 12 months after transplant.ConclusionPreexisting pulmonary nodules were common in the cohort (71%), yet latent and active pulmonary infections were rare. Appearance of new or worsening pulmonary nodules does not appear to directly correlate with pulmonary infections in the post-transplant period. Routine chest computed tomography is not recommended in the pretransplant period, but follow-up is favored in patients with confirmed nodular opacities. Clinical monitoring is essential. |
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