02740nas a2200277   4500008004100000020001400041024001700055245013700072210006900209260031200278300001400590490000700604520155000611653003802161653002502199653002502224100002202249700001902271700002002290700001902310700001902329700002302348700002102371700002102392856004902413       2005                        eng d  a0041-1337  awej, 013214400aChlamydia pneumoniae Serology in Donors and Recipients and the Risk of Bronchiolitis Obliterans Syndrome after Lung Transplantation.0 aChlamydia pneumoniae Serology in Donors and Recipients and the R  a(C) 2005 Lippincott Williams & Wilkins, Inc.b(1) Department of Respiratory Medicine and Heart-Lung Transplant Service, Alfred Hospital, Melbourne, Australia.(2) Department of Medicine, Monash University, Melbourne, Australia.(3) Department of Microbiology and Infectious Diseases, Alfred Hospital, Mec2005  a269 - 2750 v793 aBackground. Bronchiolitis obliterans syndrome (BOS) is a common late complication in lung transplant recipients (LTR). Chlamydia pneumoniae (C. pneumoniae) is a common but difficult to diagnose respiratory pathogen with a propensity to latency., Methods. We studied the impact of C. pneumoniae on BOS development using donor-recipient serology obtained before transplantation in a cohort of 76 LTR., Results. BOS was present in 29.9% patients (mean follow-up 866 days). High donor C. pneumoniae immunoglobulin (Ig)G titers were associated with BOS in the recipient (area under the curve [AUC] 0.71, 95% confidence interval [CI] 0.52-0.91, P=0.027), whereas high recipient titers were inversely associated with BOS (AUC 0.27, 95% CI 0.11-0.44, P=0.018). The risk of developing BOS was 75.0% in the case of a primary seromismatch for C. pneumoniae (D+/R-), whereas a reverse mismatch had a risk of 4.6% (likelihood ratio 9.8, P=0.02). In a multivariate model that included human leukocyte antigen matching, acute rejection and cytomegalovirus pneumonitis, C. pneumoniae IgG donor 32 or greater and C. pneumoniae IgG recipient 32 or greater remained positive and negative independent risk factors, respectively, for BOS in LTR. In the freedom from BOS analysis, BOS occurred more frequently and earlier in C. pneumoniae seropositive donors, and the reverse was true in seronegative recipients., Conclusion. C. pneumoniae serology in donor and recipient is associated with the development of BOS in LTR., (C) 2005 Lippincott Williams & Wilkins, Inc.10aBronchiolitis obliterans syndrome10aChlamydia pneumoniae10aLung Transplantation1 aKotsimbos, Thomas1 aSnell, Gregory1 aLevvey, Bronwyn1 aSpelman, Denis1 aFuller, Andrew1 aWesselingh, Steven1 aWilliams, Trevor1 aOstergaard, Lars  uhttps://www.notifylibrary.org/reference/4258