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. 2021 Dec;9(4):1716-1723.
doi: 10.1002/iid3.527. Epub 2021 Sep 21.

Airway cilia recovery post lung transplantation

Randy Suryadinata  1   2 , Kovi Levin  3 , Lynda Holsworth  3 , Miranda Paraskeva  3 , Philip Robinson  1   2   4
Affiliations

Airway cilia recovery post lung transplantation

Randy Suryadinata et al. Immun Inflamm Dis. 2021 Dec.

Abstract

Background: Normally functioning airway cilia is essential for efficient mucociliary clearance to protect the airway from various insults. Impaired clearance may lead to increased risk of infections and progressive lung damage. Significant morbidity in the immediate post lung transplantation period is associated with airway infection, which we hypothesize may be caused by impaired cilia function.

Methods: Airway cilia beating pattern (CBP) and frequency (CBF) were studied on brushing samples taken from above and below the transplant anastomosis of adult lung transplant recipients (n = 20) during routine bronchoscopies at 6, 12, and 26 weeks posttransplant. Bronchoaveolar Lavage (BAL) samples were also collected at each time points.

Results: At 6 weeks posttransplant (n = 16), CBP from the donated lung showed reduced beating amplitude with the overall CBF 2.28 Hz slower than the patients' native upper airway cilia (median ± SIQR: 5.36 ± 0.93 Hz vs. 7.64 ± 0.92 Hz, p value < .001). At 12 weeks (n = 16), donor lungs CBP showed recovery with the difference in CBF reduced to 0.74 Hz (6.36 ± 1.46 Hz vs. 7.10 ± 0.86 Hz, p value < .05). Impaired cilia function was not associated with positive BAL cultures.

Conclusion: Reduced cilia function is evident in the first 12 weeks post lung transplant, with both CBP and CBF returning to levels of function indistinguishable to the patients' upper airway cilia beyond this time.

Keywords: cilia; lung transplantation; mucociliary clearance.

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Conflict of interest statement

The authors declare that there are no conflict of interests.

Figures

Figure 1
Figure 1
Cilia beat frequency analysis (CBF) following lung transplantation. Median ± SIQR CBF of donor lungs' cilia (white bars) and patients' native cilia (black bars) were compared. (A) Donor lungs' CBF was significantly slower than the patients' native CBF at 6 weeks posttransplant. The CBF of the donor lungs showed significant improvement at 12 weeks posttransplant (n = 16). (B) Continuing improvement in CBF was observed in the donor lungs at 26 weeks posttransplant, with minimal difference in CBF between the donor lungs' cilia and patients' native cilia recorded (n = 14). Statistical significance of p value < .05 (*) and p value < .001 (**) were demonstrated
Figure 2
Figure 2
Relationship between intensive care unit (ICU) intubation time and donor lungs' cilia function following transplantation. A Spearman's correlation analysis revealed a weak negative correlation (R = −0.4957) between time spent in ICU for postoperative intubation and the associated donor lungs' CBF assessed at 6 weeks posttransplant (n = 17). CBF, cilia beat frequency
Figure 3
Figure 3
Correlation analysis between organ ischemic time and donor lungs' cilia function post‐transplant. A Spearman's correlation analysis revealed no association (R = −0.043) between ischemic time and donor lungs' CBF assessed at 6 weeks posttransplant (n = 19). CBF, cilia beat frequency
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