Organizing Pneumonia Following Pulmonary Transplantation and the Development of Obliterative Bronchiolitis1

Milne, Duncan; Gascoigne, A.; Ashcroft, T; Sviland, Lisbet; Malcolm, Archie J.; Corris, Paul A.

doi:10.1097/00007890-199457120-00013

Cited by 44 publications

(10 citation statements)

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“…In the case presented here we saw that this can also be true for a combination with BOOP. This condition is known to occur after transplantation of bone marrow, kidney, or the lung itself [4–6]. However, to our knowledge, this has not to date been described after liver transplantation.…”

Section: Discussionmentioning

confidence: 95%

Bronchiolitis obliterans organizing pneumonia associated with Pneumocystis carinii infection in a liver transplant patient receiving tacrolimus

Kleindienst¹,

Fend²,

C³

et al. 1999

Clinical Transplantation

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We report on a case of bronchiolitis obliterans organizing pneumonia (BOOP) associated with Pneumocystis carinii pneumonia (PCP) after liver transplantation and tacrolimus based immunosuppression. Radiologically, bilateral diffuse interstitial shadowing and patchy alveolar infiltrates developed after switching the patient from cyclosporin A to tacrolimus for persistent rejection. Bronchoalveolar lavage (BAL) fluid showed inflammatory cells but no pathogenic organisms. Open lung biopsy revealed BOOP with granulomatous PCP. Thus, even in the case of negative BAL the possibility of an atypical P. carinii infection has to be considered for differential diagnosis of pneumonia in immunocompromised patients after organ transplantation. The combination of BOOP with PCP after liver transplantation and tacrolimus medication has not been reported previously.

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Section: Discussionmentioning

confidence: 95%

Bronchiolitis obliterans organizing pneumonia associated with Pneumocystis carinii infection in a liver transplant patient receiving tacrolimus

Kleindienst¹,

Fend²,

C³

et al. 1999

Clinical Transplantation

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“…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

European Respiratory Journal

477

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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“…Bronchial epithelial cell isolation and culture Bronchoscopy (using an Olympus FB45.5 bronchoscope; Olympus, Tokyo, Japan) was performed in patients premedicated with intravenous midazolam and topical 4% lignocaine, applied to the vocal cords and tracheal lumen in 1 mL aliquots to a maximum dose of 7 mg?kg -1 body weight. Bronchial brushings (n54-6) were obtained from subsegmental bronchi using a protected specimen single-sheathed nylon cytology brush (5 fr; Wilson-Cook, Winston-Salem, NC, USA) and dispersed in 5 mL of sterile phosphate-buffered saline with later addition of 5 mL of RPMI and 10% foetal calf serum (FCS) based on a method previously described [13]. The suspended samples were centrifuged for 5 min at 10006g.…”

Section: Patient Microbiological Prophylaxismentioning

confidence: 99%

“…Epithelial activation is noted in BOS, as reflected by increased expression of human leukocyte antigen (HLA) class II antigens (HLA-DR and HLA-DP) [12][13][14] along with increased expression of mRNA transcripts for the co-stimulatory molecules, CD80 and CD86, on bronchial epithelial cells from patients with BOS [15]. An increased expression of airway epithelium inducible nitric oxide (NO) synthase, associated with elevated exhaled NO levels has been described in subjects with BOS, which were correlated with airway neutrophilia [16].…”

mentioning

confidence: 99%

Primary airway epithelial cell culture from lung transplant recipients

Forrest

Murphy²,

Ward³

et al. 2005

European Respiratory Journal

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Long-term survival in lung transplantation is limited by the development of obliterative bronchiolitis, a condition characterised by inflammation, epithelial injury, fibroproliferation and obliteration of bronchioles leading to airflow obstruction. To investigate the role of the bronchial epithelium in the pathogenesis of obliterative bronchiolitis the current study aimed to establish primary bronchial epithelial cell cultures (PBEC) from lung allografts.Four to six bronchial brushings were obtained from sub-segmental bronchi of lung allografts. Cells were seeded onto collagen-coated plates and grown to confluence in bronchial epithelial growth medium.Bronchial brushings (n533) were obtained from 27 patients. PBECs were grown to confluence from 12 out of 33 (39%) brushings. Failure to reach confluence was due to early innate infection. Bacteria were usually isolated from both bronchoalveolar lavage and culture media, but a separate population was identified in culture media only.Primary culture of bronchial epithelial cells from lung transplant recipients is feasible, despite a high rate of early, patient-derived infection. Latent infection of the allograft, identified only by bronchial brushings, may itself be a persistent stimulus for epithelial injury. This technique facilitates future mechanistic studies of airway epithelial responses in the pathogenesis of obliterative bronchiolitis.

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Organizing Pneumonia Following Pulmonary Transplantation and the Development of Obliterative Bronchiolitis1

Cited by 44 publications

References 0 publications

Bronchiolitis obliterans organizing pneumonia associated with Pneumocystis carinii infection in a liver transplant patient receiving tacrolimus

Bronchiolitis obliterans organizing pneumonia associated with Pneumocystis carinii infection in a liver transplant patient receiving tacrolimus

Cryptogenic organising pneumonia

Primary airway epithelial cell culture from lung transplant recipients

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