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


Authors: Lowery, E. M.; Bemiss, B.; Cascino, T.; Durazo-Arvizu, R. A.; Forsythe, S. M.; Alex, C.; Laghi, F.; Love, R. B.; Camacho, P
Article Title: Low vitamin D levels are associated with increased rejection and infections after lung transplantation.
Abstract: 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. Copyright 2012 International Society for Heart and Lung Transplantation. All rights reserved.
Keywords: Adult; Aged; Female; Humans; Middle Aged; Male; Retrospective Studies; Risk Factors; Survival Rate; Cohort Studies; IM; Incidence; Kaplan-Meier Estimate; Pulmonary and Critical Care Medicine; Lung transplantation; Cystic Fibrosis/su [Surgery]; Graft Rejection/ep [Epidemiology]; Lung Transplantation/mo [Mortality]; Pulmonary Disease, Chronic Obstructive/su [Surgery]; Respiratory Tract Infections/ep [Epidemiology]; Vitamin D/bl [Blood]; Vitamin D Deficiency/bl [Blood]; Vitamin D Deficiency/co [Complications]
Journal Title: Journal of Heart Lung Transplantation
Volume: 31
Issue: 7
ISSN: 1053-2498
Publisher: Unknown  
Journal Place: United States
Date Published: 2012
Start Page: 700
End Page: 707
Language: English
DOI/URL:
Notes: ID: 12625; Status: MEDLINE; Comments: Comment in: J Heart Lung Transplant. 2012 Jul;31(7):789-90; PMID: 22595753; Publishing Model: Journal available in: Print-Electronic Citation processed from: Internet; NLM Journal Code: a0q, 9102703
LUC Authors
  1. Pauline Camacho
    25 Camacho
  2. Franco Laghi
    12 Laghi
  3. Erin Lowery
    17 Lowery
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