Author(s)
Anyull Bohorquez, MD
Estephania Candelo, Research Fellow
Karol Avila-Castano, MD
Angela M. Donaldson, MD
Affiliation(s)
Department of Otorhinolaryngology, Mayo Clinic Florida, Jacksonville, FL, USA.;
Abstract:
Introduction:
Chronic rhinosinusitis (CRS) affects approximately 30% of the transplant population. Despite growing research, there is little evidence on the estimated timing in which CRS symptoms develop after transplant. This gap as well as potential differences between solid and non-solid transplantation remains unexplored. We aim to analyze the time to CRS diagnosis after solid versus non-solid transplantation.
Methods:
This retrospective cohort study analyzed 2,128 transplanted patients with a rhinology consult at Mayo Clinic between 2017 and 2022. Patients were categorized into five groups based on time to CRS diagnosis: <6, 6 to 12, 12 to 24, 24 to 60, and > 60 months. A Kaplan-Meier curve was used for time to event analysis and a proportional Cox hazard regression model evaluated mean survival time by transplant type and known risk factors.
Results:
603 transplanted patients developed CRS with 379 (62.9%) having had solid-organ transplant. 50% were diagnosed within the first 36 months. Non-solid transplants experienced earlier diagnoses than solid recipients (median event time: 23 vs. 46 months, p<0.0001). Additionally, non-solid transplants recipients demonstrated an increased propensity for developing CRS during the five years post-transplant (HR:1.79, p=0.005 at six; HR:1.96, p=0.006 from 6-12; HR:2.45, p<0.001 from 12-24; HR:1.67, p=0.001 from 24 to 60 months).
Conclusion:
Half of the transplanted population who develop CRS will be diagnosed within 3 years of transplantation. Physicians should consider the type and timing of transplant, in addition to the presence of risk factors in the effective and timely management of CRS among this population.