Tags

Type your tag names separated by a space and hit enter

Yield of surveillance bronchoscopy for acute rejection and lymphocytic bronchitis/bronchiolitis after lung transplantation.
J Heart Lung Transplant. 2004 Dec; 23(12):1396-404.JH

Abstract

BACKGROUND

Better understanding of the timing and pattern of surveillance bronchoscopy findings after lung transplantation could influence the timing and frequency of surveillance bronchoscopy. We present our surveillance bronchoscopy experience and test the hypothesis that patients not encountering early acute rejection or lymphocytic bronchitis/bronchiolitis are less likely to have subsequent occult occurrences in the 1st year after lung transplantation.

METHODS

We conducted a retrospective study of 204 patients who underword transplantation between 1996 and 2000. Based on contemporary biopsy-specimen grading in the first 100 days, we formed 2 groups: No Early Rejection and Early Rejection. We compared subsequent yields of surveillance bronchoscopy and the incidence of acute rejection or of lymphocytic bronchitis/bronchiolitis.

RESULTS

We reviewed 645 biopsies taken from 204 recipients during the first 100 days to classify patients into a No Early Rejection Group (n=67) or an Early Rejection Group (n=137). Yield of surveillance bronchoscopy for acute rejection or lymphocytic bronchitis/bronchiolitis was 31% with the greatest yield during the first 30 days (45%), and then decreasing to 26% (p <0.001). After Day 100, 71% of occult acute rejection episodes involved minimal (A1) lesions. Yield of surveillance bronchoscopy after Day 100 was 20% in the No Early Rejection Group and was 27% in the Early Rejection Group (p=0.22). Incidence of acute rejection or lymphocytic bronchitis/bronchiolitis after Day 100 was 41% in the No Early Rejection Group and was 50% in the Early Rejection Group (p=0.17).

CONCLUSION

Surveillance bronchoscopy detects occult acute rejection or lymphocytic bronchitis/bronchiolitis in approximately one-third of biopsy specimens during the 1st year, with the majority of late abnormalities being minimal (A1) rejection. The absence of acute rejection or lymphocytic bronchitis/bronchiolitis during the first 100 days does not predict freedom from such events in the remainder of the 1st year.

Authors+Show Affiliations

Division of Pulmonary and Critical Care Medicine, Saint Louis, Missouri 63110, USA. chakinalam@wustl.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15607670

Citation

Chakinala, Murali M., et al. "Yield of Surveillance Bronchoscopy for Acute Rejection and Lymphocytic Bronchitis/bronchiolitis After Lung Transplantation." The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation, vol. 23, no. 12, 2004, pp. 1396-404.
Chakinala MM, Ritter J, Gage BF, et al. Yield of surveillance bronchoscopy for acute rejection and lymphocytic bronchitis/bronchiolitis after lung transplantation. J Heart Lung Transplant. 2004;23(12):1396-404.
Chakinala, M. M., Ritter, J., Gage, B. F., Lynch, J. P., Aloush, A., Patterson, G. A., & Trulock, E. P. (2004). Yield of surveillance bronchoscopy for acute rejection and lymphocytic bronchitis/bronchiolitis after lung transplantation. The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation, 23(12), 1396-404.
Chakinala MM, et al. Yield of Surveillance Bronchoscopy for Acute Rejection and Lymphocytic Bronchitis/bronchiolitis After Lung Transplantation. J Heart Lung Transplant. 2004;23(12):1396-404. PubMed PMID: 15607670.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Yield of surveillance bronchoscopy for acute rejection and lymphocytic bronchitis/bronchiolitis after lung transplantation. AU - Chakinala,Murali M, AU - Ritter,Jon, AU - Gage,Brian F, AU - Lynch,John P, AU - Aloush,Aviva, AU - Patterson,G Alexander, AU - Trulock,Elbert P, PY - 2003/04/17/received PY - 2003/09/08/revised PY - 2003/09/10/accepted PY - 2004/12/21/pubmed PY - 2005/3/24/medline PY - 2004/12/21/entrez SP - 1396 EP - 404 JF - The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation JO - J. Heart Lung Transplant. VL - 23 IS - 12 N2 - BACKGROUND: Better understanding of the timing and pattern of surveillance bronchoscopy findings after lung transplantation could influence the timing and frequency of surveillance bronchoscopy. We present our surveillance bronchoscopy experience and test the hypothesis that patients not encountering early acute rejection or lymphocytic bronchitis/bronchiolitis are less likely to have subsequent occult occurrences in the 1st year after lung transplantation. METHODS: We conducted a retrospective study of 204 patients who underword transplantation between 1996 and 2000. Based on contemporary biopsy-specimen grading in the first 100 days, we formed 2 groups: No Early Rejection and Early Rejection. We compared subsequent yields of surveillance bronchoscopy and the incidence of acute rejection or of lymphocytic bronchitis/bronchiolitis. RESULTS: We reviewed 645 biopsies taken from 204 recipients during the first 100 days to classify patients into a No Early Rejection Group (n=67) or an Early Rejection Group (n=137). Yield of surveillance bronchoscopy for acute rejection or lymphocytic bronchitis/bronchiolitis was 31% with the greatest yield during the first 30 days (45%), and then decreasing to 26% (p <0.001). After Day 100, 71% of occult acute rejection episodes involved minimal (A1) lesions. Yield of surveillance bronchoscopy after Day 100 was 20% in the No Early Rejection Group and was 27% in the Early Rejection Group (p=0.22). Incidence of acute rejection or lymphocytic bronchitis/bronchiolitis after Day 100 was 41% in the No Early Rejection Group and was 50% in the Early Rejection Group (p=0.17). CONCLUSION: Surveillance bronchoscopy detects occult acute rejection or lymphocytic bronchitis/bronchiolitis in approximately one-third of biopsy specimens during the 1st year, with the majority of late abnormalities being minimal (A1) rejection. The absence of acute rejection or lymphocytic bronchitis/bronchiolitis during the first 100 days does not predict freedom from such events in the remainder of the 1st year. SN - 1053-2498 UR - https://www.unboundmedicine.com/medline/citation/15607670/Yield_of_surveillance_bronchoscopy_for_acute_rejection_and_lymphocytic_bronchitis/bronchiolitis_after_lung_transplantation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1053249803004741 DB - PRIME DP - Unbound Medicine ER -