Predictive Factors for De-novo Chronic Rhinosinusitis in Transplant Patients

Introduction: Transplant recipients have an increased risk of developing chronic rhinosinusitis (CRS).
Nevertheless, there is a paucity of studies that elucidate the factors contributing to the onset
of de-novo CRS in this population. This study aims to identify predictive factors associated
with the emergence of de-novo CRS in transplant recipients.

Methods: This cohort comprised 1,464 transplant recipients evaluated between 2017 and 2022.
Among these, 509 patients met the inclusion criteria and were classified based on the
diagnosis of de-novo CRS during the post-transplant period. The analysis involved both
univariate and multivariate approaches to determine the odds ratio (OR) and identify
predictive factors.

Results: Among the 1,464 patients, 509 (34.7%) developed CRS. Those diagnosed with CRS
exhibited a higher prevalence of asthma and allergic rhinitis (AR) and primary
immunodeficiency during the pre-transplant period compared to non-CRS patients.
Multivariate analysis revealed that individuals with primary immunodeficiency and those
undergoing additional transplants had a 2-fold and 2.8-fold increased risk, respectively, of
developing de-novo CRS post-transplant (95% CI: 1.3–3.0, p = .001) and (95% CI:
1.01–8.06, p = .04). Additionally, graft-versus-host disease (GVHD) was associated with a
higher likelihood of developing de-novo CRS (OR = 1.4, 95% CI: 1.02–1.9, p = .03).

Conclusions: This study represents the largest cohort to date focused on identifying predictive factors for
the development of de-Novo CRS in transplant recipients. The findings indicate that patients
with asthma, AR, primary immunodeficiency, GVHD, and those requiring additional
transplants have a higher likelihood of developing de-novo CRS post-transplantation.