Respiratory Viral Infections and Patient Outcomes in Solid Organ Transplant Recipients

M. Gonzalez¹, A. Vostal¹, N. Darling², C. Papastamelos², M. Natarajan³, P. Kumar³, J. Timpone³

¹Internal Medicine, MedStar Georgetown University Medical Center, Washington, DC, ²School of Medicine, Georgetown University, Washington, DC, ³Infectious Disease, MedStar Georgetown University Medical Center, Washington, DC

Meeting: 2019 American Transplant Congress

Abstract number: A349

Keywords: Kidney transplantation, Liver transplantation, Lung infection, Rejection

Session Information

Session Name: Poster Session A: Transplant Infectious Diseases

Session Type: Poster Session

Date: Saturday, June 1, 2019

Session Time: 5:30pm-7:30pm

Presentation Time: 5:30pm-7:30pm

Location: Hall C & D

*Purpose: Community acquired respiratory viral infections (RVI) have been associated with significant morbidity and mortality in solid organ transplant recipients (SOTR). Acute rejection and allograft loss may be associated with RVI. Using the FilmArray Respiratory Panel (BioFire DX ™) we identified RVI in SOTR who presented with respiratory symptoms.

*Methods: We performed a retrospective, single-center study on consecutive SOTD admitted to MedStar Georgetown University Hospital who presented with respiratory symptoms and were evaluated with the FilmArray Multiplex Respiratory Panel (RP) between July 1, 2016 to April 1, 2018. Clinical and virologic characteristics were assessed, including allograft and patient outcomes. A students T-test was performed for all comparisons.

*Results: We identified 152 SOTR who presented with respiratory symptoms and underwent RP testing: 51 OLT, 62 Kidney, 11 OLT+Kidney, 8 Kidney+Pancreas, 15 small intestine, 3 multivisceral, and 2 lung. 25% (N=38) of SOTR were diagnosed with an RVI that occurred a mean of 31 months from the time of transplant (range 25 days to 159 months). The majority (37/38) of the SOTR had abdominal organ allografts. 6 of these patients were co-infected with 2 respiratory viruses. There were 13 Rhinovirus/Enterovirus, 11 Influenza (Types A/H1, A/H3, A/H1-2209, and B), 9 Coronavirus (Types NL63, OC43, 229E, and HKU1), 3 RSV, 3 Metapneumovirus, and 3 Parainfluenza (Types 2, 3, and 4). 3 patients had co-infection with CMV and 3 had co-infection with EBV. Allograft rejection occurred within one month of SOTR with RVI in 10.5% (4/38) vs 8.8% (10/114) of SOTR without RVI (P = 0.7504). 7.9% (3/38) required ICU admission, and only 1 required mechanical ventilation. During the follow up period, no mortalities were observed in SOTR who had an RVI. A similar length of stay for SOTR with an RVI vs SOTR without an RVI was observed (8.1 days vs 9.9 days respectively, P = 0.4328). SOTR with an RVI demonstrated a trend towards shorter antibiotic courses compared to SOTR patients without an RVI (6.2 vs 10.3 days respectively, P = 0.1202).

*Conclusions: Although respiratory viral infections are common in SOTR, we observed that allograft rejection and mortality was an uncommon complication in abdominal organ transplant recipients with RVI.

To cite this abstract in AMA style:

Gonzalez M, Vostal A, Darling N, Papastamelos C, Natarajan M, Kumar P, Timpone J. Respiratory Viral Infections and Patient Outcomes in Solid Organ Transplant Recipients [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/respiratory-viral-infections-and-patient-outcomes-in-solid-organ-transplant-recipients/. Accessed November 21, 2024.

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