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Seasonal onset of bronchiolitis obliterans syndrome in lung transplant recipients.
J Heart Lung Transplant. 1996 Sep; 15(9):888-94.JH

Abstract

BACKGROUND

Bronchiolitis obliterans syndrome is the major complication in long-term survival of patients with lung transplants. Bronchiolitis obliterans syndrome is thought to represent a form of chronic allograft rejection and is associated with obstructive airways disease. Viral infections or other exogenous factors may trigger this condition.

METHODS

Because respiratory viral infections show seasonal clustering we studied seasonal onset of bronchiolitis obliterans syndrome in 157 lung and heart-lung transplant recipients. Individual baseline values of forced expiratory volume in 1 second were evaluated according to the International Society for Heart and Lung Transplantation criteria. For bronchiolitis obliterans syndrome classification, values of forced expiratory volume in 1 second were determined by the average of two measurements made at least 1 month apart. Onset of bronchiolitis obliterans syndrome was defined as the date of the initial pulmonary function test showing a persistent decline of forced expiratory volume in 1 second. Other factors causing obstructive airways disease were excluded.

RESULTS

Forty-nine patients (31%) showed development of bronchiolitis obliterans syndrome (n = 10 stage I, n = 13 stage II, n = 26 stage III) with onset of bronchiolitis obliterans syndrome 507 +/- 372 days (mean +/- standard deviation) after transplantation. Baseline value of forced expiratory volume in 1 second was reached at 270 +/- 231 days. Between January and March of each year onset of bronchiolitis obliterans syndrome developed in 23 patients (47%). In the second (April to June) and third (July to September) quarters a persistent decline of pulmonary function test results developed in 13 (27%) and 12 (24%) patients, respectively, whereas only 1 patient (2%) showed deterioration between October and December (p < 0.001).

CONCLUSIONS

Seasonal clustering of onset of bronchiolitis obliterans syndrome might thus indicate underlying unknown infectious triggers.

Authors+Show Affiliations

Hannover Medical School, Department of Respiratory Medicine, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8889984

Citation

Hohlfeld, J, et al. "Seasonal Onset of Bronchiolitis Obliterans Syndrome in Lung Transplant Recipients." The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation, vol. 15, no. 9, 1996, pp. 888-94.
Hohlfeld J, Niedermeyer J, Hamm H, et al. Seasonal onset of bronchiolitis obliterans syndrome in lung transplant recipients. J Heart Lung Transplant. 1996;15(9):888-94.
Hohlfeld, J., Niedermeyer, J., Hamm, H., Schäfers, H. J., Wagner, T. O., & Fabel, H. (1996). Seasonal onset of bronchiolitis obliterans syndrome in lung transplant recipients. The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation, 15(9), 888-94.
Hohlfeld J, et al. Seasonal Onset of Bronchiolitis Obliterans Syndrome in Lung Transplant Recipients. J Heart Lung Transplant. 1996;15(9):888-94. PubMed PMID: 8889984.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Seasonal onset of bronchiolitis obliterans syndrome in lung transplant recipients. AU - Hohlfeld,J, AU - Niedermeyer,J, AU - Hamm,H, AU - Schäfers,H J, AU - Wagner,T O, AU - Fabel,H, PY - 1996/9/1/pubmed PY - 1996/9/1/medline PY - 1996/9/1/entrez SP - 888 EP - 94 JF - The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation JO - J. Heart Lung Transplant. VL - 15 IS - 9 N2 - BACKGROUND: Bronchiolitis obliterans syndrome is the major complication in long-term survival of patients with lung transplants. Bronchiolitis obliterans syndrome is thought to represent a form of chronic allograft rejection and is associated with obstructive airways disease. Viral infections or other exogenous factors may trigger this condition. METHODS: Because respiratory viral infections show seasonal clustering we studied seasonal onset of bronchiolitis obliterans syndrome in 157 lung and heart-lung transplant recipients. Individual baseline values of forced expiratory volume in 1 second were evaluated according to the International Society for Heart and Lung Transplantation criteria. For bronchiolitis obliterans syndrome classification, values of forced expiratory volume in 1 second were determined by the average of two measurements made at least 1 month apart. Onset of bronchiolitis obliterans syndrome was defined as the date of the initial pulmonary function test showing a persistent decline of forced expiratory volume in 1 second. Other factors causing obstructive airways disease were excluded. RESULTS: Forty-nine patients (31%) showed development of bronchiolitis obliterans syndrome (n = 10 stage I, n = 13 stage II, n = 26 stage III) with onset of bronchiolitis obliterans syndrome 507 +/- 372 days (mean +/- standard deviation) after transplantation. Baseline value of forced expiratory volume in 1 second was reached at 270 +/- 231 days. Between January and March of each year onset of bronchiolitis obliterans syndrome developed in 23 patients (47%). In the second (April to June) and third (July to September) quarters a persistent decline of pulmonary function test results developed in 13 (27%) and 12 (24%) patients, respectively, whereas only 1 patient (2%) showed deterioration between October and December (p < 0.001). CONCLUSIONS: Seasonal clustering of onset of bronchiolitis obliterans syndrome might thus indicate underlying unknown infectious triggers. SN - 1053-2498 UR - https://www.unboundmedicine.com/medline/citation/8889984/Seasonal_onset_of_bronchiolitis_obliterans_syndrome_in_lung_transplant_recipients_ L2 - http://www.diseaseinfosearch.org/result/971 DB - PRIME DP - Unbound Medicine ER -