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Minimal acute cellular rejection remains prevalent up to 2 years after lung transplantation: a retrospective analysis of 2697 transbronchial biopsies.
Transplantation. 2008 Feb 27; 85(4):547-53.T

Abstract

BACKGROUND

Acute cellular rejection (ACR) is the most consistently reported risk factor for the development of bronchiolitis obliterans syndrome, an important cause of late mortality after lung transplantation. This retrospective study comprised all transbronchial biopsies (TBB) obtained during the first 2 years after transplantation in a consecutive cohort of 299 patients transplanted 1996-2006 (n=2697).

METHODS

TBB were aligned to the closest TBB surveillance schedule.

RESULTS

Patients completed a mean of 6+/-2 (median 8) TBB schedules. The proportion of patients demonstrating ACR (>or=A2) decreased with increasing time from transplantation from 43% at 2 weeks to 27% at 6 months, and 13% and 4% at 1 and 2 years, respectively (trend test, P<0.0001). There was a significant trend between increased previous occurrence of ACR and increasing subsequent risk of A>or=2 from 1, 3, and 12 months after transplantation (P<0.0001, P=0.0005, and P=0.001, respectively). Multivariate analyses identified interleukin-2-receptor induction with daclizumab versus antithymocyte globulin was independently associated with more frequent/severe ACR (P<0.0001).

CONCLUSIONS

Minimal ACR remains prevalent up to 2 years after lung transplantation. Previous occurrence of ACR was associated with an increased risk of subsequent ACR.

Authors+Show Affiliations

Department of Cardiology, Division of Lung Transplantation, Institute of Public Health, Copenhagen University, Copenhagen, Denmark. cmburton@doctors.net.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18347533

Citation

Burton, Christopher M., et al. "Minimal Acute Cellular Rejection Remains Prevalent Up to 2 Years After Lung Transplantation: a Retrospective Analysis of 2697 Transbronchial Biopsies." Transplantation, vol. 85, no. 4, 2008, pp. 547-53.
Burton CM, Iversen M, Scheike T, et al. Minimal acute cellular rejection remains prevalent up to 2 years after lung transplantation: a retrospective analysis of 2697 transbronchial biopsies. Transplantation. 2008;85(4):547-53.
Burton, C. M., Iversen, M., Scheike, T., Carlsen, J., & Andersen, C. B. (2008). Minimal acute cellular rejection remains prevalent up to 2 years after lung transplantation: a retrospective analysis of 2697 transbronchial biopsies. Transplantation, 85(4), 547-53. https://doi.org/10.1097/TP.0b013e3181641df9
Burton CM, et al. Minimal Acute Cellular Rejection Remains Prevalent Up to 2 Years After Lung Transplantation: a Retrospective Analysis of 2697 Transbronchial Biopsies. Transplantation. 2008 Feb 27;85(4):547-53. PubMed PMID: 18347533.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Minimal acute cellular rejection remains prevalent up to 2 years after lung transplantation: a retrospective analysis of 2697 transbronchial biopsies. AU - Burton,Christopher M, AU - Iversen,Martin, AU - Scheike,Thomas, AU - Carlsen,Jørn, AU - Andersen,Claus B, PY - 2008/3/19/pubmed PY - 2008/5/31/medline PY - 2008/3/19/entrez SP - 547 EP - 53 JF - Transplantation JO - Transplantation VL - 85 IS - 4 N2 - BACKGROUND: Acute cellular rejection (ACR) is the most consistently reported risk factor for the development of bronchiolitis obliterans syndrome, an important cause of late mortality after lung transplantation. This retrospective study comprised all transbronchial biopsies (TBB) obtained during the first 2 years after transplantation in a consecutive cohort of 299 patients transplanted 1996-2006 (n=2697). METHODS: TBB were aligned to the closest TBB surveillance schedule. RESULTS: Patients completed a mean of 6+/-2 (median 8) TBB schedules. The proportion of patients demonstrating ACR (>or=A2) decreased with increasing time from transplantation from 43% at 2 weeks to 27% at 6 months, and 13% and 4% at 1 and 2 years, respectively (trend test, P<0.0001). There was a significant trend between increased previous occurrence of ACR and increasing subsequent risk of A>or=2 from 1, 3, and 12 months after transplantation (P<0.0001, P=0.0005, and P=0.001, respectively). Multivariate analyses identified interleukin-2-receptor induction with daclizumab versus antithymocyte globulin was independently associated with more frequent/severe ACR (P<0.0001). CONCLUSIONS: Minimal ACR remains prevalent up to 2 years after lung transplantation. Previous occurrence of ACR was associated with an increased risk of subsequent ACR. SN - 0041-1337 UR - https://www.unboundmedicine.com/medline/citation/18347533/Minimal_acute_cellular_rejection_remains_prevalent_up_to_2_years_after_lung_transplantation:_a_retrospective_analysis_of_2697_transbronchial_biopsies_ L2 - https://doi.org/10.1097/TP.0b013e3181641df9 DB - PRIME DP - Unbound Medicine ER -