title: Obliterative bronchiolitis in lung allografts removed at retransplant for intractable airway problems.
abstract: OBJECTIVE
  The role of large airway ischaemia, with resultant airway narrowing, in the development of post-lung transplant bronchiolitis obliterans has not been defined. A determination of clinical bronchiolitis obliterans syndrome (BOS), which is defined as a decline in FEV(1) from a stable post-transplant baseline, is difficult in the setting of airway complications. The aim of this study was to assess the evidence for histological bronchiolitis obliterans in lung allografts removed during retransplantation for severe recurrent airway narrowing.
  
  
  METHODS
  Case records and histological findings in allograft lungs removed at retransplantation were retrospectively reviewed.
  
  
  RESULTS
  Five lung transplant recipients, who had undergone retransplantation because of severe recalcitrant airway stenosis, were identified. In each case, explant allograft lung pathology revealed evidence of bronchiolitis obliterans.
  
  
  CONCLUSIONS
  There is a possible link between airway ischaemia, large airway stenosis and the development of bronchiolitis obliterans, which is the most common cause of death in lung transplant recipients after the first year. These findings may provide an impetus for evaluation of the role of bronchial artery revascularization techniques in the prevention of bronchiolitis obliterans.
authors.affiliation: Divisions of Pulmonary and Critical Care Medicine, University of Florida Health Sciences Center, Gainesville, Florida 32610-0395, USA. akindoa@medicine.ufl.edu
authors.forename: Olufemi
authors.initials: O
authors.lastname: Akindipe
authors.forename: Sebastian
authors.initials: S
authors.lastname: Fernandez-Bussy
authors.forename: Michael
authors.initials: M
authors.lastname: Jantz
authors.forename: Li
authors.initials: L
authors.lastname: Lu
authors.forename: Amy
authors.initials: A
authors.lastname: Deem
authors.forename: Wendy
authors.initials: W
authors.lastname: Swafford
authors.forename: Edward
authors.initials: E
authors.lastname: Staples
authors.forename: Maher
authors.initials: M
authors.lastname: Baz
mesh_terms: D000328:Adult; D001989:Bronchiolitis Obliterans / Q000209:etiology* / Q000473:pathology* / Q000601:surgery; D005260:Female; D006084:Graft Rejection / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012307:Risk Factors