Abstract
Diagnosis of acute lung allograft rejection is currently based on transbronchial lung biopsies. Additional methods to detect acute allograft dysfunction derived from plasma and bronchoalveolar lavage samples might facilitate diagnosis and ultimately improve allograft survival. This review article gives an overview of the cell profiles of bronchoalveolar lavage and plasma samples during acute lung allograft rejection. The value of these cells and changes within the pattern of differential cytology to support the diagnosis of acute lung allograft rejection is discussed. Current findings on the topic are highlighted and trends for future research are identified.
Highlights
Lung transplantation is an established treatment option for selected patients with advanced lung disease [1, 2]
Despite improvement in surgical, postoperative and immunosuppressive management, the overall survival after lung transplantation remains lower than for recipients of other solid organ transplants [2, 3]. This is mainly due to development of chronic lung allograft dysfunction (CLAD), of which bronchiolitis obliterans syndrome (BOS) is the most common phenotype, being observed in more than 75 % of lung transplant recipients after 10 years [4, 5]
alveolar macrophages (AM) percentage in bronchoalveolar lavage (BAL) shows a trend towards reduction during acute allograft rejection (AR) [25, 32, 40, 42]
Summary
Lung transplantation is an established treatment option for selected patients with advanced lung disease [1, 2]. Despite improvement in surgical, postoperative and immunosuppressive management, the overall survival after lung transplantation remains lower than for recipients of other solid organ transplants [2, 3]. This is mainly due to development of chronic lung allograft dysfunction (CLAD), of which bronchiolitis obliterans syndrome (BOS) is the most common phenotype, being observed in more than 75 % of lung transplant recipients after 10 years [4, 5]. The gold standard for AR diagnosis is the analysis of serial
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