{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T10:10:50Z","timestamp":1789207850154,"version":"build-2803163510"},"reference-count":17,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pleural space infections (PSI) are a common complication after lung transplantation (LT) and have historically been linked to impaired allograft function and decreased survival, though contemporary outcome data are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort included adult LT recipients (LTRs) who underwent pleural effusion drainage \u2264\u00a090 days posttransplant from June 2013 to December 2023. Pulmonary function tests (PFTs; FEV1 and FVC percent predicted) and 1\u2010year survival were compared between LTRs with and without culture\u2010proven PSI using linear mixed\u2010effects models. Survival was analyzed using an adjusted Cox proportional hazards model controlling for restrictive lung disease, with Kaplan\u2013Meier curves to visualize survival trajectories. PSI diagnosis, microbiology, and management considerations were also described.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 1005 LTRs, 7% developed PSI (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a072) and 30% had sterile effusions (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0304). A pleural neutrophil percentage &gt;\u00a021% predicted infection with 71% sensitivity and 76% specificity. Gram\u2010positive bacteria and\n                      <jats:italic>Candida<\/jats:italic>\n                      comprised 80% of isolates. Median antimicrobial treatment was 4 weeks, combined with pleural drainage. Surgical intervention within 30 days of nonoperative drainage was more frequent in PSI patients (22% vs. 7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001; two\u2010thirds VATS procedures). PSI was associated with modest early pulmonary impairment (\u223c4%\u20137% lower PFTs), primarily reflecting stable (non\u2010improving) values from Months 1 to Month 2. However, both groups showed similar trajectories thereafter, with &gt;10% absolute PFT improvement from Month 1 to Month 12. One\u2010year survival was 93% (PSI) versus 94% (non\u2010PSI) (HR: 1.23, 95% CI: 0.44\u20134.43,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.69).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      PSI remains frequent post\u2010LT but with contemporary management\u2014including drainage, antimicrobials, and early surgical intervention\u2014may no longer carry excess risk for sustained allograft dysfunction or death relative to pleural effusions without associated infection.\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/tid70200-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tid.70200","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T10:24:48Z","timestamp":1772965488000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Characteristics and Clinical Outcomes of Postoperative Pleural Space Infections Among Lung Transplant Recipients"],"prefix":"10.1111","volume":"28","author":[{"given":"Miranda","family":"Arzate","sequence":"first","affiliation":[{"name":"Department of Pharmacy Services St. Joseph's Hospital and Medical Center Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"Nailor","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services St. Joseph's Hospital and Medical Center Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2821-8776","authenticated-orcid":false,"given":"Sofya","family":"Tokman","sequence":"additional","affiliation":[{"name":"Division of Transplant Pulmonology Norton Thoracic Institute Dignity Health St. Joseph's Hospital and Medical Center  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Curt","family":"Bay","sequence":"additional","affiliation":[{"name":"Department of Interdisciplinary Health Science Arizona School of Health Science  Mesa Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katelyn","family":"Madrid","sequence":"additional","affiliation":[{"name":"Office of Research and Sponsored Programs Midwestern University College of Pharmacy  Glendale Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9736-0891","authenticated-orcid":false,"given":"Kellie J.","family":"Goodlet","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice Midwestern University College of Pharmacy  Glendale Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,6]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2020.06.052"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.08\u20101339"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1053\u20102498(02)01230\u20105"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.115.5.1312"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022\u20105223(05)80005\u20104"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.14267"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.70234"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciab752"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2017.01.030"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.15040"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2007.10.096"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2016.02.014"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2013.033"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.117.6.1672"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaa656"},{"issue":"12","key":"e_1_2_8_17_1","first-page":"1454","article-title":"Sat\u201077. Impact of Candida Respiratory Colonization on Pleural Space Infection Risk After Lung Transplantation","volume":"8","author":"Goodlet K. 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