The Utility of Cytopathology Testing in Lung Transplant Recipients

Wanner, Tracy; Gerhardt, Susan G.; Diette, Gregory B.; Rosenthal, Dorothy L.; Orens, Jonathan B.

doi:10.1016/j.healun.2004.04.019

Cited by 7 publications

(3 citation statements)

References 17 publications

(16 reference statements)

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“…Although commonly requested in routine lung recipient care, the value of sending BAL cytology with pathology examination as a routine study has been questioned, particularly in light of the relative cost. 43 , 44 Prior studies examining the diagnostic performance of BAL cytology for infection have yielded conflicting results. Al Zaabi et al 43 demonstrated a poor detection rate for infectious agents utilizing cytology.…”

Section: Statementsmentioning

confidence: 99%

International Society for Heart and Lung Transplantation consensus statement for the standardization of bronchoalveolar lavage in lung transplantation

Martinu

Koutsokera

Benden

et al. 2020

The Journal of Heart and Lung Transplantation

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Bronchoalveolar lavage (BAL) is a key clinical and research tool in lung transplantation (LTx). However, BAL collection and processing are not standardized across LTx centers. This International Society for Heart and Lung Transplantation–supported consensus document on BAL standardization aims to clarify definitions and propose common approaches to improve clinical and research practice standards. The following 9 areas are covered: (1) bronchoscopy procedure and BAL collection, (2) sample handling, (3) sample processing for microbiology, (4) cytology, (5) research, (6) microbiome, (7) sample inventory/tracking, (8) donor bronchoscopy, and (9) pediatric considerations. This consensus document aims to harmonize clinical and research practices for BAL collection and processing in LTx. The overarching goal is to enhance standardization and multicenter collaboration within the international LTx community and enable improvement and development of new BAL-based diagnostics.

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Section: Statementsmentioning

confidence: 99%

International Society for Heart and Lung Transplantation consensus statement for the standardization of bronchoalveolar lavage in lung transplantation

Martinu

Koutsokera

Benden

et al. 2020

The Journal of Heart and Lung Transplantation

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“…Nonetheless, studies have suggested a low diagnostic yield for BAL cytology. A study of 366 bronchoscopies on 65 subjects found only two unique and clinically significant diagnoses 4 . Similarly, a study of 10 lung transplant recipients identified Candida sp .…”

Section: Introductionmentioning

confidence: 99%

“…A study of 366 bronchoscopies on 65 subjects found only two unique and clinically significant diagnoses. 4 Similarly, a study of 10 lung transplant recipients identified Candida sp. as the major diagnostic yield, for which there is uncertain clinical significance.…”

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confidence: 99%

Inflammation on bronchoalveolar lavage cytology is associated with decreased chronic lung allograft dysfunction‐free survival

Greenland

Deiter

Calabrese

et al. 2022

Clinical Transplantation

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Background: Lung transplant recipients undergo bronchoalveolar lavage (BAL) to detect antecedents of chronic lung allograft dysfunction (CLAD), but routine assessment of BAL cytology is controversial. We hypothesized that inflammation on BAL cytology would predict CLAD-free survival.Methods: In a single-center retrospective cohort, associations between cytology results and clinical characteristics were compared using generalized-estimating equation-adjusted regression. The association between BAL inflammation and CLAD or death risk was assessed using time-dependent Cox models. Results:In 3365 cytology reports from 451 subjects, inflammation was the most common finding (6.2%, 210 cases), followed by fungal forms (5.3%, 178 cases, including 24 cases of suspected Aspergillus). Inflammation on BAL cytology was more common in procedures for symptoms (8.5%) versus surveillance (3.2%, p < .001). Inflammation on cytology was associated with automated neutrophil and lymphocyte counts, acute cellular rejection, infection, and portended a 2.2-fold hazard ratio (CI 1.2-4.0, p = .007) for CLAD or death. However, inflammation by cytology did not inform CLAD-free survival risk beyond automated BAL cell counts (p = .57). Conclusions:Inflammation on BAL cytology is clinically significant, suggesting acute rejection or infection and increased risk of CLAD or death. However, other indicators of allograft inflammation can substitute for much of the information provided by BAL cytology.

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Lung Transplant, Acute Rejection

Takei¹

2018

Encyclopedia of Pathology

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The Utility of Cytopathology Testing in Lung Transplant Recipients

Cited by 7 publications

References 17 publications

International Society for Heart and Lung Transplantation consensus statement for the standardization of bronchoalveolar lavage in lung transplantation

International Society for Heart and Lung Transplantation consensus statement for the standardization of bronchoalveolar lavage in lung transplantation

Inflammation on bronchoalveolar lavage cytology is associated with decreased chronic lung allograft dysfunction‐free survival

Lung Transplant, Acute Rejection

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