Background: The indirect effects of RVI in LTR are controversial. We aimed to define patterns of RVI in LTR and the impact on CLAD and mortality.

Methods: Single center retrospective review of all LTR transplanted (2004-2015 inclusive) who underwent respiratory virus testing. Patterns of RV isolation post lung transplantation were assigned as follows: 1) No RV isolated; 2) Single RV isolated; 3) More than 1 different type of RV isolated; 4) Repeated isolation of the same type of RV, defined as repeated isolation of the same virus type ≥14 days but <6 months after the initial positive. Severe CLAD was defined as a drop of FEV1 <50% of the baseline (the two greatest FEV1 values >3 weeks apart). We evaluated the association between the patterns of RVI with severe CLAD and mortality.

Results: We analyzed 3005 valid specimens from 301 patients. There were 576 positive samples (positivity rate 19.2%). Patient distributions were: Group 1 (n= 124;40%), Group 2 (n=87;29%), Group 3 (n=51;17%) and Group 4 (n=39;13%). The prevalence of RVI in our cohort was 58.8%. The most frequently isolated viruses were picornaviruses, parainfluenza viruses 1-4 (combined) and influenza A. Seasonality reflected the expected circulating patterns in the general community. We found no significant association of the pre-defined RVI pattern with mortality at 5 year post-transplant. Twenty-four percent of patients assigned to Group 4 (repeated isolation of the same virus) developed severe CLAD at 5 years compared to 10% of those in Groups 1-3 (HR 2.476, 95% CI 1.112-5.514, p=0.026).

Conclusion: In our cohort, repeated isolation of the same RV was associated with severe CLAD, while other patterns of RVI was not.

CITATION INFORMATION: Somerville L., Drews S., Halloran K., Lee N., Kabbani D., Hirji H., Doucette K., Cervera C. Pattern of Respiratory Virus Infection (RVI) and Chronic Lung Allograft Dysfunction (CLAD) in Lung Transplant Recipients (LTR) Am J Transplant. 2017;17 (suppl 3).

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