title: Bronchiolitis obliterans syndrome leads to a functional deterioration of the acinus post lung transplant.
abstract: Bronchiolitis obliterans syndrome (BOS) limits long-term survival of lung transplant recipients, and airflow obstruction in these patients likely originates in the small airways. 61 double lung transplant recipients performed multiple breath nitrogen washouts to obtain indices of acinar and conductive ventilation heterogeneity (Sacin, Scond). There was a significant association of BOS status with Sacin (Kruskal-Wallis; p<0.001) but not with Scond (p=0.1). These results demonstrate that it is the structural alteration of the terminal bronchioles, generating ventilation heterogeneity at the level of the diffusion front, and not the bronchioles located more proximally, that is driving the airflow obstruction that determines BOS status.
authors.affiliation: Allergy, Immunology, and Respiratory Medicine, Alfred Hospital, , Melbourne, Australia.
authors.forename: Bruce R
authors.initials: BR
authors.lastname: Thompson
authors.forename: Yvonne M
authors.initials: YM
authors.lastname: Hodgson
authors.forename: Tom
authors.initials: T
authors.lastname: Kotsimbos
authors.forename: Pam
authors.initials: P
authors.lastname: Liakakos
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Ellis
authors.forename: Gregory I
authors.initials: GI
authors.lastname: Snell
authors.forename: Sylvia
authors.initials: S
authors.lastname: Verbanck
mesh_terms: D061354:Acinar Cells / Q000473:pathology*; D001989:Bronchiolitis Obliterans / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology*; D006084:Graft Rejection / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D012129:Respiratory Function Tests; D012720:Severity of Illness Index
keywords: Lung Physiology; Lung Transplantation; Respiratory Measurement