Serum Ammonia Screening and Donor Mollicutes Detection for Hyperammonemia Syndrome Post–Lung Transplantation: A Prospective Observational Study.
Background Hyperammonemia syndrome (HS) is a rare but potentially fatal complication of lung transplantation (LT). Optimal screening methods are unknown. Here we investigated serum ammonia screening (SAS) for HS and compared it with polymerase chain reaction (PCR) for Mollicutes (Urease -producing b...
| Publicado en: | Clinical Infectious Diseases Vol. 81; no. 5; pp. 998 - 1005 |
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| Autores principales: | , , , , , , , , , |
| Formato: | algorithm research tables/charts Journal Article |
| Publicado: |
Oxford University Press / USA
11/15/2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=190481280&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 190481280 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10584838 46X jtl: Clinical Infectious Diseases issn: 10584838 maglogo: N pubinfo: dt: 11/15/2025 vid: 81 iid: 5 pid: 622 pub: Oxford University Press / USA artinfo: ui: 190481280 190481280 190481280 10.1093/cid/ciaf078 190481280 ppf: 998 ppct: 7 formats: tig: atl: Serum Ammonia Screening and Donor Mollicutes Detection for Hyperammonemia Syndrome Post–Lung Transplantation: A Prospective Observational Study. aug: au: Walti, Laura N Ng, Chun Fai Kaur, Simran Almansour, Sarah Mazzulli, Tony Bitterman, Roni Sidhu, Aman Keshavjee, Shaf Chaparro, Cecilia Martinu, Tereza affil: Transplant Infectious Diseases, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, CanadaDepartment of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland sug: subj: Hyperammonemia Epidemiology Hyperammonemia Diagnosis Hyperammonemia Mortality Ammonia Blood Lung Transplantation Adverse Effects Gram-Negative Bacteria Polymerase Chain Reaction Funding Source Human Male Female Middle Age Aged Prospective Studies Nonexperimental Studies Comparative Studies ROC Curve Data Analysis Software Descriptive Statistics Postoperative Complications Bacterial Infections Transplant Donors Transplant Recipients Neurologic Manifestations Tissue Banks Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Background Hyperammonemia syndrome (HS) is a rare but potentially fatal complication of lung transplantation (LT). Optimal screening methods are unknown. Here we investigated serum ammonia screening (SAS) for HS and compared it with polymerase chain reaction (PCR) for Mollicutes (Urease -producing bacteria). Methods All LT recipients from July 2019 to February 2020 and October 2021 to November 2022 with available donor bronchial wash samples from the LT biobank were included. Mollicutes PCR was performed using 2 commercially available kits. Daily ammonia serum levels were measured for the first 14 days. Recipients were prospectively followed for HS for 30 days post-LT. HS was defined by new neurological symptoms and the presence of elevated serum ammonia (>1 × >70 µmol/L). Results Of 241 LT recipients, 5 (2%) developed HS within the first month post-LT. Median time to HS was 8 (interquartile range, 5–10) days. All HS was diagnosed within the first 14 days post-LT, while daily SAS was in place. Ammonia was confirmed elevated (>1 × >70 µmol/L) in 4% (9/241) during follow-up; however, outside of HS, 4 were found to be related to liver disease. Donor and recipient Mollicutes PCR was positive in 8% (19/241) and 1% (1/72), respectively, at transplant. Donor Mollicutes PCR, in contrast to recipient Mollicutes PCR, was associated with HS but only in 2 of the 5 HS cases. No HS patient died within 90 days post-LT. Conclusions HS was a rare complication in our LT cohort. Daily post-LT SAS might add to early HS diagnosis and treatment and is potentially associated with improved outcome. Donor screening with Mollicutes PCR has limited predictive value for HS post-LT. pubtype: Academic Journal doctype: algorithm research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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