Comparative Analysis of Chronic Rhinosinusitis Phenotypes and Endotypes in Transplant Recipients

Tuesday, October 1, 2024

8:54 AM – 9:00 AM EDT

Location: MBCC, 230

Disclosure(s):

Natalie R. Weiss, MD, MBA:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Katerina J. Green, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Karol Avila-Castano, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Angela M. Donaldson, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: As rates of organ transplantation increase, understanding the burden of rhinologic diseases in the post-transplant population becomes increasingly important. This study aims to provide insight into the prevalence of chronic rhinosinusitis (CRS) phenotypes and endotypes in patients who have undergone solid organ (SOT) versus non-solid organ transplants (NSOT).

Methods: Post-transplant patients seen from 2017-2022 in the Mayo Clinic Rhinology Clinic with CRS were identified through retrospective chart review. They were categorized into two cohorts: SOT and NSOT. Chi-square analysis was used to compare the categorical measures of CRS endotypes between cohorts and analyze endotype differences between patients who required endoscopic sinus surgery (ESS) and those who did not. Endotypes included CRS with nasal polyps (CRSwNP) and without nasal polyps (CRSsNP), acute invasive fungal sinusitis, allergic fungal rhinosinusitis, odontogenic infection, and mycetoma.

Results: In total, 573 post-transplant patients with CRS were identified. Of these, 372/573 (57.1% ) received SOT and 246/573 (42.9%) received NSOT. Mycetoma was the only endotype with a statistically significant difference between SOT and NSOT [7/372 vs 0/246, 2.1% vs 0.0%, p=0.021], respectively. In the total cohort, odontogenic sinusitis was the most common endotype with (35/573, 6.1%) and CRSsNP had a higher incidence (477/573, 83.2%) in comparison to CRSwNP (71/573, 12.4%). A high proportion of those with CRSsNP developed recalcitrant disease requiring ESS (161/477, 33.8%).

Conclusions: Among post-transplant patients, CRSsNP was the most common phenotype encountered and frequently had recalcitrant disease. Mycetoma was encountered exclusively in the SOT cohort, while other endotypes occurred with similar frequencies between NSOT and SOT groups.

Presenting Author(s)

Natalie R. Weiss, MD, MBA

Resident Physician
Mayo Clinic Florida
Jacksonville, FL, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

KG

Katerina J. Green, MD

Resident
Mayo Clinic Florida
Jacksonville, Florida, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Estephania Candelo, MD, MSc

Resident Physician
University of Washington
Jacksonville, Florida, United States

Disclosure information not submitted.
Karol Avila-Castano, MD

Research Fellow
Mayo Clinic Florida
Jacksonville, Florida, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Senior Author(s)

Angela M. Donaldson, MD

Associate Professor of Otolaryngology I Rhinology and Anterior Skull Base
Mayo Clinic in Florida
Jacksonville, FL, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.