PMID- 18342749
OWN - NLM
STAT- MEDLINE
DCOM- 20080417
LR  - 20161124
IS  - 1557-3117 (Electronic)
IS  - 1053-2498 (Linking)
VI  - 27
IP  - 3
DP  - 2008 Mar
TI  - Exudative bronchiolitis after lung transplantation.
PG  - 276-81
LID - 10.1016/j.healun.2007.12.010 [doi]
AB  - BACKGROUND: After lung transplantation patients frequently develop small airways 
      disease. Exudative bronchiolitis (EB) has not been described previously in this 
      population. We describe a case series of patients who have developed EB after 
      lung transplantation. METHODS: We reviewed the clinical records and radiologic 
      data of 99 patients who underwent single and bilateral lung transplantation. Data 
      relating to ethnicity, transplant indication, human leukocyte antigen (HLA) 
      status, complications and survival were recorded. The EB cohort, defined by 
      high-resolution computed tomographic (HRCT) evidence of the disease, was compared 
      with a group of patients who had not developed EB. RESULTS: The majority of 
      patients had chronic obstructive pulmonary disease (COPD; n = 51), followed by 
      cystic fibrosis (CF; n = 22), pulmonary fibrosis (n = 8), pulmonary hypertension 
      (n = 7), bronchiectasis (n = 5), lymphangioleiomyomatosis (n = 3) and 
      Eisenmenger's syndrome (n = 3). Thirteen patients were found to have developed 
      EB. EB was more commonly seen in Maori and Pacific Island patients (p < 0.05). EB 
      was significantly associated with early infection post-transplant (p < 0.05) and 
      a history of Aspergillus infection (p < 0.005) or diabetes (p < 0.05). The 
      patients with EB were also significantly more likely to develop bronchiolitis 
      obliterans syndrome (p < 0.0005), bronchiectasis (p < 0.0005) or small airways 
      disease (p < 0.05). Patients with EB had a varied response to treatment, with the 
      majority showing improvement. CONCLUSIONS: EB was noted to occur after lung 
      transplantation in a significant proportion of patients, but will not be detected 
      unless HRCT is used routinely. It has been associated with patients' ethnicity, 
      donor haplotype, infection and the development of airways disease. EB may be a 
      prominent indicator of the likelihood of developing BOS.
FAU - McManus, Terence E
AU  - McManus TE
AD  - Department of Respiratory Medicine, Auckland City Hospital, Auckland, New 
      Zealand. terrymcmanus@doctors.org.uk
FAU - Milne, David G
AU  - Milne DG
FAU - Whyte, Kenneth F
AU  - Whyte KF
FAU - Wilsher, Margaret L
AU  - Wilsher ML
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Heart Lung Transplant
JT  - The Journal of heart and lung transplantation : the official publication of the 
      International Society for Heart Transplantation
JID - 9102703
SB  - IM
MH  - Adult
MH  - Aspergillosis, Allergic Bronchopulmonary/physiopathology
MH  - Aspergillus/pathogenicity
MH  - Bronchiolitis Obliterans/*diagnostic imaging/ethnology/*etiology/physiopathology
MH  - Diabetes Mellitus/physiopathology
MH  - Female
MH  - Humans
MH  - Lung/diagnostic imaging/microbiology
MH  - Lung Transplantation/*adverse effects
MH  - Male
MH  - Middle Aged
MH  - Pacific Islands
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Tomography, X-Ray Computed
MH  - Treatment Outcome
EDAT- 2008/03/18 09:00
MHDA- 2008/04/18 09:00
CRDT- 2008/03/18 09:00
PHST- 2007/09/09 00:00 [received]
PHST- 2007/12/07 00:00 [revised]
PHST- 2007/12/17 00:00 [accepted]
PHST- 2008/03/18 09:00 [pubmed]
PHST- 2008/04/18 09:00 [medline]
PHST- 2008/03/18 09:00 [entrez]
AID - S1053-2498(07)01528-8 [pii]
AID - 10.1016/j.healun.2007.12.010 [doi]
PST - ppublish
SO  - J Heart Lung Transplant. 2008 Mar;27(3):276-81. doi: 
      10.1016/j.healun.2007.12.010.