%0 Multicenter Study
%T Prognostic implications of and clinical risk factors for acute lung injury and organizing pneumonia after lung transplantation: Data from a multicenter prospective cohort study.
%A Pavlisko EN
%A Neely ML
%A Kopetskie H
%A Hwang DM
%A Farver CF
%A Wallace WD
%A Arrossi A
%A Illei P
%A Sever ML
%A Kirchner J
%A Frankel CW
%A Snyder LD
%A Martinu T
%A Shino MY
%A Zaffiri L
%A Williams N
%A Robien MA
%A Singer LG
%A Budev M
%A Tsuang W
%A Shah PD
%A Reynolds JM
%A Weigt SS
%A Belperio JA
%A Palmer SM
%A Todd JL
%J Am J Transplant
%V 22
%N 12
%D 12 2022
%M 36031951
%F 9.369
%R 10.1111/ajt.17183
%X We determined prognostic implications of acute lung injury (ALI) and organizing pneumonia (OP), including timing relative to transplantation, in a multicenter lung recipient cohort. We sought to understand clinical risks that contribute to development of ALI/OP. We analyzed prospective, histologic diagnoses of ALI and OP in 4786 lung biopsies from 803 adult lung recipients. Univariable Cox regression was used to evaluate the impact of early (≤90 days) or late (>90 days) posttransplant ALI or OP on risk for chronic lung allograft dysfunction (CLAD) or death/retransplantation. These analyses demonstrated late ALI/OP conferred a two- to threefold increase in the hazards of CLAD or death/retransplantation; there was no association between early ALI/OP and these outcomes. To determine risk factors for late ALI/OP, we used univariable Cox models considering donor/recipient characteristics and posttransplant events as candidate risks. Grade 3 primary graft dysfunction, higher degree of donor/recipient human leukocyte antigen mismatch, bacterial or viral respiratory infection, and an early ALI/OP event were significantly associated with increased late ALI/OP risk. These data from a contemporary, multicenter cohort underscore the prognostic implications of ALI/OP on lung recipient outcomes, clarify the importance of the timing of these events, and identify clinical risks to target for ALI/OP prevention.