Predictive Factors for Development of Chronic Rhinosinusitis in Transplant Recipients

Introduction: Studies suggest that transplant patients have higher risk of developing chronic rhinosinusitis (CRS) compared to general population. However, there is a lack of published data describing which factors may be related to the development of CRS in this population. We aim to determine the risk factors associated with the development of CRS in transplant recipients.

Methods: This is a retrospective chart review of 1318 transplant recipients seen at Mayo Clinic between 2017 and 2022. A total of 1303 patients met inclusion criteria and were divided based on the presence or absence of a CRS diagnosis during the post-transplant period. Univariate and logistic regression analysis were performed to identify odds ratio (OR).

Results: Of the 1303 patients, 711/1303 (54.5%) had CRS. Patients with CRS had increased history of ESS, allergic rhinitis, and recurrent acute rhinosinusitis (p=0.003) in the pre-transplant period. According to the multivariate regression analysis, patients with primary immunodeficiency and leukopenia were 3.18 and 1.78 times more likely to develop CRS (95% CI 1.84 – 5.49, p< 0.0001), (95% CI 1.09 -2.90, p=0.02) during the posttransplant period, respectively. Sirolimus use was also associated with the development of CRS (OR= 1.52, 95% CI 1.03 – 2.23, p=0.032).

Conclusions: To date, this study is the largest longitudinal cohort to determine the predictive factors associated with the development of CRS in the post-transplant period. Patients with pretransplant rhinologic conditions, hematologic deficiencies, and use of specific immunosuppressants were more likely to develop CRS after transplantation.