The two forms of bronchiolitis obliterans in heart-lung transplant recipients

Abernathy, Evelyn C.; Hruban, Ralph H.; Baumgartner, William A.; Reitz, Bruce A.; Hutchins, Grover M.

doi:10.1016/0046-8177(91)90262-n

Cited by 68 publications

(31 citation statements)

References 25 publications

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“…This was associated with innate inflammation as these patients had concurrent infections and aspiration. The first three patients may well represent fBOS, whereas the latter four resemble NRAD [41]. An important difference is that ABERNATHY et al [41] describe a difference in histological localisation, as in this study NRAD developed distally in the airways (resembling bronchiolitis obliterans organising pneumonia), whereas fBOS was the ''pure OB type''.…”

Section: Discussionmentioning

confidence: 58%

“…The present observations need to be evaluated and confirmed by the lung transplant sector. However, in a study by ABERNATHY et al [41], this hypothesis can be seen when one reads between the lines. ABERNATHY et al [41] carried out autopsies on seven patients following heart-lung transplantation and described three patients with acellular concentric fibrosis of the terminal bronchioles, which had started to develop .6 months after transplantation.…”

Section: Discussionmentioning

confidence: 93%

“…However, in a study by ABERNATHY et al [41], this hypothesis can be seen when one reads between the lines. ABERNATHY et al [41] carried out autopsies on seven patients following heart-lung transplantation and described three patients with acellular concentric fibrosis of the terminal bronchioles, which had started to develop .6 months after transplantation. The remaining four patients had cellular bronchiolitis obliterans on autopsy, which extended into the alveolar spaces with onset ,6 months after transplantation.…”

Section: Discussionmentioning

confidence: 93%

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A dichotomy in bronchiolitis obliterans syndrome after lung transplantation revealed by azithromycin therapy

Vanaudenaerde

Meyts²,

Vos³

et al. 2008

Eur Respir J

151

110

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Bronchiolitis obliterans syndrome (BOS) is the most important cause of late mortality following lung transplantation, resulting in major morbidity and a huge burden on healthcare resources. Treatment options are limited, resulting in a mere stabilisation of the lung function decline. Recent introduction of the macrolide antibiotic azithromycin raised new hope after demonstrating lung function improvement in subsets of patients.The present study aimed to provide an overview of the clinical effects on azithromycin in the setting of BOS after lung transplantation, with special emphasis on the anti-inflammatory actions. Moreover, the authors proposed a new frame of thinking centred on a dichotomy in the pathogenesis and clinical phenotype of BOS. Subsets of BOS patients were identified who do or do not respond to azithromycin (regarding forced expiratory volume in one second (FEV1), bronchoalveolar lavage (BAL) neutrophilia/interleukin-8). These observations have shed new light on the current belief that BOS represents a homogenous clinical entity in which the neutrophil is the main culprit.Recent clinical observations, supported by research findings, have revealed a dichotomy in the clinical spectrum of BOS with neutrophilic (partially) reversible allograft dysfunction (responding to azithromycin) and fibroproliferative BOS (not responding to azithromycin). This concept is reinforced by unique data obtained in BOS patients, consisting of histology specimens, physical and radiological examination, FEV1 and BAL examination.The acceptance of this dichotomy can improve understanding of the heterogeneous pathological condition that constitutes bronchiolitis obliterans syndrome, thus encouraging a more accurate diagnosis and, ultimately, better tailored treatment for each bronchiolitis obliterans syndrome patient.

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 93%

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A dichotomy in bronchiolitis obliterans syndrome after lung transplantation revealed by azithromycin therapy

Vanaudenaerde

Meyts²,

Vos³

et al. 2008

Eur Respir J

151

110

View full text Add to dashboard Cite

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“…Radiation-primed organising pneumonia is thus quite similar to COP. Interestingly, this peculiar iatrogenic organising pneumonia provides some insight into the pathogenesis of Chlamydia pneumoniae [184,185] Coxiella burnetii [186,187] Legionella pneumophila [95,[188][189][190][191][192][193][194] Mycoplasma pneumoniae [95,189,[195][196][197] Nocardia asteroides [198,199] Pseudomonas aeruginosa [200] Serratia marcescens [201]; in lung transplant recipient [200] Staphylococcus aureus In lung transplant recipient [200] Streptococcus pneumoniae [5,6,202] Viruses Adenovirus [203] Cytomegalovirus [203,204] Herpes virus In lung transplant recipient [200] HIV [205][206][207][208][209][210]; in a pregnant patient using cocaine [205]; following highly active antiretroviral therapy introduction [211] Influenza virus [189,[212][213][214] Parainfluenza virus [215] Human herpes virus-7 …”

Section: Determined Causes Of Organising Pneumoniamentioning

confidence: 99%

“…idiopathic bronchiolitis with organising pneumonia) was a source of confusion with bronchiolitis obliterans with airflow obstruction (obliterative bronchiolitis), which is the major cause of lung transplant failure and also a severe complication after allogenic bone marrow graft resulting from immune processes (namely transplant rejection and graft versus host disease, respectively). Several cases of organising pneumonia have been reported after lung transplantation [183,200,203,[348][349][350][351]. In this context, when not explained by a determined cause (such as infection, which is common in this immunosuppressed population), organising pneumonia may be considered as an associated or predominant pattern of acute lung rejection with or without concomitant ''pure'' bronchiolitis obliterans [200,183,200,352,353].…”

Section: Fungimentioning

confidence: 99%

Cryptogenic organising pneumonia

Jf¹

2006

Eur Respir J

485

466

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Organising pneumonia is defined histopathologically by intra-alveolar buds of granulation tissue, consisting of intermixed myofibroblasts and connective tissue. Although nonspecific, this histopathological pattern, together with characteristic clinical and imaging features, defines cryptogenic organising pneumonia when no cause or peculiar underlying context is found. Rapid clinical and imaging improvement is obtained with corticosteroid treatment, but relapses are common after stopping treatment.

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Bronchiolitis obliterans organizing pneumonia in renal transplant patients

Hasni

Slusher

Siddiqui

et al. 2010

Dialysis & Transplantation

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Bronchiolitis obliterans organizing pneumonia (BOOP) is a syndrome with distinct clinical, radiological, and histological features. The radiographic changes of BOOP vary from multiple patchy, alveolar, or ground‐glass infiltrates to diffuse reticulonodular opacities. The most frequently observed CT features are areas of lung consolidation and ground‐glass opacity often with a subpleural distribution and small nodules; in addition, bronchial wall thickening and bronchodilatation can be seen. The exact pathogenesis of BOOP after organ transplantation remains to be clarified. Some researchers have suggested that BOOP is a non‐specific reaction to injury; rejection is the most common injury in lung and kidney transplant recipients.

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The two forms of bronchiolitis obliterans in heart-lung transplant recipients

Cited by 68 publications

References 25 publications

A dichotomy in bronchiolitis obliterans syndrome after lung transplantation revealed by azithromycin therapy

A dichotomy in bronchiolitis obliterans syndrome after lung transplantation revealed by azithromycin therapy

Cryptogenic organising pneumonia

Bronchiolitis obliterans organizing pneumonia in renal transplant patients

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