Chronic allograft rejection: epidemiology, diagnosis, pathogenesis, and treatment.
Lung transplantation is a therapeutic option for patients with end-stage pulmonary disorders. Unfortunately, chronic lung allograft rejection, in the form of obliterative bronchiolitis and its clinical correlate bronchiolitis obliterans syndrome (BOS), continues to be highly prevalent and is the major limitation to long-term survival. The pathogenesis of BOS is complex and involves alloimmune and nonalloimmune pathways. The airway obstruction involved is classically progressive and unresponsive to treatment; however, the course is highly variable, and distinguishable phenotypes may exist. A better understanding of the risk factors and their relationship to the pathological mechanisms of chronic lung allograft rejection should lead to better pharmacological targets to prevent or treat this syndrome.
Weigt
S Samuel
SS
Division of Pulmonary, Critical Care Medicine, Allergy, and Clinical Immunology, Department of Internal Medicine, The David Geffen School of Medicine at UCLA, Los Angeles, California 90095, USA. sweigt@mednet.ucla.edu
Wallace
W Dean
WD
Derhovanessian
Ariss
A
Saggar
Rajan
R
Saggar
Rajeev
R
Lynch
Joseph P
JP
Belperio
John A
JA
D001989:Bronchiolitis Obliterans / Q000276:immunology; D006084:Graft Rejection / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016040:Lung Transplantation / Q000276:immunology*; D014019:Tissue Donors
D007166:Immunosuppressive Agents