Chronic lung allograft rejection: mechanisms and therapy.
@article{Belperio2009ChronicLA,
title={Chronic lung allograft rejection: mechanisms and therapy.},
author={John A Belperio and S Samuel Weigt and Michael C. Fishbein and Joseph P. Iii Lynch},
journal={Proceedings of the American Thoracic Society},
year={2009},
volume={6 1},
pages={
108-21
}
}Lung transplantation is a therapeutic option for patients with end-stage pulmonary disorders. Unfortunately, due to post-lung transplant complications, both infectious and noninfectious, it is only a treatment and not a cure. Importantly, despite induction combined with triple or quadruple maintenance immunosuppressive therapy, chronic lung rejection, in the form of obliterative bronchiolitis or its clinical correlate bronchiolitis obliterans syndrome (BOS), continues to be highly prevalent and…
180 Citations
Pediatric Lung Transplantation
- MedicinePediatric Respiratory Diseases
- 2020
The postoperative period is not only crucial for early detection of complications, such as infections and rejection, but also in the long term when gastrointestinal and neurological complications may compromise up to 50% of the patients.
Antifibrotic drugs in lung transplantation and chronic lung allograft dysfunction: a review
- MedicineEuropean Respiratory Review
- 2021
In a large multicentre randomised trial, pirfenidone did not appear to have a beneficial effect on lung function decline in established bronchiolitis obliterans syndrome, and continuation of antifibrotic treatment during waiting time for lung transplantation proved to be safe.
Diagnosis, Pathophysiology and Experimental Models of Chronic Lung Allograft Rejection
- MedicineTransplantation
- 2018
The pathological hallmarks of chronic rejection, recent insights gained from both clinical and basic science research, and the current state of animal models of chronic lung rejection are explored.
Considerations for Lung Transplantation in Patients With Idiopathic Pulmonary Fibrosis
- Medicine
- 2015
Idiopathic pulmonary fibrosis patients have worse survival after lung transplant, at least in part due to early mortality, but it remains a mainstay of therapy given the lack of effective alternatives.
Targeting Allograft Injury and Inflammation in the Management of Post‐Lung Transplant Bronchiolitis Obliterans Syndrome
- MedicineAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
- 2009
This review deals with nonalloimmune factors that may potentiate alloimmune injury and infection and reflux/aspiration as examples of allograft injury, which may lead to chronic loss of graft function and BOS.
Preliminary Report on the Effect of Mesenchymal Stem Cell Therapy in Patients with Chronic Lung Allograft Dysfunction
- MedicineJournal of Stem Cell Therapy and Transplantation
- 2018
Long-term survival of lung transplant recipients is compromised by chronic lung allograft dysfunction (CLAD), either obstructive (or bronchiolitis obliterans syndrome [BOS]) or restrictive (restrictive allografted syndrome) [8].
An Unwelcome Guest: Aspergillus Colonization in Lung Transplantation and Its Association with Bronchiolitis Obliterans Syndrome
- Medicine, BiologyAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
- 2009
A clear association of Aspergillus colonization with the subsequent onset of BOS is shown, with colonization being an independent predictor of morbidity and mortality due to BOS regardless of acute rejection scores.
[Predictors for the Bronchiolitis Obliterans Syndrome in Lung Transplant Patient].
- MedicineZhongguo fei ai za zhi = Chinese journal of lung cancer
- 2020
The current state of knowledge on predictors for bronchiolitis obliterans syndrome is reviewed, which is regarded as a fibrosing process in the small airways leading to irreversible airway obstruction.
Bronchiolitis obliterans syndrome after lung transplantation: biomarkers for inflammation and fibrogenesis
- Medicine, Biology
- 2012
Genetic polymorphisms in TLRs, MMP7 and CAV1 and biomarkers in serum, such as Th2 cytokines, M MP-7 and MMP-9, are related to the development of BOS after lung transplantation, and may be potential biomarkers for clinical decision making.
References
SHOWING 1-10 OF 184 REFERENCES
Chronic allograft rejection (obliterative bronchiolitis).
- MedicineSeminars in respiratory and critical care medicine
- 2001
The current knowledge of chronic rejection after heart-lung and lung transplantation is reviewed, and a clinical grading system has been proposed, divided into four and, more recently, five categories, depending on the severity of airflow obstruction.
Bronchiolitis obliterans syndrome complicating lung or heart-lung transplantation.
- MedicineSeminars in respiratory and critical care medicine
- 2003
A greater understanding of the pathogenic mechanisms operative in BOS are critical to developing novel strategies to treat and prevent this devastating complication.
Acute and chronic rejection after lung transplantation.
- MedicineSeminars in respiratory and critical care medicine
- 2006
Over the last decade, improvements in surgical techniques, lung preservation, immunosuppression, and management of ischemia-reperfusion injury and infections have contributed to increase the 1 year…
Non-immune acute graft injury after lung transplantation and the risk of subsequent bronchiolitis obliterans syndrome (BOS).
- MedicineThe Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
- 2002
Early experience with sirolimus in lung transplant recipients with chronic allograft rejection.
- MedicineThe Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
- 2003
Minimal Acute Rejection after Lung Transplantation: A Risk for Bronchiolitis Obliterans Syndrome
- MedicineAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
- 2005
It is concluded that minimal rejection is associated with an increased risk for BOS development and progression that is comparable to A2 rejection.
Pathologic correlates of bronchiolitis obliterans syndrome in pulmonary retransplant recipients.
- MedicineChest
- 2006
It is concluded that significant histologic heterogeneity exists among patients undergoing retransplantation for BOS, potentially contributing to the variability of patient responses to treatment.
Obliterative bronchiolitis after lung and heart-lung transplantation. An analysis of risk factors and management.
- MedicineThe Journal of thoracic and cardiovascular surgery
- 1995
Analysis of risk factors for the development of bronchiolitis obliterans syndrome.
- MedicineAmerican journal of respiratory and critical care medicine
- 1999
Analysis of the current data leads us to believe that LBB, in the absence of infection, is in fact a manifestation of acute rejection, with similar implications for graft function as acute perivascular rejection.
Bronchiolitis obliterans after human lung transplantation.
- MedicineAmerican journal of respiratory and critical care medicine
- 2002
Current concepts regarding post-transplant bronchiolitis obliterans are presented, including the recently updated classification system for bronchiola obliterans syndrome (BOS), an overview of current concepts regarding its pathogenesis and risk factors, potential surrogate markers that may contribute to early detection, and approaches to the management of this devastating complication.



