Abstract:
:Although transbronchial lung biopsy (TBBx) is widely acknowledged as the "gold standard" for diagnosis of acute rejection, controversy exists regarding the need to perform follow-up procedures. Over a 5-yr period, we performed 1,142 TBBx of which 173 were follow-up TBBx in 99 patients with pulmonary allograft rejection greater than or equal to International Society for Heart and Lung Transplantation (ISHLT) grade A(2) on initial TBBx. Rejection on the previous 173 TBBx was associated with lymphocytic bronchiolitis/bronchitis (LBB) > or = ISHLT grade B(2) in 82 patients and with cytomegalovirus (CMV) pneumonitis in 16 patients. Persistent rejection (> or = A(2)) was observed in 45 of 173 (26%) follow-up TBBx. Persistent B grade rejection (> or = B(2)) was present in 28 patients whereas new B grade rejection developed in 11 patients with > or = A(2) grade rejection. Rejection > or = B(2) was significantly (p < 0.05) associated with rejection > or = A(2). Fifteen follow-up TBBx showed new B grade rejection without signs of > or = A(2) rejection. A new diagnosis of CMV pneumonitis was made in 33 of 173 (19%). CMV pneumonitis occurred in 35 follow-up TBBx, four associated with > or = A(2) rejection and eight with > or = B(2) rejection. The overall incidence of bronchiolitis obliterans syndrome (BOS) in both groups was similar. Patients with persistent rejection on follow-up TBBx developed BOS at a median of 1.3 yr and median of 2.0 yr (p = not significant [NS]) posttransplantation. The practice of follow-up TBBx after rejection within 2 yr posttransplant is clinically useful as it provides valuable diagnostic information.
journal_name
Am J Respir Crit Care Medauthors
Aboyoun CL,Tamm M,Chhajed PN,Hopkins P,Malouf MA,Rainer S,Glanville ARdoi
10.1164/ajrccm.164.3.2011152keywords:
subject
Has Abstractpub_date
2001-08-01 00:00:00pages
460-3issue
3eissn
1073-449Xissn
1535-4970journal_volume
164pub_type
杂志文章abstract::Rationale: To detect pulmonary arterial hypertension (PAH) at any early stage is a promising approach to optimize the outcome. Objectives: To investigate the impact of school ECG-based screening on detecting idiopathic or heritable (I/H)-PAH in the general pediatric population. Methods: This was a nationwide survey of...
journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/rccm.201802-0375OC
更新日期:2019-06-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
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doi:10.1164/ajrccm.151.3.7881650
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journal_title:American journal of respiratory and critical care medicine
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journal_title:American journal of respiratory and critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2000-07-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
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更新日期:2012-09-01 00:00:00
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更新日期:2003-05-15 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2003-07-15 00:00:00
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journal_title:American journal of respiratory and critical care medicine
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pub_type: 杂志文章,评审
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更新日期:2017-12-01 00:00:00
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pub_type: 杂志文章
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journal_title:American journal of respiratory and critical care medicine
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doi:10.1164/rccm.201311-1951OC
更新日期:2014-04-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/ajrccm.156.3.9701051
更新日期:1997-09-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/ajrccm.158.2.9710084
更新日期:1998-08-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/rccm.201503-0578OC
更新日期:2015-10-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 指南,杂志文章
doi:10.1164/rccm.201806-1160ST
更新日期:2018-08-15 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/rccm.201106-1059OC
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/ajrccm.156.1.9607072
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更新日期:2001-07-01 00:00:00
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doi:10.1164/ajrccm.163.3.2003070
更新日期:2001-03-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
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doi:10.1164/ajrccm.161.1.9902113
更新日期:2000-01-01 00:00:00
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pub_type: 杂志文章,评审
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journal_title:American journal of respiratory and critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2001-03-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章,随机对照试验
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更新日期:2012-08-15 00:00:00
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journal_title:American journal of respiratory and critical care medicine
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doi:10.1164/rccm.200903-0329OC
更新日期:2010-07-15 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/ajrccm.153.3.8630550
更新日期:1996-03-01 00:00:00