help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Published ahead of print on August 5, 2004, doi:10.1164/rccm.200302-165OC

Am. J. Respir. Crit. Care Med., Volume 170, Number 9, November 2004, 1022-1026

A more recent version of this article appeared on November 1, 2004
This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
200302-165OCv1
170/9/1022    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Hopkins, P. M
Right arrow Articles by Glanville, A. R
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Hopkins, P. M
Right arrow Articles by Glanville, A. R

Submitted on February 10, 2003
Accepted on August 3, 2004

Association of Minimal Rejection in Lung Transplant Recipients with Obliterative Bronchiolitis

Peter M Hopkins1*, Christina L Aboyoun1, Prashant N Chhajed1, Monique A Malouf1, Marshall L Plit1, Stephen P Rainer1, and Allan R Glanville1

1 The Lung Transplant Unit, St. Vincent's Hospital, Sydney, NSW, Australia

* To whom correspondence should be addressed. E-mail: peterwakatipu{at}hotmail.com.

The clinical significance of minimal acute rejection (grade A1) in lung transplant recipients is unknown. We prospectively analysed 1159 transbronchial lung biopsies in 184 patients. Two hundred and seventy-nine biopsies in 128 participants confirmed A1 histology at a mean post-operative day of 229±340. Sixty-four of 255 surveillance A1 lesions progressed to high grade acute rejection by 3 months follow up, whilst 40 developed new lymphocytic bronchiolitis. Twenty-four A1 biopsies were symptomatic with only 2 cases progressing to high grade rejection following steroid therapy. Seventy-eight of 184 patients experienced multiple (≥2) A1 biopsies in the first 12 months post transplant. Bronchiolitis obliterans syndrome developed in 68% of patients with multiple A1 lesions at a mean of 599±435 days, compared to 43% of patients with ≤1 A1 lesion at a mean of 819± 526 (p=0.022). Eighteen patients experienced multiple A1 biopsies post transplant in the absence of high grade rejection episodes yet also developed earlier obliterative bronchiolitis (456±245 days, p=0.020). We conclude that for A1 transbronchial lung biopsies, the conventional treatment of observation only is now challenged even in asymptomatic patients. Patients who experience multiple A1 lesions develop earlier onset of obliterative bronchiolitis and may warrant alternative immunosuppressive strategies.
Key words: minimal rejection, lung transplant




This article has been cited by other articles:


Home page
 Therapeutic Advances in Respiratory DiseaseHome page
J. Gottlieb
Review: Update on lung transplantation
Therapeutic Advances in Respiratory Disease, August 1, 2008; 2(4): 237 - 247.
[Abstract] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
A. R. Glanville, C. L. Aboyoun, A. Havryk, M. Plit, S. Rainer, and M. A. Malouf
Severity of Lymphocytic Bronchiolitis Predicts Long-Term Outcome after Lung Transplantation
Am. J. Respir. Crit. Care Med., May 1, 2008; 177(9): 1033 - 1040.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
J.-F. Cordier
Challenges in pulmonary fibrosis {middle dot} 2 : Bronchiolocentric fibrosis
Thorax, July 1, 2007; 62(7): 638 - 649.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
R. Stovold, I. A. Forrest, P. A. Corris, D. M. Murphy, J. A. Smith, S. Decalmer, G. E. Johnson, J. H. Dark, J. P. Pearson, and C. Ward
Pepsin, a Biomarker of Gastric Aspiration in Lung Allografts: A Putative Association with Rejection
Am. J. Respir. Crit. Care Med., June 15, 2007; 175(12): 1298 - 1303.
[Abstract] [Full Text] [PDF]

Home page
 FASEB J.Home page
H. Liu, L. Liu, B. S. Fletcher, and G. A. Visner
Sleeping Beauty-based gene therapy with indoleamine 2,3-dioxygenase inhibits lung allograft fibrosis
FASEB J, November 1, 2006; 20(13): 2384 - 2386.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. Estenne and R. M. Kotloff
Update in transplantation 2005.
Am. J. Respir. Crit. Care Med., March 15, 2006; 173(6): 593 - 598.
[Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
G. Tino
Clinical Year in Review III: Sleep-disordered Breathing, Interstitial Lung Disease, Lung Transplantation, and Pediatric Pulmonary Disease
Proceedings of the ATS, November 1, 2005; 2(4): 251 - 254.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
T. D. Bradley, Y. E. Miller, F. J. Martinez, D. C. Angus, W. MacNee, and E. Abraham
Interstitial Lung Disease, Lung Cancer, Lung Transplantation, Pulmonary Vascular Disorders, and Sleep-disordered Breathing in AJRCCM in 2004
Am. J. Respir. Crit. Care Med., April 1, 2005; 171(7): 675 - 685.
[Full Text] [PDF]

Home page
 Eur Respir JHome page
D. H. Bryant
Obliterative bronchiolitis in haematopoietic stem cell transplantation: can it be treated?
Eur. Respir. J., March 1, 2005; 25(3): 402 - 405.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
J. J. Egan
Obliterative Bronchiolitis after Lung Transplantation: A Repetitive Multiple Injury Airway Disease
Am. J. Respir. Crit. Care Med., November 1, 2004; 170(9): 931 - 932.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 2004 American Thoracic Society 		  ATS PAR News