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Semin Respir Crit Care Med 2010; 31(2): 189-207
DOI: 10.1055/s-0030-1249116
© Thieme Medical Publishers

Chronic Allograft Rejection: Epidemiology, Diagnosis, Pathogenesis, and Treatment

S. Samuel Weigt1 , W. Dean Wallace2 , Ariss Derhovanessian1 , Rajan Saggar1 , Rajeev Saggar1 , Joseph P. Lynch1 , John A. Belperio1
  • 1Division of Pulmonary, Critical Care Medicine, Allergy, and Clinical Immunology, Department of Internal Medicine, The David Geffen School of Medicine at UCLA, Los Angeles, California
  • 2Department of Pathology and Laboratory Medicine, The David Geffen School of Medicine at UCLA, Los Angeles, California
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Publication History

Publication Date:
30 March 2010 (online)

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ABSTRACT

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.

KEYWORDS

Lung transplantation - chronic rejection - bronchiolitis obliterans syndrome

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S. Samuel WeigtM.D. 

The David Geffen School of Medicine at UCLA, Division of Pulmonary, Critical Care Medicine, Allergy, and Clinical Immunology

10833 Le Conte Ave., 37-131 CHS, Los Angeles, CA 90095

Email: sweigt@mednet.ucla.edu

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