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https://hdl.handle.net/2440/71679
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Type: | Journal article |
Title: | A novel approach to the assessment of lymphocytic bronchiolitis after lung transplantation-transbronchial brush |
Author: | Chambers, D. Hodge, S. Hodge, G. Yerkovich, S. Kermeen, F. Reynolds, P. Holmes, M. Hopkins, P. |
Citation: | Journal of Heart and Lung Transplantation, 2011; 30(5):544-551 |
Publisher: | Elsevier Science Inc |
Issue Date: | 2011 |
ISSN: | 1053-2498 1557-3117 |
Statement of Responsibility: | Daniel C. Chambers, Sandra Hodge, Greg Hodge, Stehanie T. Yerkovich, Fiona D. Kermeen, Paul Reynolds, Mark Holmes and Peter M.A. Hopkins |
Abstract: | <h4>Background</h4>Lymphocytic bronchiolitis (LB) is the strongest risk factor for subsequent allograft loss due to bronchiolitis obliterative syndrome (BOS); however, it is poorly assessed by transbronchial biopsy (TBBx) because of sampling error, interpretation error and the presence of non-alloimmune airway inflammation. We hypothesized that flow cytometric evaluation of bronchiolar brushings (transbronchial brush, TBBr) may be a better approach.<h4>Methods</h4>Transbronchial brushings (2 to 3 cm from the pleural surface under radiologic guidance) were obtained prior to TBBx in 32 patients and analyzed by flow cytometry. We assessed the proportion of nucleated cells that were CD3(+)CD103(+) (epithelial-specific T cells).<h4>Results</h4>No adverse events occurred; 0.5% (0.27 to 0.84) of the cells were epithelial-specific T cells and numbers increased with episodes of Grade A1 rejection (p < 0.01) and in patients with BOS (p = 0.02). Viral and invasive fungal infection were associated with marked infiltration with CD103(-) T cells (p < 0.01).<h4>Conclusion</h4>TBBr is simple to obtain, low risk, quantitative, and can discriminate between infective and alloimmune LB. It may be a valuable addition to current lung allograft assessment. |
Keywords: | Bronchi T-Lymphocytes Humans Bronchiolitis Bronchiolitis Obliterans Integrin alpha Chains Antigens, CD Diagnostic Techniques, Respiratory System Bronchoscopy Lung Transplantation Flow Cytometry Risk Factors Cross-Sectional Studies Graft Rejection Adult Middle Aged Female Male |
Rights: | Copyright © 2011 Elsevier B.V. |
DOI: | 10.1016/j.healun.2010.10.018 |
Published version: | http://dx.doi.org/10.1016/j.healun.2010.10.018 |
Appears in Collections: | Aurora harvest Medicine publications |
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