A study of the pneumology research group of the Vall d'Hebron Research Institute (VHIR) has received the award for the best basic research work in lung transplant at the congress of the European Respiratory Society (ERS). The meeting held in Barcelona brought together more than 19,000 experts in respiratory diseases, making it one of the most important events in the specialty. The research carried out by Victoria Ruiz and led by Dr. Antonio Román and Dr. Susana Gómez has analyzed the evolution of the microbiome present in the upper airways of patients who have received a lung transplant. They have found that people who one year after the intervention current significant changes in the composition of microorganisms in their nasal cavity are more likely to develop chronic lung allograft dysfunction (CLAD).
A patient is diagnosed with CLAD when after having acquired good respiratory capacity following the transplant there is a persistent and irreversible loss of function of the new organ. According to the latest international registries, CLAD results in the death of 30-40% of lung transplant patients after the first year after the operation. Currently, the determining cause that favors the development of CLAD is unknown and it has different forms of presentation, a fact that complicates its treatment and prevention.
The new study has established the relationship between the nasopharyngeal microbiome and the development of CLAD. To do so, 68 patients who received a lung transplant were followed up. All of them experienced a reduction in the diversity of the microbiota present in the nose and pharynx during the first months post-transplant, but this diversity gradually recovered after one year. However, while in one group of the patients analyzed the "new" microbiome had a composition similar to that of healthy people, others were not able to re-establish the pre-operative microbiome. It was this second group that were diagnosed with CLAD. The study seems to indicate that early detection of dysfunction could be made by analyzing the composition of the upper airway microbiome of transplanted patients in the year of the intervention, this early detection would enable a better response to treatment.