{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T01:05:28Z","timestamp":1791248728366,"version":"4.1.0"},"reference-count":43,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2004,7,1]],"date-time":"2004-07-01T00:00:00Z","timestamp":1088640000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2004,7,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Bronchiolitis obliterans syndrome (BOS) is the major obstacle to long-term survival after lung transplantation, in part because its pathogenesis is poorly understood and treatment options are limited. To identify unique risk factors for BOS and death, we performed a retrospective cohort study on 259 consecutive adult lung transplant recipients over a 5-year period. The demographic and clinical characteristics of this population were analyzed for an association between BOS or death and potential risk factors, including community-acquired respiratory viral (CARV) infections, acute rejection, and cytomegalovirus pneumonitis. Respiratory syncytial virus, parainfluenza, influenza, and adenovirus accounted for 21 CARV infections. Univariate and multivariate time-dependent Cox regression analyses demonstrated that this CARV group was more likely to develop BOS, death, and death from BOS. Furthermore, these trends were more pronounced in patients with evidence of lower respiratory tract-CARV (lower-CARV) infections. Notably, the CARV and lower-CARV infections were risk factors for BOS, death, and death from BOS distinct from the risk attributable to acute rejection. Identification of CARV and lower-CARV infections as BOS and mortality risk factors has important clinical implications and may provide insight into disease pathogenesis and accelerate the development of novel treatment strategies to modify post-CARV BOS.<\/jats:p>","DOI":"10.1164\/rccm.200310-1359oc","type":"journal-article","created":{"date-parts":[[2004,5,10]],"date-time":"2004-05-10T20:53:33Z","timestamp":1084222413000},"page":"181-187","source":"Crossref","is-referenced-by-count":274,"title":["Respiratory Viral Infections Are a Distinct Risk for Bronchiolitis Obliterans Syndrome and Death"],"prefix":"10.1093","volume":"170","author":[{"given":"Anthony P.","family":"Khalifah","sequence":"first","affiliation":[{"name":"Divisions of Pulmonary and Critical Care Medicine, Biostatistics, and Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramsey R.","family":"Hachem","sequence":"additional","affiliation":[{"name":"Divisions of Pulmonary and Critical Care Medicine, Biostatistics, and Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murali M.","family":"Chakinala","sequence":"additional","affiliation":[{"name":"Divisions of Pulmonary and Critical Care Medicine, Biostatistics, and Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth B.","family":"Schechtman","sequence":"additional","affiliation":[{"name":"Divisions of Pulmonary and Critical Care Medicine, Biostatistics, and Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. Alexander","family":"Patterson","sequence":"additional","affiliation":[{"name":"Divisions of Pulmonary and Critical Care Medicine, Biostatistics, and Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel P.","family":"Schuster","sequence":"additional","affiliation":[{"name":"Divisions of Pulmonary and Critical Care Medicine, Biostatistics, and Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thalachallour","family":"Mohanakumar","sequence":"additional","affiliation":[{"name":"Divisions of Pulmonary and Critical Care Medicine, Biostatistics, and Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elbert P.","family":"Trulock","sequence":"additional","affiliation":[{"name":"Divisions of Pulmonary and Critical Care Medicine, Biostatistics, and Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Walter","sequence":"additional","affiliation":[{"name":"Divisions of Pulmonary and Critical Care Medicine, Biostatistics, and Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2004,7,15]]},"reference":[{"key":"2026032606260097800_BIB1","first-page":"625","volume-title":"J Heart Lung Transplant","year":"2003"},{"key":"2026032606260097800_BIB2","first-page":"440","volume-title":"Am J Respir Crit Care Med","year":"2002"},{"key":"2026032606260097800_BIB3","first-page":"297","volume-title":"J Heart Lung Transplant","year":"2002"},{"key":"2026032606260097800_BIB4","first-page":"311","volume-title":"Eur J Cardiothorac Surg","year":"1998"},{"key":"2026032606260097800_BIB5","first-page":"195","volume-title":"J Thorac Cardiovasc Surg","year":"1997"},{"key":"2026032606260097800_BIB6","first-page":"1255","volume-title":"J Heart Lung Transplant","year":"1998"},{"key":"2026032606260097800_BIB7","first-page":"829","volume-title":"Am J Respir Crit Care Med","year":"1999"},{"key":"2026032606260097800_BIB8","first-page":"1200","volume-title":"J Heart Lung Transplant","year":"1996"},{"key":"2026032606260097800_BIB9","first-page":"828","volume-title":"J Heart Lung Transplant","year":"1999"},{"key":"2026032606260097800_BIB10","first-page":"1168","volume-title":"Chest","year":"2002"},{"key":"2026032606260097800_BIB11","first-page":"1155","volume-title":"Transplantation","year":"1999"},{"key":"2026032606260097800_BIB12","first-page":"799","volume-title":"Transplantation","year":"2002"},{"key":"2026032606260097800_BIB13","first-page":"271","volume-title":"J Heart Lung Transplant","year":"2002"},{"key":"2026032606260097800_BIB14","first-page":"362","volume-title":"Ann Surg","year":"1999"},{"key":"2026032606260097800_BIB15","first-page":"79","volume-title":"Transpl Int","year":"2000"},{"key":"2026032606260097800_BIB16","first-page":"1277","volume-title":"Chest","year":"2001"},{"key":"2026032606260097800_BIB17","first-page":"416","volume-title":"J Heart Lung Transplant","year":"1997"},{"key":"2026032606260097800_BIB18","first-page":"944","volume-title":"Chest","year":"1998"},{"key":"2026032606260097800_BIB19","first-page":"479","volume-title":"J Heart Lung Transplant","year":"1995"},{"key":"2026032606260097800_BIB20","first-page":"2004","volume-title":"Clin Infect Dis","year":"2001"},{"key":"2026032606260097800_BIB21","first-page":"287","volume-title":"Am J Transplant","year":"2002"},{"key":"2026032606260097800_BIB22","first-page":"617","volume-title":"J Thorac Cardiovasc Surg","year":"1998"},{"key":"2026032606260097800_BIB23","first-page":"559","volume-title":"J Heart Lung Transplant","year":"2002"},{"key":"2026032606260097800_BIB24","first-page":"754","volume-title":"J Heart Lung Transplant","year":"2003"},{"key":"2026032606260097800_BIB25","first-page":"468","volume-title":"Am J Respir Crit Care Med","year":"2004"},{"key":"2026032606260097800_BIB26","first-page":"1","volume-title":"J Heart Lung Transplant","year":"1996"},{"key":"2026032606260097800_BIB27","first-page":"648","volume-title":"Transplantation","year":"1998"},{"key":"2026032606260097800_BIB28","first-page":"1017","volume-title":"Am Rev Respir Dis","year":"1993"},{"key":"2026032606260097800_BIB29","first-page":"221","volume-title":"J Infect","year":"1999"},{"key":"2026032606260097800_BIB30","first-page":"339","volume-title":"J Clin Virol","year":"2003"},{"key":"2026032606260097800_BIB31","first-page":"171","volume-title":"J Clin Virol","year":"2002"},{"key":"2026032606260097800_BIB32","first-page":"935","volume-title":"J Heart Lung Transplant","year":"2001"},{"key":"2026032606260097800_BIB33","first-page":"418","volume-title":"Transplantation","year":"1994"},{"key":"2026032606260097800_BIB34","first-page":"1583","volume-title":"Transplantation","year":"1995"},{"key":"2026032606260097800_BIB35","first-page":"339","volume-title":"J Exp Med","year":"2001"},{"key":"2026032606260097800_BIB36","first-page":"19","volume-title":"Physiol Rev","year":"2002"},{"key":"2026032606260097800_BIB37","first-page":"165","volume-title":"J Clin Invest","year":"2002"},{"key":"2026032606260097800_BIB38","first-page":"6866","volume-title":"J Immunol","year":"2003"},{"key":"2026032606260097800_BIB39","first-page":"1757","volume-title":"Transplantation","year":"1996"},{"key":"2026032606260097800_BIB40","first-page":"627","volume-title":"J Heart Lung Transplant","year":"1999"},{"key":"2026032606260097800_BIB41","first-page":"461","volume-title":"J Immunol","year":"2000"},{"key":"2026032606260097800_BIB42","first-page":"721","volume-title":"J Heart Lung Transplant","year":"2002"},{"key":"2026032606260097800_BIB43","first-page":"541","volume-title":"Lancet","year":"1999"}],"container-title":["American Journal of Respiratory and Critical Care Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajrccm\/article-pdf\/170\/2\/181\/67497277\/ajrccm_170_2_181.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajrccm\/article-pdf\/170\/2\/181\/67497277\/ajrccm_170_2_181.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T10:26:08Z","timestamp":1774520768000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajrccm\/article\/170\/2\/181\/8538654"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,7]]},"references-count":43,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2004,7,15]]},"published-print":{"date-parts":[[2004,7,15]]}},"URL":"https:\/\/doi.org\/10.1164\/rccm.200310-1359oc","relation":{},"ISSN":["1073-449X","1535-4970"],"issn-type":[{"value":"1073-449X","type":"print"},{"value":"1535-4970","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2004,7]]},"published":{"date-parts":[[2004,7]]}}}