Low vitamin D levels are associated with increased rejection and infections after lung transplantation

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• 作者：Erin M. Lowery ; MD^a ; ^{elowery@lumc.edu} ; Bradford Bemiss ; MD^b ; Thomas Cascino ; BS^c ; Ramon A. Durazo-Arvizu ; PhD^d ; Sean M. Forsythe ; MD^a ; Charles Alex ; MD^a ; Franco Laghi ; MD^a ; Robert B. Love ; MD^e ; Pauline Camacho ; MD^f
• 关键词：lung transplantation ; vitamin D ; rejection ; infection ; survival
• 刊名：The Journal of Heart and Lung Transplantation
• 出版年：2012
• 期刊代码：161_10532498
• 类别：med
• 出版时间：July, 2012
• 卷：31
• 期：7
• 页码：700-707
• 文件大小：640 K

摘要

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Background

The prevalence of vitamin D deficiency in lung disease is greater than in the general population. Vitamin D deficiency may negatively affect immune and lung function. Accordingly, we hypothesized that lung transplant recipients with vitamin D deficiency are more susceptible to rejection and infections after transplantation.

Methods

Transplant outcomes were reviewed in a retrospective cohort of 102 lung transplant recipients who had 25-hydroxyvitamin D [25(OH)D] levels drawn during the near-transplant period (100 days pre- or post-transplant).

Results

In the near-transplant period, 80%of recipients were 25(OH)D-deficient and 20%were not 25(OH)D-deficient. Episodes of acute cellular rejection in the deficient group were more frequent than in the non-deficient group [mean 1.27 (0.99 to 1.55) vs 0.52 (0.12 to 0.93), p = 0.006]. The rejection rate in the deficient group was more than double that of the the non-deficient group [IRR 2.43 (1.30 to 4.52), p = 0.005]. Infectious episodes were also more frequent in the deficient group than in the non-deficient group [mean 4.01 (3.24 to 4.79) vs 2.71 (1.47 to 3.96), p = 0.04]. The mortality rate of recipients who remained 25(OH)D-deficient 1 year after transplant was almost 5-fold higher than in recipients who were not 25(OH)D-deficient [IRR 4.79 (1.06 to 21.63), p = 0.04].

Conclusions

Low serum 25(OH)D levels in lung transplant recipients were associated with increased incidence of acute rejection and infection. The mortality of recipients who remained deficient 1 year post-transplant was higher than that of recipients who maintained normal vitamin D levels at 1 year post-transplant.