Lung rejection occurs in lung transplant recipients with blood chimerism.
BACKGROUND
It has been postulated that chimerism after transplantation might promote graft acceptance. In the present study, we prospectively assessed blood chimerism in 10 lung transplant recipients during the first posttransplant year and investigated whether chimerism was associated with an immunologically stable situation of the graft.


METHODS
The recipients' peripheral blood mononuclear cells were obtained before transplantation and at various time points during the first postoperative year. Donor cells were detected using nested polymerase chain reaction amplification of a donor-specific HLA-DRB1 allele. Clinical graft acceptance was determined by the number of rejection episodes.


RESULTS
The incidence of blood chimerism was high during the first 3 postoperative months and then decreased over time. All patients experienced at least one acute rejection episode, and three patients developed chronic rejection.


CONCLUSIONS
We, thus, conclude that rejection of the lung allograft may occur in the presence of blood chimerism.
Knoop
C
C
Department of Chest Medicine, Erasme University Hospital, Brussels, Belgium.
Andrien
M
M
Defleur
V
V
Antoine
M
M
de Francquen
P
P
Goldman
M
M
Estenne
M
M
D000293:Adolescent; D000328:Adult; D001706:Biopsy / Q000379:methods; D001980:Bronchi / Q000473:pathology; D002648:Child; D005260:Female; D006084:Graft Rejection / Q000097:blood / Q000235:genetics / Q000473:pathology; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D016040:Lung Transplantation / Q000276:immunology*; D008297:Male; D013997:Time Factors; D018183:Transplantation Chimera