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31 December 2015 : Original article  

Higher Risk of Acute Cellular Rejection in Lung Transplant Recipients with Cystic Fibrosis

Fiorella CalabreseAEF, Francesca LunardiBDE, Nazarena NanniniBE, Elisabetta BalestroB, Monica LoyB, Giuseppe MarulliB, Francesca CalabreseBE, Stefania Edith VuljanB, Marco SchiavonB, Egle PerissinottoCDE, Federico ReaADF

DOI: 10.12659/AOT.894785

Ann Transplant 2015; 20:769-776

Abstract

BACKGROUND: Acute cellular rejection (ACR) affects up to 40% of recipients within the first year after lung transplant (LTx). The aim of this study was to determine the frequency of ACR and associated major risk factors in cystic fibrosis (CF) recipients. Bronchiolitis obliterans syndrome (BOS) and 1-year/long-term survival were also evaluated.

MATERIAL AND METHODS: ACR was reviewed in 643 scheduled biopsies from 44 CF (Group 1) versus 89 other recipients (Group 2). We performed univariate/multivariate analyses of risk factors for ACR and BOS, and survival analysis.

RESULTS: Group 1 showed higher ACR frequency, especially for ACR ≥A2. Multivariable generalized linear models considering both native lung disease and age showed that higher values of ACR index were significantly related to the pretransplant diagnosis of CF. BOS and long-term survival were not influenced by the increased incidence of ACR. Poorer long-term survival was observed in Group 2.

CONCLUSIONS: CF recipients have a higher ACR risk, which may be due to enhanced immune activation related to a genetic disorder, and younger age.

Keywords: Cystic Fibrosis, Graft Rejection, Lung Transplantation

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358