Bronchiolitis obliterans in recipients of single, double, and heart-lung transplantation

C. A. Keller, P. T. Cagle, R. W. Brown, G. Noon, A. E. Frost

Research output: Contribution to journalArticle

110 Scopus citations

Abstract

Thirty-two recipients of single, double, or heart-lung transplantation followed-up for at least 3 months posttransplant were retrospectively reviewed to assess the frequency, predictors, and risk factors associated with the development of bronchiolitis obliterans (BO). A clinical definition for the diagnosis of BO was made using the following criteria; persistent and progressive decline in FEF25-75, associated with normal results of cytologic and microbiologic studies for significant pathogens in bronchoalveolar lavage fluid, with a normal chest radiograph. This was correlated with histologic diagnosis and patient outcome. Sixteen (50%) of the patients developed BO, and this was associated with a 56% mortality. All but 1 patient with histologic BO had a clinical diagnosis of BO made (often months) prior to diagnostic biopsy. No patients with normal histologic findings had a clinical diagnosis of BO. More than 3 episodes of histologically documented acute rejections in any 12-month period were eventually associated with a 100% incidence of BO. Cytomegalovirus occurred with greater frequency in patients with BO, and in most cases, preceded or occurred concomitantly with the diagnosis of acute rejection or BO.

Original languageEnglish (US)
Pages (from-to)973-980
Number of pages8
JournalCHEST
Volume107
Issue number4
DOIs
StatePublished - Jan 1 1995

Keywords

  • acute rejection
  • bronchiolitis obliterans
  • cytomegalovirus disease
  • lung transplantation
  • pulmonary function testing

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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