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Prognostic value of bronchoalveolar lavage neutrophilia in stable lung transplant recipients.
J Heart Lung Transplant. 2009 May; 28(5):468-74.JH

Abstract

BACKGROUND

Bronchoalveolar lavage (BAL) neutrophilia may identify patients prone to develop bronchiolitis obliterans syndrome (BOS) after lung transplantation (LTx). This study assessed the predictive value of BAL neutrophilia in stable recipients.

METHODS

Evaluated were 63 consecutive recipients 3 to 12 months after LTx demonstrating no acute rejection (AR) and lymphocytic bronchitis (LB; B < or = 1 without infection; BOS, 0). Recipients were subdivided into never-BOS (follow-up > or = 12 months) and ever-BOS groups (i.e., BOS development > or = 1 after bronchoscopy).

RESULTS

The groups were statistically indistinguishable for demographic data and preceding AR and LB episodes. Onset of BOS was at a median of 232 days (range, 87-962) after bronchoscopy. The ever-BOS group (16 patients) demonstrated a significantly higher percentage of neutrophils compared with the never-BOS group (47 patients) at the time of bronchoscopy (33.6% +/- 2.1% vs 9.9% +/- 1.1%, p < 0.05). By Cox regression analysis, a BAL neutrophil percentage of > or = 20% remained a significant predictor for BOS > or = 1 (hazard ratio, 3.57; 95% confidence interval, 1.71-8.40, p < 0.05) distinct from known potential BOS predictor variables. The positive and negative predictive value of BAL neutrophilia of > or = 20% for future BOS was 0.72 and 0.93, respectively (p < 0.05).

CONCLUSION

BAL neutrophilia in stable recipients is of predictive value to identify recipients at risk for BOS. These data warrant prospective confirmation and further studies to evaluate the benefit of preemptive therapy for potential BOS patients.

Authors+Show Affiliations

Department of Internal Medicine I, Division of Pulmonary Diseases, Klinikum Grosshadern, Ludwig-Maximilians University, Munich, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo 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

19416775

Citation

Neurohr, Claus, et al. "Prognostic Value of Bronchoalveolar Lavage Neutrophilia in Stable Lung Transplant Recipients." The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation, vol. 28, no. 5, 2009, pp. 468-74.
Neurohr C, Huppmann P, Samweber B, et al. Prognostic value of bronchoalveolar lavage neutrophilia in stable lung transplant recipients. J Heart Lung Transplant. 2009;28(5):468-74.
Neurohr, C., Huppmann, P., Samweber, B., Leuschner, S., Zimmermann, G., Leuchte, H., Baumgartner, R., Hatz, R., Frey, L., Ueberfuhr, P., Bittmann, I., & Behr, J. (2009). Prognostic value of bronchoalveolar lavage neutrophilia in stable lung transplant recipients. The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation, 28(5), 468-74. https://doi.org/10.1016/j.healun.2009.01.014
Neurohr C, et al. Prognostic Value of Bronchoalveolar Lavage Neutrophilia in Stable Lung Transplant Recipients. J Heart Lung Transplant. 2009;28(5):468-74. PubMed PMID: 19416775.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prognostic value of bronchoalveolar lavage neutrophilia in stable lung transplant recipients. AU - Neurohr,Claus, AU - Huppmann,Patrick, AU - Samweber,Benedikt, AU - Leuschner,Stefan, AU - Zimmermann,Gregor, AU - Leuchte,Hanno, AU - Baumgartner,Rainer, AU - Hatz,Rudolf, AU - Frey,Ludwig, AU - Ueberfuhr,Peter, AU - Bittmann,Iris, AU - Behr,Juergen, AU - ,, Y1 - 2009/03/14/ PY - 2008/10/26/received PY - 2009/01/09/revised PY - 2009/01/14/accepted PY - 2009/5/7/entrez PY - 2009/5/7/pubmed PY - 2009/7/31/medline SP - 468 EP - 74 JF - The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation JO - J. Heart Lung Transplant. VL - 28 IS - 5 N2 - BACKGROUND: Bronchoalveolar lavage (BAL) neutrophilia may identify patients prone to develop bronchiolitis obliterans syndrome (BOS) after lung transplantation (LTx). This study assessed the predictive value of BAL neutrophilia in stable recipients. METHODS: Evaluated were 63 consecutive recipients 3 to 12 months after LTx demonstrating no acute rejection (AR) and lymphocytic bronchitis (LB; B < or = 1 without infection; BOS, 0). Recipients were subdivided into never-BOS (follow-up > or = 12 months) and ever-BOS groups (i.e., BOS development > or = 1 after bronchoscopy). RESULTS: The groups were statistically indistinguishable for demographic data and preceding AR and LB episodes. Onset of BOS was at a median of 232 days (range, 87-962) after bronchoscopy. The ever-BOS group (16 patients) demonstrated a significantly higher percentage of neutrophils compared with the never-BOS group (47 patients) at the time of bronchoscopy (33.6% +/- 2.1% vs 9.9% +/- 1.1%, p < 0.05). By Cox regression analysis, a BAL neutrophil percentage of > or = 20% remained a significant predictor for BOS > or = 1 (hazard ratio, 3.57; 95% confidence interval, 1.71-8.40, p < 0.05) distinct from known potential BOS predictor variables. The positive and negative predictive value of BAL neutrophilia of > or = 20% for future BOS was 0.72 and 0.93, respectively (p < 0.05). CONCLUSION: BAL neutrophilia in stable recipients is of predictive value to identify recipients at risk for BOS. These data warrant prospective confirmation and further studies to evaluate the benefit of preemptive therapy for potential BOS patients. SN - 1557-3117 UR - https://www.unboundmedicine.com/medline/citation/19416775/Prognostic_value_of_bronchoalveolar_lavage_neutrophilia_in_stable_lung_transplant_recipients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1053-2498(09)00035-7 DB - PRIME DP - Unbound Medicine ER -