(341) Effect of Statin Use for Aspergillosis Post Lung Transplant (LT) - A Multicenter Study

PurposeStatin use was associated with lower Invasive Aspergillosis (IA) rates in LT recipients in our published North American single center study. Confirmation in larger studies is lacking. In addition, the effect of statin use on Aspergillus colonization (AC) is unknown. We therefore investigated the association of statins with IA and AC in a multicenter study.MethodsLT recipients transplanted January 2010 to December 2019 were followed for 1 year after transplantation. We combined the published data (n=791) with an additional center in Europe (n=293). IA and AC were established as per ISHLT criteria. We evaluated the impact of factors including statin use on the development of IA and AC using multivariable logistic regression models.ResultsWe included 1083 LT recipients with 98 IA events (9%) in the first year post-LT. Median time to IA was 101 days (d) (IQR 46-180). Overall, 600/1083 (55%) received statins; median time from LT to statin start was 6 d (IQR 1-35). In univariable analyses, female sex (OR 0.53, p=0.005), CMV-viremia (OR 1.7, p=0.013), AC post-LT (3.21, p<0.001), universal prophylaxis strategy (1.79, p=0.017) and statin use (OR 0.36, p<0.001) were associated with IA, while age, underlying disease, single LT and pre-LT AC were not. Moreover, in multivariable analysis, only statin use (OR 0.32, p<0.001), AC post-LT (OR 3.54, p<0.001) and female sex (OR 0.45, p=0.002) were associated with IA Table A. AC was seen in 283 LT recipients (26%) during follow-up, median time to AC was 85 d (IQR 1-187). In univariable analyses, Cystic Fibrosis (OR 1.93, p=0.001), pre-LT AC (OR 2.56, p<0.001), universal prophylaxis strategy (OR 0.49, p<0.001) and statin use (OR 0.49, p<0.001) were associated with AC. In multivariable analysis, only pre-LT AC (OR 2.12, p=0.001), universal prophylaxis strategy (OR 0.25, p<0.001) and statin use (OR 0.43, p<0.001) were associated with AC Table B.ConclusionIn this multicentre study including >1000 LT recipients, statin use was associated with a reduction in IA as well as AC in the first year post-LT. Statin use was associated with lower Invasive Aspergillosis (IA) rates in LT recipients in our published North American single center study. Confirmation in larger studies is lacking. In addition, the effect of statin use on Aspergillus colonization (AC) is unknown. We therefore investigated the association of statins with IA and AC in a multicenter study. LT recipients transplanted January 2010 to December 2019 were followed for 1 year after transplantation. We combined the published data (n=791) with an additional center in Europe (n=293). IA and AC were established as per ISHLT criteria. We evaluated the impact of factors including statin use on the development of IA and AC using multivariable logistic regression models. We included 1083 LT recipients with 98 IA events (9%) in the first year post-LT. Median time to IA was 101 days (d) (IQR 46-180). Overall, 600/1083 (55%) received statins; median time from LT to statin start was 6 d (IQR 1-35). In univariable analyses, female sex (OR 0.53, p=0.005), CMV-viremia (OR 1.7, p=0.013), AC post-LT (3.21, p<0.001), universal prophylaxis strategy (1.79, p=0.017) and statin use (OR 0.36, p<0.001) were associated with IA, while age, underlying disease, single LT and pre-LT AC were not. Moreover, in multivariable analysis, only statin use (OR 0.32, p<0.001), AC post-LT (OR 3.54, p<0.001) and female sex (OR 0.45, p=0.002) were associated with IA Table A. AC was seen in 283 LT recipients (26%) during follow-up, median time to AC was 85 d (IQR 1-187). In univariable analyses, Cystic Fibrosis (OR 1.93, p=0.001), pre-LT AC (OR 2.56, p<0.001), universal prophylaxis strategy (OR 0.49, p<0.001) and statin use (OR 0.49, p<0.001) were associated with AC. In multivariable analysis, only pre-LT AC (OR 2.12, p=0.001), universal prophylaxis strategy (OR 0.25, p<0.001) and statin use (OR 0.43, p<0.001) were associated with AC Table B. In this multicentre study including >1000 LT recipients, statin use was associated with a reduction in IA as well as AC in the first year post-LT.