Bronchiolitis obliterans syndrome and restrictive allograft syndrome: do risk factors differ?

摘要: BACKGROUND Chronic rejection is the major problem hampering long-term survival after lung transplantation. Recently, it became clear that patients may develop an obstructive (bronchiolitis obliterans syndrome [BOS]) or a restrictive function defect (restrictive allograft [RAS]), for which specific risk factors are unknown. METHODS A retrospective analysis of our transplantation cohort was performed (n=380). Patients with irreversible decline in forced expiratory volume 1 second were identified and classified as BOS RAS. Patient characteristics, bronchoalveolar lavage (BAL) cellularity, rates respiratory tract infection, colonization, acute rejection, lymphocytic bronchiolitis compared between BOS, RAS, stable patients. RESULTS There 103 suffering from chronic 79 had 24 diagnosed more infection pseudomonal colonizations RAS control (P=0.0090 P=0.0034, respectively). More ever experienced severe rejections (A≥2; both P<0.0001) (P=0.0006) versus control. experiencing (P=0.031). BAL neutrophilia elevated at days 360, 540, 720 but especially patients, frequent episodes increased eosinophilia (≥2%; P<0.0001). CONCLUSION Acute bronchiolitis, colonization pseudomonas, later development not only also BOS.