title: [Bronchiolitis obliterans after lung transplantation].
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.
authors.affiliation: Service de Pneumologie et Réanimation, Hôpital Beaujon, Clichy.
authors.forename: M
authors.initials: M
authors.lastname: Fournier
authors.forename: O
authors.initials: O
authors.lastname: Groussard
authors.forename: C
authors.initials: C
authors.lastname: Sleiman
authors.forename: H
authors.initials: H
authors.lastname: Mal
authors.forename: C
authors.initials: C
authors.lastname: Darne
authors.forename: R
authors.initials: R
authors.lastname: Pariente
mesh_terms: D001989:Bronchiolitis Obliterans / Q000150:complications* / Q000276:immunology / Q000382:microbiology / Q000473:pathology; D016572:Cyclosporine / Q000627:therapeutic use; D006084:Graft Rejection / Q000276:immunology; D006801:Humans; D007108:Immune Tolerance; D016040:Lung Transplantation / Q000009:adverse effects* / Q000379:methods; D012131:Respiratory Insufficiency / Q000209:etiology; D014777:Virus Diseases / Q000382:microbiology
chemical_list: D016572:Cyclosporine
vernacular_title: Bronchiolite oblitérante après transplantation pulmonaire.