1. [Bronchiolitis obliterans after lung transplantation].
- Author
-
Fournier M, Groussard O, Sleiman C, Mal H, Darne C, and Pariente R
- Subjects
- Bronchiolitis Obliterans immunology, Bronchiolitis Obliterans microbiology, Bronchiolitis Obliterans pathology, Cyclosporine therapeutic use, Graft Rejection immunology, Humans, Immune Tolerance, Lung Transplantation methods, Respiratory Insufficiency etiology, Virus Diseases microbiology, Bronchiolitis Obliterans complications, Lung Transplantation adverse effects
- Abstract
Lung transplantation has become a realistic treatment in some patients with severe respiratory impairment or severe pulmonary arterial hypertension. Immunosuppression therapy is about the same in all transplantation units and includes cyclosporin, corticosteroids and azathioprine. The diagnosis of acute rejection episodes has been greatly facilitated by the histological study of transbronchial biopsies obtained by endoscopy. Improvements in the short-term prognosis of these patients have made it possible to individualize an unusual and delayed complication: bronchiolitis obliterans. This progressive and diffuse obstruction followed by destruction of the transplant's bronchioles is interpreted as a consequence of chronic rejection. The diagnosis of bronchiolitis obliterans is difficult and rests essentially on degradation of the respiratory function resisting to increased immunosuppression. Some viral infections perhaps contribute to its development, and it may be so severe as to require another lung transplantation.
- Published
- 1992