Early posttransplant reductions in club cell secretory protein associate with future risk for chronic allograft dysfunction in lung recipients: results from a multicenter study

Todd, Jamie L.; Weber, Jeremy M.; Kelly, Francine L.; Neely, Megan L.; Nagler, Andrew; Carmack, Dylan; Frankel, Courtney W.; Brass, David M.; Belperio, John A.; Budev, Marie; Hartwig, Matthew G.; Martinu, T.; Reynolds, John M.; Shah, Pali D.; Singer, L.G.; Snyder, L.D.; Weigt, S. Sam; Palmer, Scott M.

doi:10.1016/j.healun.2023.02.1495

Cited by 3 publications

(1 citation statement)

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“…Quantification of CD16+ NK cells (potentially important in the recognition of DSAs) in 508 lavage samples showed an increased frequency with increasing HLA mismatches and increased AMR grade and reduced CLAD-free survival thereby alluding to its role in pulmonary AMR/CLAD [22]. Reduced BAL club cell secretory protein produced by goblet cells was also found to be a valid measure for early posttransplant risk stratification, as it was found to be lower with histological signs of injury and independently associated with probable CLAD [23]. Further assessment of markers of epithelial cell death and mucus production in BAL also showed their differential expression in CLAD patients and showed that these can help in differentiating CLAD phenotypes and outcomes [24].…”

Section: Risk Factors In Broncho-alveolar Lavage and Tissuementioning

confidence: 91%

The diagnosis and management of chronic lung allograft dysfunction

Verleden,

Hendriks,

Verleden

2024

Current Opinion in Pulmonary Medicine

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Purpose of review Chronic lung allograft dysfunction (CLAD) remains a life-threatening complication following lung transplantation. Different CLAD phenotypes have recently been defined, based on the combination of pulmonary function testing and chest computed tomography (CT) scanning and spurred renewed interests in differential diagnosis, risk factors and management of CLAD. Recent findings Given their crucial importance in the differential diagnosis, we will discuss the latest development in assessing the pulmonary function and chest CT scan, but also their limitations in proper CLAD phenotyping, especially with regards to patients with baseline allograft dysfunction. Since no definitive treatment exists, it remains important to timely identify clinical risk factors, but also to assess the presence of specific patterns or biomarkers in tissue or in broncho alveolar lavage in relation to CLAD (phenotypes). We will provide a comprehensive overview of the latest advances in risk factors and biomarker research in CLAD. Lastly, we will also review novel preventive and curative treatment strategies for CLAD. Summary Although this knowledge has significantly advanced the field of lung transplantation, more research is warranted because CLAD remains a life-threatening complication for all lung transplant recipients.

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Section: Risk Factors In Broncho-alveolar Lavage and Tissuementioning

confidence: 91%