Bronchiolitis obliterans syndrome: the final frontier for lung transplantation.

@article{Todd2011BronchiolitisOS,
  title={Bronchiolitis obliterans syndrome: the final frontier for lung transplantation.},
  author={Jamie L. Todd and Scott M. Palmer},
  journal={Chest},
  year={2011},
  volume={140 2},
  pages={
          502-508
        }
}
Bronchiolitis obliterans syndrome (BOS) is a form of chronic lung allograft dysfunction that affects a majority of lung transplant recipients and is the principal factor limiting long-term transplant survival. BOS is characterized by progressive airflow obstruction unexplained by acute rejection, infection, or other coexistent condition. Although BOS is a proven useful clinical syndrome that identifies patients at increased risk for death, its clinical course and underlying causative factors… 

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References

SHOWING 1-10 OF 56 REFERENCES
Immune mechanisms in the pathogenesis of bronchiolitis obliterans syndrome after lung transplantation
TLDR
The evidence presented in this review indicates that BOS is the result of humoral and cellular immune responses developed against major histocompatibility complex molecules expressed by airway epithelial cells of the lung allograft.
Bronchiolitis obliterans syndrome 2001: an update of the diagnostic criteria.
  • M. Estenne, J. Maurer, S. Yousem
  • Medicine
    The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
  • 2002
Human and murine obliterative bronchiolitis in transplant.
  • J. McDyer
  • Medicine
    Proceedings of the American Thoracic Society
  • 2007
TLDR
A National Institutes of Health-supported Lung Transplant Network is called for to better orchestrate translational research efforts in obliterative bronchiolitis pathogenesis and treatment, and to advance the field of lung transplantation.
Survival after bronchiolitis obliterans syndrome among bilateral lung transplant recipients.
TLDR
High-grade onset of BOS, regardless of its timing after transplant, is associated with a very poor prognosis, and results suggested an interaction might exist between early onset and high- grade onset.
Post-transplant obliterative bronchiolitis and other late lung sequelae in human heart-lung transplantation.
Since March 1981, 19 patients have undergone heart-lung transplantation for end-stage pulmonary vascular disease, with 14 long-term survivors. In five of the survivors, obstructive airway disease has
Aspergillus Colonization of the Lung Allograft Is a Risk Factor for Bronchiolitis Obliterans Syndrome
  • S. Weigt, R. Elashoff, J. Belperio
  • Biology, Medicine
    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
  • 2009
TLDR
A potential causative role for Aspergillus colonization in the development of bronchiolitis obliterans syndrome post‐lung transplantation is suggested and the possibility that strategies aimed to prevent AsperGillus colonization may help delay or reduce the incidence of BOS is raised.
Risk factors for bronchiolitis obliterans: a systematic review of recent publications.
Infectious Etiology of Bronchiolitis Obliterans: The Respiratory Viruses Connection – Myth or Reality?
  • R. Vilchez, J. Dauber, S. Kusne
  • Medicine
    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
  • 2003
TLDR
Clinical data are suggestive of a possible role for respiratory viruses in the development of bronchiolitis obliterans in lung transplantation, but further control studies are required to evaluate the significance of respiratory virus infections as a causal factor.
Association of Humoral Immunity and Bronchiolitis Obliterans Syndrome
TLDR
Humoral immunity may play a role in the pathogenesis of BOS; the antigenic targets include the bronchial wall microvasculature, bronchian epithelium, and chondrocytes, and immunoglobulin.
Alemtuzumab in the Treatment of Refractory Acute Rejection and Bronchiolitis Obliterans Syndrome After Human Lung Transplantation
  • B. D. Reams, L. Musselwhite, S. Palmer
  • Medicine
    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
  • 2007
TLDR
First evidence is provided that alemtuzumab is a potentially useful therapy in lung transplant recipients with RAR or BOS, as a humanized anti‐CD52 antibody which results in potent lymphocyte depletion is utilized.
...
1
2
3
4
5
...