Respiratory viral infections in lung transplantation: Recent advances in epidemiology, clinical impact, and therapeutic approaches

Respiratory viruses encompass a diverse group of viruses, including influenza, respiratory syncytial virus (RSV), parainfluenza (PIV), human metapneumovirus (hMPV), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and adenovirus. Lung transplant recipients are particularly vulnerable to complications from respiratory viral infections (RVIs), leading to increased morbidity and mortality. This heightened risk is a result of both anatomical and functional modifications from transplant surgery, as well as immunosuppressive therapy. Beyond the immediate morbidity associated with infection, RVIs are also recognized for their association with both acute rejection and chronic lung allograft dysfunction (CLAD)/bronchiolitis obliterans syndrome (BOS). This article provides updated insights into epidemiology, clinical outcomes, prevention strategies, and treatment options for RVIs in lung transplant recipients.