Clinical lung and heart/lung transplantationPrognostic Value of Bronchoalveolar Lavage Neutrophilia in Stable Lung Transplant Recipients
Section snippets
Study Design
This study retrospectively evaluated 184 consecutive patients who underwent LTx from January 1996 through December 2007 at the University of Munich. The study was performed in accordance with recommendations of the local board on medical ethics at Ludwig Maximilians University of Munich. Informed written consent was obtained from each patient.
Follow-up data were collected through December 1, 2007. Demographic and clinical data were prospectively obtained from medical records and computerized
Patient Cohorts
From 652 TBBs in 184 patients (median, 3 bronchoscopies/patient; range, 1–9) that were assessed, 469 biopsy specimens (72%) showed no AR (A0), 112 (17%) demonstrated minimal AR (A1), and in 71 (11%) showed AR of A ≥ 2. No evidence of LB (B0) was found in 187 specimens (28%), LB grade B1 was confirmed in 306 (47%), and grade B ≥ 2 in 163 (25%).
Of a total of 184 patients, 63 (34.2%) fulfilled the criteria for stable LTx recipients and were entered in this analysis. Of these, 47 (74.6%) did not
Discussion
Our results demonstrated that in stable LTx recipients, an increased percentage of BAL neutrophils in the absence of confounders constitutes an increased risk for AR and has a predictive value for BOS. Moreover, IL-8 BAL levels were positively and SLPI BAL levels were negatively correlated with the relative number of neutrophils, indicating a potentially important role in the pathogenesis of BOS.
Several studies have investigated the usefulness of BAL analysis in providing information related to
References (39)
- et al.
Pulmonary Scientific Council of the International Society for Heart and Lung TransplantationInternational guidelines for the selection of lung transplant candidates: 2006 update--a consensus report from the Pulmonary Scientific Council of the International Society for Heart and Lung Transplantation
J Heart Lung Transplant
(2006) - et al.
Registry of the International Society for Heart and Lung Transplantation: twenty-fourth official adult lung and heart-lung transplantation report--2007
J Heart Lung Transplant
(2007) - et al.
Risk factors for bronchiolitis obliterans: a systematic review of recent publications
J Heart Lung Transplant
(2002) - et al.
Bronchiolitis obliterans syndrome 2001: an update of the diagnostic criteria
J Heart Lung Transplant
(2002) - et al.
Persistent increases of BAL neutrophils as a predictor of mortality following lung transplant
Chest
(1999) - et al.
Nomenclature for factors of the HLA system, 2004
Hum Immunol
(2005) - et al.
Yield of surveillance bronchoscopy for acute rejection and lymphocytic bronchitis/bronchiolitis after lung transplantation
J Heart Lung Transplant
(2004) - et al.
Bronchoalveolar lavage fluid characteristics in acute and chronic lung transplant rejection
J Heart Lung Transplant
(2004) - et al.
Upregulation of chemokines in bronchoalveolar lavage fluid as a predictive marker of post-transplant airway obliteration
J Heart Lung Transplant
(2002) - et al.
The dynamics and associations of airway neutrophilia post lung transplantation
Am J Transplant
(2006)