An update on current treatment strategies for managing bronchiolitis obliterans syndrome after lung transplantation

Arjuna, A.; Olson, Merle S.; Walia, Rajat; Bremner, Ross M.; Smith, Michael A.; Mohanakumar, Thalachallour

doi:10.1080/17476348.2021.1835475

Cited by 16 publications

(14 citation statements)

References 98 publications

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“…Moreover, the prevalence of BOS in these patients was comparable to the prevalence in patients without scleroderma (109). GERD is thought to play a significant role in the decline in lung function before transplant, as well as in allograft dysfunction after lung transplant, especially acute rejection and BOS (110)(111)(112). Treatment for GERD in transplant recipients may necessitate surgical intervention, such as a Nissen fundoplication.…”

Section: Scleroderma and Gastroesophageal Reflux Diseasementioning

confidence: 78%

Current trends in candidate selection, contraindications, and indications for lung transplantation

Arjuna¹,

Olson²,

Walia³

2021

J Thorac Dis

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Lung transplant has been established as the treatment of choice for patients with various forms of end-stage lung disease, in whom non-transplant therapeutic options have failed. Many advances in the realms of basic science, clinical research, surgical technique, and perioperative management have emerged over the past few decades; these innovations have contributed to substantial improvements in survival and quality of life for transplant recipients. However, the field of lung transplantation faces appreciable challenges, including expanding the lung donor pool and ameliorating posttransplant complications, such as primary graft dysfunction, cellular-and antibodymediated rejection, chronic lung allograft dysfunction, and infection (1). One of the most important questions

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Section: Scleroderma and Gastroesophageal Reflux Diseasementioning

confidence: 78%

Current trends in candidate selection, contraindications, and indications for lung transplantation

Arjuna¹,

Olson²,

Walia³

2021

J Thorac Dis

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“…Chronic Lung allograft Dysfunction (CLAD) remains the most fearful diagnosis in lung transplant recipients. It is the leading cause of death after the first year, reported to develop in as many as 50% of recipients in 5 years [126,127,132]. CLAD is defined by the ISHLT as a persistent decline in forced expiratory volume (FEV1), ≥20% from baseline for at least 3 months [132][133][134].…”

Section: Detection Of Rejectionmentioning

confidence: 99%

A Breath of Fresh Air - Lung Transplantation Has Come of Age

Keshavamurthy¹,

Russell²

2023

OBM Transplant

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A boundless spectrum of chronic lung diseases is said to effect over 500 million persons globally. Lung transplantation is a well-established therapeutic option for patients suffering from end-stage lung diseases, however waitlist mortality and primary graft failure remain major determinants as post-transplantation 5-year survival is just above 50 percent. Recent innovations in lung transplantation have been aimed at increasing organ availability, improving allograft quality, function, and longevity. Ex-vivo Lung Perfusion (EVLP) is an exciting modality responsible for multiple paths of lung allograft reconditioning as well as significantly extending preservation times. Mechanical circulatory support (MCS), specifically extracorporeal membrane oxygenation (ECMO) has consistently gained popularity not only for its use as a bridge to transplantation, but also its intraoperative role. In tandem, EVLP and ECMO have shown promising results in increasing the number of lung transplantations performed, therefore decreasing waitlist mortality. Primary graft dysfunction (PGD) and chronic lung allograft rejection (CLAD) continue to be the most feared predictors of poor outcomes. In this review we will highlight the historical progression of lung transplantation, its encumbrance, and the most recent advancements in promising techniques for long-term allograft protection and patient survival.

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“…Because BOS is associated with the worst long-term survival in LTx patients, many studies are focused on the early identification of BOS [ 15 ]. Markers may be useful for diagnosis [ 16 , 17 , 18 ] and for understanding the molecular and immunological mechanisms involved in the onset of BOS [ 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

“…Evidence of aberrant angiogenesis has also been reported in bronchiolitis obliterans lesions, consisting of the proliferation and enlargement of the microvasculature [ 14 , 15 ]. This mechanism could explain the flow limitation and dyspnoea typical of patients with BOS [ 27 , 28 , 29 ].…”

Section: Introductionmentioning

confidence: 99%

Markers of Bronchiolitis Obliterans Syndrome after Lung Transplant: Between Old Knowledge and Future Perspective

et al. 2022

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Bronchiolitis obliterans syndrome (BOS) is the most common form of CLAD and is characterized by airflow limitation and an obstructive spirometric pattern without high-resolution computed tomography (HRCT) evidence of parenchymal opacities. Computed tomography and microCT analysis show abundant small airway obstruction, starting from the fifth generation of airway branching and affecting up to 40–70% of airways. The pathogenesis of BOS remains unclear. It is a multifactorial syndrome that leads to pathological tissue changes and clinical manifestations. Because BOS is associated with the worst long-term survival in LTx patients, many studies are focused on the early identification of BOS. Markers may be useful for diagnosis and for understanding the molecular and immunological mechanisms involved in the onset of BOS. Diagnostic and predictive markers of BOS have also been investigated in various biological materials, such as blood, BAL, lung tissue and extracellular vesicles. The aim of this review was to evaluate the scientific literature on markers of BOS after lung transplant. We performed a systematic review to find all available data on potential prognostic and diagnostic markers of BOS.

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An update on current treatment strategies for managing bronchiolitis obliterans syndrome after lung transplantation

Cited by 16 publications

References 98 publications

Current trends in candidate selection, contraindications, and indications for lung transplantation

Current trends in candidate selection, contraindications, and indications for lung transplantation

A Breath of Fresh Air - Lung Transplantation Has Come of Age

Markers of Bronchiolitis Obliterans Syndrome after Lung Transplant: Between Old Knowledge and Future Perspective

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