@entity364 and complications involving the bronchial XXXX following @entity1 lung transplantation.

@entity1 @entity548 @entity2488 @entity254 @entity17593 @entity281 @entity364 @entity20544 @entity850
STUDY OBJECTIVE: To demonstrate an association between saprophytic @entity364 occurring at the bronchial @entity254 (BA) and the development of additional complications arising at this site. DESIGN: Retrospective review. SETTING: University lung transplant center. MATERIALS AND METHODS: Review of all single-lung and double-lung transplant (LTX) recipients who underwent transplantation between June 1993 and December 2000. All recipients were subjected to surveillance bronchoscopy with biopsy at predetermined intervals and when clinically indicated. Bronchial wash fluid and biopsy material were examined using appropriate fungal stains and culture techniques. An @entity281 was defined when fungal organisms were identified in tissue specimens. RESULTS: Fifteen saprophytic @entity364 involving the BA were identified in 61 LTX recipients (24.6%) who survived a minimum of 75 days post-transplantation. Infections were attributed to Aspergillus sp (n = 9), Candida sp (n = 2), @entity20544 sp (n = 1), and mixed flora (ie, Penicillium + Candida, two @entity1 ; and Aspergillus + Candida, one @entity1 ). @entity364 occurred by a median of postoperative day 35 (range, 13 to 159 days). Airway complications involving the BA ultimately developed in 11 of 61 recipients (18%). These complications included symptomatic @entity850 (nine @entity1 ), @entity17593 (one @entity1 ), and fatal @entity548 (one @entity1 ). Bronchial complications arose in 7 of 15 recipients (46.7%) with saprophytic @entity364 of the BA in contrast to 4 of 46 (8.7%) without @entity281 (p = 0.003, Fisher exact test). Also demonstrated was a positive correlation between @entity281 and bronchial complications (Phi coefficient = 0.43; p = 0.001), while logistic regression analysis revealed that the absence of @entity281 predicted the absence of such complications (p = 0.002). The risk of developing an additional complication following an @entity281 in @entity1 with @entity281 was five times that of those recipients without an @entity281 (relative risk, 5.36; 95% confidence interval [CI], 1.82 to 15.79). The odds in favor of a @entity2488 following an @entity281 were eight times greater than in those recipients without @entity281 (odds ratio, 8.31; 95% CI, 1.96 to 35.16). CONCLUSIONS: Following LTX, saprophytic @entity364 of the BA are associated with serious airway complications.
