The role of upper and lower respiratory tract microbiota as a prognostic marker for complication-free survival after lung transplantation
Culture-independent microbiological methods have become increasingly popular in the past decade as they can provide a fast and comprehensive approach for analyzing complex microbial communities. Assessing these microbial communities as a risk factor in complex epidemiological studies has been described as a major task for epidemiological research in a recent review in the American Journal of Epidemiology. Changes in lung and lower airway microbiota after lung transplantation have been proposed as a potential risk factor for post-transplant immune-mediated complications. In these patients the lung is transplanted with its microbial colonization from the donor to the recipient, bringing together the lower respiratory microbiome of the donor with the upper respiratory microbiome of the recipient and a heavily suppressed immune system. However, given that patients after lung transplantation often receive antibiotics which might also introduce changes in microbial colonization it is not clear to what extent the different effects contribute to the development of the post-transplant microbiome. While bacterial and viral infectious complications after transplantation are an important risk factor for graft rejection due to their role in the development of BOS in the long-term, they are also the major cause of death in the first 6 months after transplantation. It is the aim of our study to assess the effect of changes in the microbial colonization of the upper and lower respiratory tract on infectious and immunological complications after lung transplantation.
This project is funded by the German Centre for Infection Research (DZIF).