Presented in part at the World Transplant Congress, Boston, MA, July 2006.
Clinical and Radiologic Factors Associated with Pulmonary Nodule Etiology in Organ Transplant Recipients
Article first published online: 16 OCT 2006
American Journal of Transplantation
Volume 6, Issue 11, pages 2759–2764, November 2006
How to Cite
Copp, D. H., Godwin, J. D., Kirby, K. A. and Limaye, A. P. (2006), Clinical and Radiologic Factors Associated with Pulmonary Nodule Etiology in Organ Transplant Recipients. American Journal of Transplantation, 6: 2759–2764. doi: 10.1111/j.1600-6143.2006.01545.x
- Issue published online: 16 OCT 2006
- Article first published online: 16 OCT 2006
- Received 7 June 2006, revised and accepted for publication 1 August 2006.
- pulmonary nodule;
Identifying clinical and radiographic factors that are associated with a specific etiology of pulmonary nodules (PNs) in solid-organ transplant (SOT) recipients might be helpful in guiding empiric therapy. Multivariable logistic regression was used to assess the relationship of clinical and radiographic variables to the etiology of PN in a retrospectively identified cohort of SOT recipients at a single transplant center. PNs in 55 SOT recipients (lung 15%, heart 22%, liver 42%, kidney 18% or kidney/pancreas 5%) were diagnosed at a mean of 1061 days post-transplant and were infectious in 31 of 55 (56%) (bacterial 22%, fungal 33%, viral 2%) and noninfectious in 24 of 55 (44%) [post-transplant lymphoproliferative disorder (PTLD) 25%, carcinoma 18%]. Radiographic ‘consolidation’ was independently associated with an infectious etiology (OR, 20.2, p < 0.01). Epstein-Barr virus seronegativity and lung transplant were each associated with PTLD (OR, 21.7, p < 0.01) and (OR, 36.6, p < 0.001), respectively. Diagnosis less than 90 days post-transplant was associated with Aspergillus infection (OR, 12.9, p = 0.007). Specific clinical and radiographic features are associated with specific etiologies of PNs in SOT recipients and might be useful for guiding empiric therapy while awaiting results of definitive diagnostic studies.