BACKGROUND: The objectives of this study were to describe the natural history of bronchiolitis obliterans syndrome (BOS) in a large consecutive series of patients from a national center in accordance with the most recent grading criteria, and to examine the prognosis with respect to onset and severity of BOS. METHODS: All patients receiving a cadaveric lung transplant between 1992 and 2004 were included in the study (n = 389). Exclusion criteria were patients not surviving at least 3 months after transplantation (n = 39) and lack of available lung function measurements (n = 4). RESULTS: The 1-, 3-, 5- and 10-year actuarial survival rates for the entire series were 81%, 67%, 60% and 36%, respectively. The 1-, 3-, 5- and 10-year actuarial freedom from BOS Grade > or = 1 was 81%, 53%, 38% and 15%, respectively. A Cox regression model with BOS grade as a time-dependent covariate was performed in a sub-group of patients surviving at least 3 years (n = 237). Both progression from BOS Grade 1 to 2 and from BOS Grade 2 to 3 were associated with a significant increase in mortality: hazard ratio (HR) = 3.1 (confidence interval [CI] 1.2 to 7.9) and HR = 2.9 (CI 1.6 to 5.3), respectively. The addition of a non-time-dependent covariate to signify early (within 18 months of transplantation) or late (after 18 months) development of BOS was not significant (p = 0.5). CONCLUSIONS: The development and progression of chronic allograft rejection after lung transplantation (BOS Grades 2 and 3) is associated with a 3-fold increase in the risk of death at each stage, irrespective of whether BOS developed early or late.
BACKGROUND: The objectives of this study were to describe the natural history of bronchiolitis obliterans syndrome (BOS) in a large consecutive series of patients from a national center in accordance with the most recent grading criteria, and to examine the prognosis with respect to onset and severity of BOS. METHODS: All patients receiving a cadaveric lung transplant between 1992 and 2004 were included in the study (n = 389). Exclusion criteria were patients not surviving at least 3 months after transplantation (n = 39) and lack of available lung function measurements (n = 4). RESULTS: The 1-, 3-, 5- and 10-year actuarial survival rates for the entire series were 81%, 67%, 60% and 36%, respectively. The 1-, 3-, 5- and 10-year actuarial freedom from BOS Grade > or = 1 was 81%, 53%, 38% and 15%, respectively. A Cox regression model with BOS grade as a time-dependent covariate was performed in a sub-group of patients surviving at least 3 years (n = 237). Both progression from BOS Grade 1 to 2 and from BOS Grade 2 to 3 were associated with a significant increase in mortality: hazard ratio (HR) = 3.1 (confidence interval [CI] 1.2 to 7.9) and HR = 2.9 (CI 1.6 to 5.3), respectively. The addition of a non-time-dependent covariate to signify early (within 18 months of transplantation) or late (after 18 months) development of BOS was not significant (p = 0.5). CONCLUSIONS: The development and progression of chronic allograft rejection after lung transplantation (BOS Grades 2 and 3) is associated with a 3-fold increase in the risk of death at each stage, irrespective of whether BOS developed early or late.
Authors: C Ashley Finlen Copeland; Laurie D Snyder; David W Zaas; W Jackson Turbyfill; W Austin Davis; Scott M Palmer Journal: Am J Respir Crit Care Med Date: 2010-05-27 Impact factor: 21.405
Authors: Aric L Gregson; Aki Hoji; Patil Injean; Steven T Poynter; Claudia Briones; Vyacheslav Palchevskiy; S Sam Weigt; Michael Y Shino; Ariss Derhovanessian; David Sayah; Rajan Saggar; David Ross; Abbas Ardehali; Joseph P Lynch; John A Belperio Journal: Am J Respir Crit Care Med Date: 2015-12-15 Impact factor: 21.405
Authors: Hrishikesh S Kulkarni; Wida S Cherikh; Daniel C Chambers; Victoria C Garcia; Ramsey R Hachem; Daniel Kreisel; Varun Puri; Benjamin D Kozower; Derek E Byers; Chad A Witt; Jennifer Alexander-Brett; Patrick R Aguilar; Laneshia K Tague; Yuka Furuya; G Alec Patterson; Elbert P Trulock; Roger D Yusen Journal: J Heart Lung Transplant Date: 2018-09-25 Impact factor: 10.247
Authors: S S Weigt; R M Elashoff; C Huang; A Ardehali; A L Gregson; B Kubak; M C Fishbein; R Saggar; M P Keane; R Saggar; J P Lynch; D A Zisman; D J Ross; J A Belperio Journal: Am J Transplant Date: 2009-05-13 Impact factor: 8.086
Authors: S Samuel Weigt; Aric L Gregson; Jane C Deng; Joseph P Lynch; John A Belperio Journal: Semin Respir Crit Care Med Date: 2011-08-19 Impact factor: 3.119
Authors: Nirmal S Sharma; Keith M Wille; S Athira; Degui Zhi; Kenneth P Hough; Enrique Diaz-Guzman; Kui Zhang; Ranjit Kumar; Sunad Rangarajan; Peter Eipers; Yong Wang; Ritesh K Srivastava; Jose Vicente Rodriguez Dager; Mohammad Athar; Casey Morrow; Charles W Hoopes; David D Chaplin; Victor J Thannickal; Jessy S Deshane Journal: J Heart Lung Transplant Date: 2017-07-15 Impact factor: 10.247
Authors: M Iversen; C M Burton; S Vand; L Skovfoged; J Carlsen; N Milman; C B Andersen; M Rasmussen; M Tvede Journal: Eur J Clin Microbiol Infect Dis Date: 2007-12 Impact factor: 3.267
Authors: Aric L Gregson; Aki Hoji; Vyacheslav Palchevskiy; Scott Hu; S Samuel Weigt; Eileen Liao; Ariss Derhovanessian; Rajeev Saggar; Sophie Song; Robert Elashoff; Otto O Yang; John A Belperio Journal: PLoS One Date: 2010-06-29 Impact factor: 3.240