Colonization With Small Conidia Aspergillus Species Is Associated With Bronchiolitis Obliterans Syndrome: A Two-Center Validation Study
Aspergillus colonization is common after lung transplantation. Size of conidia may be important for the virulence of Aspergillus species. Weigt et al. performed a retrospective review of 780 lung transplant patients from two U.S. centers. Patients colonized with small conidia Aspergillus (but not large conidia species) had a significantly greater risk for developing bronchiolitis obliterans syndrome (BOS). The small conidia Aspergillus species were also associated with mortality. This finding may be due to the ability of smaller conidia to deposit in the small airways. In this study, it is difficult to determine whether Aspergillus colonization lead to BOS or the environment of obliterative bronchiolitis promoted colonization with Aspergillus. Nevertheless, this study lends further support for using prophylaxis strategies to prevent colonization with Aspergillus.