SDC, Table 1: clinical characteristics of the 60 study patients and the 10 control patients

SDC, Table 1: clinical characteristics of the 60 study patients and the 10 control patients

patient sex age LuTX

HCMV sero- status

underlying disease

duration of follow-up

cessation of antiviral prophylaxis

baseline sample acquisition

HCMV DNA detection

in BALF

HCMV DNA (copies/ml) at day of HCMV detection in BALF

HCMV disease

#ID (f/m) (years) D: double

S: single (days) (at day post LuTX) BALF blood

study patients

1 m 29 DLuTX D+R+ PPH 816 94 94 337 1.07E+03 <1.0E+03 no

2 m 51 DLuTX D+R+ COPD 973 137 23 189 3.17E+04 9.82E+03 no 3 m 56 DLuTX D-R+ fibrosis 1024 106 106 369 5.15E+05 <1.0E03 no 4 f 25 DLuTX D+R+ CF 686 63 26 185 1.13E+05 not det. no 5 f 59 SLuTX D+R+ COPD 708 90 95 193 9.39E+04 <1.0E+03 no 6 f 47 DLuTX D+R+ fibrosis 730 90 45 730 1.18E+03 not det. no 7 f 48 DLuTX D+R+ COPD 732 90 90 179 4.47E+06 4.63E+04 no 8 f 59 DLuTX D+R+ COPD 374 90 104 374 2.38E+03 not det. no 9 f 23 DLuTX D+R+ fibrosis 576 90 30 169 2.09E+05 2.07E+04 yes 10 m 65 DLuTX D+R+ COPD 1617 168 37 170 3.17E+03 <1.0E+03 no 11 m 31 DLuTX D+R+ Mikrolithiasis 832 54 47 366 1.07E+04 not det. no 12 f 48 DLuTX D+R+ COPD 497 104 34 161 3.01E+05 2.61E+03 no 13 m 35 DLuTX D+R+ CF 502 89 62 144 4.69E+05 <1.0E+03 no 14 m 59 DLuTX D+R+ fibrosis 718 67 90 363 1.33E+04 not det. no 15 f 46 DLuTX D+R+ COPD 632 91 91 187 1.08E+03 not det. no 16 m 56 DLuTX D+R+ COPD 906 58 80 269 1.48E+04 not det. no 17 m 63 DLuTX D+R+ fibrosis 758 83 56 187 7.67E+03 <1.0E+03 no 18 f 54 DLuTX D-R+ COPD 747 69 86 173 1.23E+05 <1.0E+03 no 19 m 57 DLuTX D-R+ COPD 748 156 55 275 6.38E+03 not det. no 20 f 35 DLuTX D+R+ LAM 673 72 78 169 1.43E+04 not det. no 21 m 59 DLuTX D-R+ COPD 362 84 114 204 5.74E+03 not det. no 22 f 66 DLuTX D+R- COPD 698 368 38 194 4.13E+03 not det. no 23 f 21 DLuTX D+R- CF 964 358 82 369 4.31E+04 2.65E+03 no 24 m 57 DLuTX D+R+ COPD 593 55 89 291 7.82E+03 <1.0E+03 no 25 f 53 DLuTX D+R+ COPD 1075 82 82 182 1.27E+03 not det. no 26 f 42 DLuTX D+R- COPD 1036 330 92 448 2.97E+04 not det. no 27 f 64 DLuTX D+R+ COPD 1001 94 179 361 4.97E+05 not det. no 28 m 63 DLuTX D+R+ COPD 633 71 57 358 1.66E+04 <1.0E+03 yes 29 m 62 DLuTX D+R+ fibrosis 963 88 88 187 2.89E+05 <1.0E+03 no 30 f 52 DLuTX D+R+ COPD 462 83 29 96 2.62E+03 1.83E+03 no 31 f 54 DLuTX D+R+ fibrosis 671 90 83 172 3.86E+03 1.10E+03 no 32 f 61 DLuTX D+R- COPD 1117 331 193 368 3.93E+03 <1.0E+03 yes 33 f 23 DLuTX D+R+ CF 759 89 68 130 2.46E+04 <1.0E+03 yes 34 f 53 DLuTX D+R+ COPD 1005 84 93 369 8.50E+04 not det. no 35 m 60 DLuTX D-R+ fibrosis 710 87 87 409 6.21E+03 not det. no 36 m 54 DLuTX D+R+ fibrosis 636 92 58 174 1.46E+03 <1.0E+03 no 37 m 51 DLuTX D-R+ COPD 565 83 88 294 1.19E+03 <1.0E+03 no 38 m 61 DLuTX D+R+ COPD 552 72 60 93 3.79E+06 4.75E+06 no 39 m 59 DLuTX D-R- COPD 368 46 58 90 1.27E+03 <1.0E+03 no 40 f 49 DLuTX D+R+ a1-ATTI 1367 93 93 265 1.08E+03 not det. no 41 f 42 DLuTX D+R+ PPH 1009 198 106 365 1.26E+03 not det. no 42 m 31 DLuTX D+R+ CF 582 89 31 200 2.87E+04 <1.0E+03 no 43 m 49 SLuTx D+R+ fibrosis 1215 56 88 389 1.10E+03 not det. no 44 f 27 DLuTX D+R+ CF 744 88 88 366 1.49E+03 not det. no 45 m 49 DLuTX D+R+ fibrosis 1023 77 92 367 1.30E+03 not det. no

46 f 51 DLuTX D-R+ Mikrolithiasis 962 87 87 178 1.12E+05 <1.0E+03 no 47 m 65 DLuTX D+R+ COPD 631 101 101 208 1.49E+03 not det. no

48 m 60 DLuTX D+R- fibrosis1 520 244 57 292 2.25E+04 2.81E+04 yes 49 m 55 DLuTX D-R+ a1-ATTI 854 99 43 146 2.38E+04 not det. no

50 m 59 DLuTX D+R- COPD 477 371 102 423 3.01E+05 5.28E+05 yes 51 f 52 DLuTX D+R- COPD 871 361 186 363 1.43E+04 <1.0E+03 no

52 f 40 DLuTX D+R- CF 766 351 94 499 1.11E+04 1.85E+03 no 53 f 53 DLuTX D+R+ COPD 362 92 33 198 3.08E+03 not det. yes 54 f 58 DLuTX D-R+ COPD 375 93 65 180 3.99E+05 7.54E+03 no 55 m 57 DLuTX D+R+ fibrosis 365 98 76 140 3.25E+03 <1.0E+03 no 56 f 57 DLuTX D+R+ COPD 755 80 36 365 5.09E+04 not det. no 57 m 51 DLuTX D+R+ a1-ATTI 970 81 48 144 4.38E+04 <1.0E+03 no 58 m 34 DLuTX D+R+ fibrosis 355 90 31 190 1.92E+03 not det. no 59 f 49 DLuTX D+R- CTEPH 597 368 98 531 2.08E+04 <1.0E+03 yes 60 f 45 DLuTX D+R- COPD 883 358 120 439 1.12E+05 <1.0E+03 no controls

1 m 42 DLuTX D-R- PPH 864 89 88 not detected not det. not det. no 2 f 57 DLuTX D-R- COPD 789 97 97 not detected not det. not det. no 3 f 51 DLuTX D-R- COPD 398 82 81 not detected not det. not det. no 4 m 31 DLuTX D-R- CF 567 91 91 not detected not det. not det. no 5 f 61 DLuTX D-R- fibrosis 421 83 83 not detected not det. not det. no 6 m 59 DLuTX D-R- COPD 566 90 90 not detected not det. not det. no 7 f 40 DLuTX D-R- CF 946 89 89 not detected not det. not det. no 8 f 48 DLuTX D-R- CTEPH 781 90 90 not detected not det. not det. no 9 m 53 DLuTX D-R- COPD 866 102 102 not detected not det. not det. no 10 m 62 DLuTX D-R- COPD 960 85 85 not detected not det. not det. no Abbrevations: a1-ATTI: Alpha-1 antitrypsin deficiency, COPD: chronic obstructive pulmonary disease, CF: cystic fibrosis, CTEPH: Chronic Thromboembolic Pulmonary Hypertension, D: Donor, LAM: Lymphangioleiomyomatosis, not det.: not detectable, R: recipient

SDC, Table 2: Criteria of baseline bronchoalveolar lavage fluid (BALF) samples

Category Criteria

on the same day the BALF sample was obtained

Clinical signs  

no clinical signs of rejection or infection

 no symptoms

 no fever (<37,5ºC)

Laboratory findings

 C-reactive protein

 leukocyte and

 lymphocyte numbers in normal range

Radiology no radiological sign for infection or rejection

Antimicrobials

no antimicrobials administered with the exception of

 Valganciclovir and

 Amphotericin B prophylaxis

Histology

of a lung biopsy specimen

obtained during the same bronchoscopy

no histological evidence of

 rejection

 diffuse alveolar damage

 lymphocytic bronchiolitis

 infection

 inflammation

 T-cell infiltration

 viral inclusion bodies

(A 0 and B 0, according to the 1996 working formulation of the International Society for Heart and Lung Transplantation) negative test result in

 immunohistochemistry and

 in-situ hybridization for HCMV and Epstein-Barr virus.

Microbiology in the BALF sample

count of resident ororpharyngeal flora < 10

⁷

/ml) Candida albicans < 100 colony forming units/ml) no other bacterial or fungal agent (culture) negative PCR:

 Acid-fast bacilli

 Mycobacteria

 Toxoplasma gondii

 Pneumocystis carinii negative ELISA and virus isolation for

 Adenovirus

 Human respiratory syncytial virus

 Influenza A and B viruses

 Parainfluenza 1, 2 and 3 viruses