Detection, classification, and management of rejection after lung transplantation.

Abstract:

:Rejection is a major complication following lung transplantation. Acute cellular rejection, lymphocytic bronchiolitis, and antibody-mediated rejection (AMR) are all risk factors for the subsequent development of chronic lung allograft dysfunction (CLAD). Acute cellular rejection and lymphocytic bronchiolitis have well defined histopathologic diagnostic criteria and grading. Diagnosis of AMR requires a multidisciplinary approach. CLAD is the major barrier to long-term survival following lung transplantation. The most common phenotype of CLAD is bronchiolitis obliterans syndrome (BOS) which is defined by a persistent obstructive decline in lung function. Restrictive allograft dysfunction (RAS) is a second phenotype of CLAD and is associated with a worse prognosis. This article will review the diagnosis, staging, clinical presentation, and treatment of acute rejection, AMR, and CLAD following lung transplantation.

journal_name

J Thorac Dis

authors

Parulekar AD,Kao CC

doi

10.21037/jtd.2019.03.83

subject

Has Abstract

pub_date

2019-09-01 00:00:00

pages

S1732-S1739

issue

Suppl 14

eissn

2072-1439

issn

2077-6624

pii

jtd-11-S14-S1732

journal_volume

11

pub_type

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