BACKGROUND: Bronchoalveolar lavage (BAL) neutrophilia may identify patients prone to develop bronchiolitis obliterans syndrome (BOS) after lung transplantation (LTx). This study assessed the predictive value of BAL neutrophilia in stable recipients. METHODS: Evaluated were 63 consecutive recipients 3 to 12 months after LTx demonstrating no acute rejection (AR) and lymphocytic bronchitis (LB; B < or = 1 without infection; BOS, 0). Recipients were subdivided into never-BOS (follow-up > or = 12 months) and ever-BOS groups (i.e., BOS development > or = 1 after bronchoscopy). RESULTS: The groups were statistically indistinguishable for demographic data and preceding AR and LB episodes. Onset of BOS was at a median of 232 days (range, 87-962) after bronchoscopy. The ever-BOS group (16 patients) demonstrated a significantly higher percentage of neutrophils compared with the never-BOS group (47 patients) at the time of bronchoscopy (33.6% +/- 2.1% vs 9.9% +/- 1.1%, p < 0.05). By Cox regression analysis, a BAL neutrophil percentage of > or = 20% remained a significant predictor for BOS > or = 1 (hazard ratio, 3.57; 95% confidence interval, 1.71-8.40, p < 0.05) distinct from known potential BOS predictor variables. The positive and negative predictive value of BAL neutrophilia of > or = 20% for future BOS was 0.72 and 0.93, respectively (p < 0.05). CONCLUSION: BAL neutrophilia in stable recipients is of predictive value to identify recipients at risk for BOS. These data warrant prospective confirmation and further studies to evaluate the benefit of preemptive therapy for potential BOS patients.
BACKGROUND: Bronchoalveolar lavage (BAL) neutrophilia may identify patients prone to develop bronchiolitis obliterans syndrome (BOS) after lung transplantation (LTx). This study assessed the predictive value of BAL neutrophilia in stable recipients. METHODS: Evaluated were 63 consecutive recipients 3 to 12 months after LTx demonstrating no acute rejection (AR) and lymphocytic bronchitis (LB; B < or = 1 without infection; BOS, 0). Recipients were subdivided into never-BOS (follow-up > or = 12 months) and ever-BOS groups (i.e., BOS development > or = 1 after bronchoscopy). RESULTS: The groups were statistically indistinguishable for demographic data and preceding AR and LB episodes. Onset of BOS was at a median of 232 days (range, 87-962) after bronchoscopy. The ever-BOS group (16 patients) demonstrated a significantly higher percentage of neutrophils compared with the never-BOS group (47 patients) at the time of bronchoscopy (33.6% +/- 2.1% vs 9.9% +/- 1.1%, p < 0.05). By Cox regression analysis, a BAL neutrophil percentage of > or = 20% remained a significant predictor for BOS > or = 1 (hazard ratio, 3.57; 95% confidence interval, 1.71-8.40, p < 0.05) distinct from known potential BOS predictor variables. The positive and negative predictive value of BAL neutrophilia of > or = 20% for future BOS was 0.72 and 0.93, respectively (p < 0.05). CONCLUSION: BAL neutrophilia in stable recipients is of predictive value to identify recipients at risk for BOS. These data warrant prospective confirmation and further studies to evaluate the benefit of preemptive therapy for potential BOSpatients.
Authors: E A Lendermon; J M Dodd-O; T A Coon; X Wang; C R Ensor; N Cardenes; C L Koodray; H L Heusey; M F Bennewitz; P Sundd; G C Bullock; I Popescu; L Guo; C P O'Donnell; M Rojas; J F McDyer Journal: Transplant Proc Date: 2018-03-09 Impact factor: 1.066
Authors: Michael P Combs; Meng Xia; David S Wheeler; Elizabeth A Belloli; Natalie M Walker; Russell R Braeuer; Dennis M Lyu; Susan Murray; Vibha N Lama Journal: J Heart Lung Transplant Date: 2020-04-19 Impact factor: 10.247
Authors: S Samuel Weigt; Ariss DerHovanessian; W Dean Wallace; Joseph P Lynch; John A Belperio Journal: Semin Respir Crit Care Med Date: 2013-07-02 Impact factor: 3.119
Authors: Elizabeth A Lendermon; Jeffrey M Dodd-o; Tiffany A Coon; Hannah L Miller; Sudipto Ganguly; Iulia Popescu; Christopher P O'Donnell; Nayra Cardenes; Melanie Levine; Mauricio Rojas; Nathaniel M Weathington; Jing Zhao; Yutong Zhao; John F McDyer Journal: Am J Respir Cell Mol Biol Date: 2015-05 Impact factor: 6.914
Authors: Elisabeth A Kastelijn; Coline Hm van Moorsel; Karin M Kazemier; Suzan M Roothaan; Henk Jt Ruven; Johanna M Kwakkel-van Erp; Ed A van de Graaf; Pieter Zanen; Diana A van Kessel; Jan C Grutters Journal: Fibrogenesis Tissue Repair Date: 2011-11-01