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Rhinosinusitis in Solid Organ Transplant Recipients: Analysis of 4562 Transplanted Patients.
- Source :
-
American journal of rhinology & allergy [Am J Rhinol Allergy] 2019 Jan; Vol. 33 (1), pp. 56-61. Date of Electronic Publication: 2018 Oct 26. - Publication Year :
- 2019
-
Abstract
- Introduction: Survival rates of solid organ transplant recipients are steadily increasing. Chronic immunosuppression is a key to sustain the transplanted organ. Thus, these patients are at a higher risk for fulminant disease and severe complications of rhinosinusitis (RS). Surprisingly, this has been scarcely discussed in the literature.<br />Objective: To analyze the characteristics and disease course of RS in solid organ transplant recipients.<br />Materials and Methods: Retrospective study. Medical records of all solid organ transplant recipients with a diagnosis RS treated at a national transplant center between the years 2001 and 2016 were reviewed.<br />Results: Of 4562 solid organ transplant recipients, a documented diagnosis of RS was identified only in 61 (1.3%) patients. Sixty-four patients presented with posttransplantation RS; of them, 54.5% had chronic RS (CRS) and the remaining 45.5% patients were diagnosed with acute RS. Microbial cultures grew almost exclusively bacterial pathogens. A documented invasive fungal infection was noted in only 2 patients. A total of 24 (40%) patients underwent endoscopic sinus surgery, the majority (22) for CRS. On subgroup analysis, surgical intervention was more frequent in lung transplant recipients ( Pā=ā.005). Neither specific disease nor surgical complications were found.<br />Conclusions: Interestingly, acute fulminant infection or sinusitis complications in solid organ transplant patients were much lower than expected. CRS in this patient group was less frequent than expected as well. Whether chronic immunosuppression minimizes the likelihood for CRS deserves further investigation. A more surgically oriented approach in CRS patients may be favored early in the management course of medically refractory patients in light of patients excellent outcomes.
- Subjects :
- Acute Disease
Adult
Chronic Disease
Endoscopy
Female
Follow-Up Studies
Humans
Immunosuppression Therapy adverse effects
Israel epidemiology
Male
Middle Aged
Retrospective Studies
Rhinitis etiology
Sinusitis etiology
Transplant Recipients
Bacterial Infections epidemiology
Organ Transplantation
Postoperative Complications epidemiology
Rhinitis epidemiology
Sinusitis epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1945-8932
- Volume :
- 33
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- American journal of rhinology & allergy
- Publication Type :
- Academic Journal
- Accession number :
- 30362361
- Full Text :
- https://doi.org/10.1177/1945892418808717