Abstract
Survival in lung transplant recipients (LTRs) lags behind heart, liver, and kidney
transplant, in part due to the direct and indirect effects of infection. LTRs have
increased susceptibility to infection due to the combination of a graft continually
exposed to the outside world, multiple mechanisms for impaired mucus clearance, and
immunosuppression. Community-acquired respiratory viral infections (CARVs) are common
in LTRs. Picornaviruses have roughly 40% cumulative incidence followed by respiratory
syncytial virus and coronaviruses. Although single-center retrospective and prospective
series implicate CARV in rejection and mortality, conclusive evidence for and well-defined
mechanistic links to long-term outcome are lacking. Treatment of viral infections
can be challenging except for influenza. Future studies are needed to develop better
treatments and clarify the links between CARV and long-term outcomes.
Keywords
lung transplantation - lung allograft rejection - influenza - respiratory syncytial
virus - adenovirus - parainfluenza
