Bronchial hyperresponsiveness and the bronchiolitis obliterans syndrome after lung transplantation

Spirometrically Significant Acute Rejection Increases the Risk for BOS and Death After Lung Transplantation

“…Our results are not surprising given that clinical outcomes are quite variable among patients with AR, and that not all patients with AR develop BOS nor do all BOS patients have a significant history of prior AR (2). Although to our knowledge no previous studies have considered the significance of SSAR as performed in this analysis, at least one prior study suggested that early physiological responses to methacholine challenge after transplant could predict the onset of BOS, consistent with the idea that physiological differences in response to AR, as shown in this study, could impact long-term prognosis (24). …”

Exudative Bronchiolitis After Lung Transplantation

“…15 Reid et al found that response to hypertonic saline after lung transplantation may reflect recipient:donor size matching and may provide useful information regarding the potential for BOS development. 16 The development of small airways disease, as visualized on chest HRCT, and progression to BOS was also more commonly seen in our EB population. Other patients who progressed to classical BOS had repeated HRCT scans without ever showing evidence of EB (n ϭ 27), confirming that EB is not a necessary prerequisite to the development of BOS.…”

Comparison of Induced Sputum and Bronchoalveolar Lavage in Lung Transplant Recipients

“…10,11 Both our group and other investigators have shown that functional parameters, such as indexes of ventilation distribution, were more sensitive than FEV 1 for detection of distal airways obstruction. 10,12,13 Biologic mediators have been proposed as early markers of OB. 14,15 We showed that bronchoalveolar lavage (BAL) neutrophilia 16 as well as interleukin-8 (IL-8) and chemokine ligand 5 (CCL-5) RANTES (regulated on activation: normal T cell expressed and secreted) 17 levels were increased in BOS patients before the classic criteria of BOS were met based on the decline in FEV 1 .…”