Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Häufige urologisch-sexualmedizinische Themen in der Praxis sind das Thema des MMW-Webinars am 5. Juni von 17.30 bis 19 Uhr. Konkret geht es um die Frage, wann bei Harnwegsinfektionen auf Antibiotika verzichtet werden kann, und um ein Update zur Therapie von Libido- und Potenzstörungen des Mannes. Der dritte Vortrag behandelt sexuell übertragbare Krankheiten. Stellen Sie Ihre Fragen an die Experten und sammeln Sie 2 CME-Punkte. Jetzt gleich anmelden!
Erweiterte Suche
Anmelden
nach oben
Drugs
Erschienen in: Drugs 6/2005

01.04.2005 | Review Article

Bronchiolitis Obliterans Syndrome

Risk Factors and Therapeutic Strategies

verfasst von: Andrew I. R. Scott, Dr Linda D. Sharples, Susan Stewart

Erschienen in: Drugs | Ausgabe 6/2005

Einloggen, um Zugang zu erhalten

Abstract

Post-transplantation bronchiolitis obliterans syndrome (BOS) is a clinicopathological syndrome characterised histologically by obliterative bronchiolitis (OB) and physiologically by airflow limitation. It affects long-term survival with no consistently effective treatment strategy.
An updated review of risk factors for OB/BOS, and approaches to prevention and treatment was performed through a systematic review of relevant studies between January 1990 and February 2005. The initial search identified 853 publications, with 56 articles reviewed after exclusions. Early acute rejection is the most significant risk factor, with late rejection (≥3 months) also significant. Lymphocytic bronchitis/bronchiolitis is relevant, with later onset associated with greater risk. Viral infections are identified as significant risk factors. Human leukocyte antigen matching and OB/BOS development is a weaker association, but is stronger with acute rejection. Recipient and donor characteristics have a minor role. There is limited evidence that altering immunosuppression is effective in reducing the rate of decline in lung function.
BOS reflects an allo-immunological injury, possibly triggered by cytomegalovirus and respiratory viral infections, or noninfectious injury. Immunological susceptibility may be reflected by more frequent acute rejection episodes. Preventative and therapeutic modifications in immunosuppression remain important. Identifying markers of immunological susceptibility and, hence, risk stratification requires further research.
Literatur
1.
Burke CM, Theodore J, Dawkins KD, et al. Post-transplant obliterative bronchiolitis and other late lung sequelae in human heart-lung transplantation. Chest 1984; 86: 824–9PubMedCrossRef
2.
El-Gamel A, Sim E, Hasleton P, et al. Transforming growth factor beta (TGF-β) and obliterative bronchiolitis following pulmonary transplantation. J Heart Lung Transplant 1999; 18: 828–37PubMedCrossRef
3.
Sharpies LD, McNeil K, Stewart S, et al. Risk factors for bronchiolitis obliterans: a systematic review of recent publications. J Heart Lung Transplant 2002; 21: 271–81CrossRef
4.
Cooper JD, Billingham M, Egan T, et al. A working formulation for the standardization of nomenclature and for clinical staging of chronic dysfunction in lung allografts. International Society for Heart and Lung Transplantation. J Heart Lung Transplant 1993; 12: 713–6
5.
Estenne M, Maurer J, Boehler A, et al. Bronchiolitis obliterans syndrome 2001: an update of the diagnostic criteria. J Heart Lung Transplant 2002; 21: 297–310PubMedCrossRef
6.
van den Berg JW, Geertsma A, van der Bij W, et al. Bronchiolitis obliterans syndrome after lung transplantation and health-related quality of life. Am J Respir Crit Care Med 2000; 161: 1937–41
7.
van den Berg JW, van Enckevort PJ, TenVergert EM, et al. Bronchiolitis obliterans syndrome and additional costs of lung transplantation. Chest 2000; 118: 1648–52PubMedCrossRef
8.
Keller C, Cagle P, Brown R, et al. Bronchiolitis obliterans in recipients of single, double and heart-lung transplantation. Chest 1995; 107: 973–80PubMedCrossRef
9.
Heng D, Sharpies L, McNeil K, et al. Bronchiolitis obliterans syndrome: incidence, natural history, prognosis, and risk factors. J Heart Lung Transplant 1998; 17: 1255–63PubMed
10.
Yousem SA, Berry GJ, Cagle PT, et al. Revision of the 1990 working formulation for the classification of pulmonary allograft rejection: Lung Rejection Study Group. J Heart Lung Transplant 1996; 15: 1–15PubMed
11.
Girgis RE, Tu I, Berry GJ, et al. Risk factors for the development of obliterative bronchiolitis after lung transplantation. J Heart Lung Transplant 1996; 15: 1200–8PubMed
12.
Bando K, Paradis IL, Similo S, et al. Obliterative bronchiolitis after lung and heart-lung transplantation: an analysis of risk factors and management. J Thorac Cardiovasc Surg 1995; 110: 4–13PubMedCrossRef
13.
Husain AN, Siddiqui MT, Holmes EW, et al. Analysis of risk factors for the development of bronchiolitis obliterans syndrome. Am J Respir Crit Care Med 1999; 159: 829–33PubMed
14.
Kroshus TJ, Kshettry VR, Savik K, et al. Risk factors for the development of bronchiolitis obliterans syndrome after lung transplantation. J Thorac Cardiovasc Surg 1997; 114: 195–202PubMedCrossRef
15.
Ciccone AM, Stewart KC, Meyers BF, et al. Does donor cause of death affect the outcome of lung transplantation? J Thorac Cardiovasc Surg 2002; 123: 429–434; discussion 434-6PubMedCrossRef
16.
Hadjiliadis D, Davis RD, Palmer SM. Is transplant operation important in determining posttransplant risk of bronchiolitis obliterans syndrome in lung transplant recipients? Chest 2002; 122: 1168–75PubMedCrossRef
17.
Fiser SM, Tribble CG, Long SM, et al. Ischemia-reperfusion injury after lung transplantation increases risk of late bronchiolitis obliterans syndrome. Ann Thorac Surg 2002; 73: 1041–1047; discussion 1047-8PubMedCrossRef
18.
van den Berg JW, Hepkema BG, Geertsma A, et al. Long-term outcome of lung transplantation is predicted by the number of HLA-DR mismatches. Transplantation 2001; 71: 368–73PubMedCrossRef
19.
Schulman LL, Weinberg AD, McGregor CC, et al. Influence of donor and recipient HLA locus mismatching on development of obliterative bronchiolitis after lung transplantation. Am J Respir Crit Care Med 2001; 163: 437–42PubMed
20.
Hopkins PM, Aboyoun CL, Chhajed PN, et al. Association of minimal rejection in lung transplant recipients with obliterative bronchiolitis. Am J Respir Crit Care Med 2004; 170: 1022–6PubMedCrossRef
21.
Swanson SJ, Mentzer SJ, Reilly JJ, et al. Surveillance transbronchial lung biopsies: implication for survival after lung transplantation. J Thorac and Cardiovasc Surg 2000; 119: 27–38CrossRef
22.
Norgaard MA, Andersen CB, Pettersson G. Does bronchial artery revascularisation influence results concerning bronchiolitis obliterans syndrome and/or obliterative bronchiolitis after lung transplantation? Eur J Cardiothorac Surg 1998; 14: 311–8PubMedCrossRef
23.
Quantz MA, Bennett LE, Meyer DM, et al. Does human leukocyte antigen matching influence the outcome of lung transplantation? An analysis of 3,459 lung transplantations. J Heart Lung Transplant 2000; 19: 473–9PubMedCrossRef
24.
Sundaresan S, Mohanakumar T, Smith MA, et al. HLA-A locus mismatches and development of antibodies to HLA after lung transplantation correlate with the development of bronchiolitis obliterans syndrome. Transplantation 1998; 65(5): 648–53PubMedCrossRef
25.
Chalermskulrat W, Neuringer IP, Schmitz JL, et al. Human leukocyte antigen mismatches predispose to the severity of bronchiolitis obliterans syndrome after lung transplantation. Chest 2003; 123: 1825–31PubMedCrossRef
26.
Girnita AL, Duquesnoy R, Yousem SA, et al. HLA-specific antibodies are risk factors for lymphocytic bronchiolitis and chronic lung allograft dysfunction. Am J Transplant 2005; 5: 131–8PubMedCrossRef
27.
Opelz G, Wujciak T. The influence of HLA compatibility on graft survival after heart transplantation: the Collaborative Transplant Study [see comments]. N Engl J Med 1994; 330: 816–9PubMedCrossRef
28.
Palmer SM, Davis RD, Hadjiliadis D, et al. Development of an antibody specific to major histocompatibility antigens detectable by flow cytometry after lung transplant is associated with bronchiolitis obliterans syndrome. Transplantation 2002; 74: 799–804PubMedCrossRef
29.
Tamm M, Aboyoun CL, Chhajed PN, et al. Treated cytomegalovirus pneumonia is not associated with bronchiolitis obliterans syndrome. Am J Respir Crit Care Med 2004; 170: 1120–3PubMedCrossRef
30.
Duncan SR, Paradis IL, Yousem SA, et al. Sequelae of cytomegalovirus pulmonary infections in lung allograft recipients. Am Rev Resp Dis 1992; 146: 1419–25PubMed
31.
Soghikian MV, Valentine VG, Berry GJ, et al. Impact of ganciclovir prophylaxis on heart-lung and lung transplant recipients. J Heart Lung Transplant 1996; 15: 881–7PubMed
32.
Speich R, Thurnheer R, Gaspert A, et al. Efficacy and cost effectiveness of oral ganciclovir in the prevention of cytomegalovirus disease after lung transplantation. Transplantation 1999; 67: 315–20PubMedCrossRef
33.
Hohlfeld J, Neidermeyer J, Hamm H. Seasonal onset of bronchiolitis obliterans syndrome in lung transplant recipients. J Heart Lung Transplant 1996; 15: 888–94PubMed
34.
Glanville AR, Gencay M, Tamm M, et al. Chlamydia pneumoniae infection after lung transplantation. J Heart Lung Transplant 2005; 24: 131–6PubMedCrossRef
35.
Kotsimbos TC, Snell GI, Levvey B, et al. Chlamydia pneumoniae serology in donors and recipients and the risk of bronchiolitis obliterans syndrome after lung transplantation. Transplantation 2005; 79: 269–75PubMedCrossRef
36.
Palmer SM, Henshaw NG, Howell DN, et al. Community respiratory viral infection in adult transplant recipients. Chest 1998; 113: 944–50PubMedCrossRef
37.
Vilchez RA, Dauber J, McCurry K, et al. Parainfluenza virus infection in adult lung transplant recipients: an emergent clinical syndrome with implications on allograft function. Am J Transplant 2003; 3: 116–20PubMedCrossRef
38.
Billings JL, Hertz MI, Savik K, et al. Respiratory viruses and chronic rejection in lung transplant recipients. J Heart Lung Transplant 2002; 21: 559–66PubMedCrossRef
39.
Scott AR, Morton JM, Plit M, et al. Intravenous ribavirin: effective therapy for respiratory syncytial virus (RSV) infection after lung transplantation [Abstract]. J Heart Lung Transplant 2003; 22: S192CrossRef
40.
Hosenpud JD, Bennett LE, Keck BM, et al. The Registry of the International Society for Heart and Lung Transplantation: seventeenth official report-2000. J Heart Lung Transplant 2000; 19: 909–31PubMedCrossRef
41.
Fiser SM, Kron IL, Long SM, et al. Influence of graft ischemic time on outcomes following lung transplantation. J Heart Lung Transplant 2001; 20: 1291–6PubMedCrossRef
42.
Fisher AJ, Wardle J, Dark JH, et al. Non-immune acute graft injury after lung transplantation and the risk of subsequent bronchiolitis obliterans syndrome (BOS). J Heart Lung Transplant 2002; 21: 1206–12PubMedCrossRef
43.
Palmer SM, Miralles AP, Howell DN, et al. Gastroesophageal reflux as a reversible cause of allograft dysfunction after lung transplantation. Chest 2000; 118: 1214–7PubMedCrossRef
44.
Baudet EM, Dromer C, Dubrez J, et al. Intermediate-term results after en-bloc double-lung transplantation with bronchial arterial revascularisation. J Thorac Cardiovasc Surg 1996; 112: 1292–9PubMedCrossRef
45.
Yacoub M, Al-Kttan KM, Tadjkarimi S, et al. Medium term results of direct bronchial arterial revascularisation using IMA for single lung transplantation (SLT) with direct revascularisation. Eur J Cardiothorac Surg 1997; 11: 1030–6PubMedCrossRef
46.
Daly RC, McGregor CGA, McDougall JC, et al. Bronchial artery revascularisation does not prevent bronchiolitis obliterans syndrome after lung transplantation [abstract]. Third International Congress on Lung Transplantation; 1998 Sep 10–11; Paris, 22
47.
Smith MA, Sundaresan S, Mohanakuma T, et al. Effect of development of antibodies to HLA and cytomegalovirus mismatch on lung transplantation survival and development of bronchiolitis obliterans syndrome. J Thorac Cardiovasc Surg 1998; 116: 812–20PubMedCrossRef
48.
Jaramillo A, Smith MA, Phelan D, et al. Development of elisadetected anti-HLA antibodies precedes the development of bronchiolitis obliterans syndrome and correlates with progressive decline in pulmonary function after lung transplantation. Transplantation 1999; 67(8): 1155–61PubMedCrossRef
49.
Milne DS, Gascoigne AD, Ashcroft T, et al. Organizing pneumonia following pulmonary transplantation and the development of obliterative bronchiolitis. Transplantation 1994; 57: 1757–62PubMed
50.
Corris P, Glanville A, McNeil K, et al. One year analysis of an ongoing international randomized study of mycophenolate mofetil (MMF) vs azathioprine (AZA) in lung transplantation. J Heart Lung Transplant 2001; 20: 149–50CrossRef
51.
Speich R, Boehler A, Zalunardo MP, et al. Improved results after lung transplantation: analysis of factors. Swiss Med Wkly 2001; 131: 238–45PubMed
52.
Whitford H, Walters EH, Levvey B, et al. Addition of inhaled corticosteroids to systemic immunosuppression after lung transplantation: a double-blind, placebo-controlled trial. Transplantation 2002; 11: 1793–9CrossRef
53.
De Soyza A, Fisher AJ, Small T, et al. Inhaled corticosteroids and the treatment of lymphocytic bronchiolitis following lung transplantation. Am J Respir Crit Care Med 2001; 164: 1209–12PubMed
54.
Garrity Jr ER, Villanueva J, Bhorade SM, et al. Low rate of acute lung allograft rejection after the use of daclizumab, an interleukin 2 receptor antibody. Transplantation 2001; 71: 773–7PubMedCrossRef
55.
Brock MV, Borja MC, Ferber L, et al. Induction therapy in lung transplantation: a prospective, controlled clinical trial comparing OKT3, anti-thymocyte globulin, and daclizumab. J Heart Lung Transplant 2001; 20: 1282–90PubMedCrossRef
56.
Barlow CW, Moon MR, Green GR, et al. Rabbit antithymocyte globulin versus OKT3 induction therapy after heart-lung and lung transplantation: effect on survival, rejection, infection, and obliterative bronchiolitis. Transpl Int 2001; 14: 234–9PubMedCrossRef
57.
Snell GI, Esmore DS, Williams TJ. Cytolytic therapy for the bronchiolitis obliterans syndrome complicating lung transplantation. Chest 1996; 109: 874–8PubMedCrossRef
58.
Kruger RM, Shannon WD, Arens MQ, et al. The impact of ganciclovir-resistant cytomegalovirus infection after lung transplantation. Transplantation 1999; 68: 1272–9PubMedCrossRef
59.
Valantine HA, Luikart H, Doyle R, et al. Impact of cytomegalovirus hyperimmune globulin on outcome after cardiothoracic transplantation: a comparative study of combined prophylaxis with CMV hyperimmune globulin plus ganciclovir versus ganciclovir alone. Transplantation 2001; 72: 1647–52PubMedCrossRef
60.
Kwak B, Mulhaupt F, Myit S, et al. Statins as a newly recognized type of immunomodulator. Nat Med 2000; 6: 1399–402PubMedCrossRef
61.
Johnson BA, Iacono AT, Zeevi A, et al. Statin use is associated with improved function and survival of lung allografts. Am J Respir Crit Care Med 2003; 167: 1271–8PubMedCrossRef
62.
Iacono AT, Keenan RJ, Duncan SR, et al. Aerosolized cyclosporine in lung recipients with refractory chronic rejection. Am J Respir Crit Care Med 1996; 153: 1451–5PubMed
63.
Iacono AT, Corcoran TE, Griffith BP, et al. Aerosol cyclosporin therapy in lung transplant recipients with bronchiolitis obliterans. Eur Respir J 2004; 23: 384–90PubMedCrossRef
64.
Klepetko W, Estenne M, Glanville A, et al. A multicentre study to assess outcome following a switch in the primary immunosuppressant from cyclosporin (CYA) to tacrolimus (TAC) in lung recipients. J Heart Lung Transplant 2001; 20: 208PubMedCrossRef
65.
Revell MP, Lewis ME, Llewellyn-Jones CG, et al. Conservation of small-airway function by tacrolimus/cyclosporine conversion in the management of bronchiolitis obliterans following lung transplantation. J Heart Lung Transplant 2000; 19: 1219–23PubMedCrossRef
66.
Roman A, Bravo C, Monforte V, et al. Preliminary results of rescue therapy with tacrolimus and mycophenolate mofetil in lung transplanted patients with bronchiolitis obliterans. Transplant Proc 2002; 34: 146–7PubMedCrossRef
67.
Cairn J, Yek T, Banner NR, et al. Time-related changes in pulmonary function after conversion to tacrolimus in bronchiolitis obliterans syndrome. J Heart Lung Transplant 2003; 22: 50–7PubMedCrossRef
68.
Fieguth H, Krueger S, Wiedenmann D, et al. Tacrolimus for treatment of bronchiolitis obliterans syndrome after unilateral and bilateral lung transplantation. Transplant Proc 2002; 34(5): 1884PubMedCrossRef
69.
Sarahrudi K, Carretta A, Wisser W, et al. The value of switching from cyclosporine to tacrolimus in the treatment of refractory acute rejection and obliterative bronchiolitis after lung transplantation. Transplant Int 2002; 15: 24–8CrossRef
70.
Gerhardt SG, McDyer JF, Girgis RE, et al. Maintenance azithromycin therapy for bronchiolitis obliterans syndrome: results of a pilot study. Am J Respir Crit Care Med 2003; 168: 121–5PubMedCrossRef
71.
Verleden GM, Dupont LJ. Azithromycin therapy for patients with bronchiolitis obliterans syndrome after lung transplantation. Transplantation 2004; 77: 1465–7PubMedCrossRef
72.
Date H, Lynch JP, Sundaresan S, et al. The impact of cytolytic therapy on bronchiolitis obliterans syndrome. J Heart Lung Transplant 1998; 17: 869–75PubMed
73.
Kesten S, Rajagopalan N, Maurer J. Cytolytic therapy for bronchiolitis obliterans syndrome following lung transplantation. Transplantation 1996; 61: 427–30PubMedCrossRef
74.
O’Hagan AR, Stillwell PC, Arroliga A, et al. Photophoresis in the treatment of refractory bronchiolitis obliterans complicating lung transplantation. Chest 1999; 115: 1459–62PubMedCrossRef
75.
Diamond DA, Michalski JM, Lynch JP, et al. Efficacy of total lymphoid irradiation for chronic allograft rejection following bilateral lung transplantation. Int J Radiat Oncol Biol Phys 1998; 41: 795–800PubMedCrossRef
76.
Verleden GM, Buyse B, Delcroix M, et al. Cyclophosphamide rescue therapy for chronic rejection after lung transplantation. J Heart Lung Transplant 1999; 18: 1139–42PubMedCrossRef
77.
Dusmet M, Maurer J, Winton T, et al. Methotrexate can halt the progression of bronchiolitis obliterans syndrome in lung transplant recipients. J Heart Lung Transplant 1996; 15: 948–54PubMed
78.
Fahrni JA, Berry GJ, Morris RE, et al. Rapamycin inhibits development of obliterative airway disease in a murine heterotopic airway transplant model. Transplantation 1997; 63: 533–7PubMedCrossRef
79.
Chaill BC, Somerville KT, Crompton JA, et al. Early experience with sirolimus in lung transplant recipients with chronic allograft rejection. J Heart Lung Transplant 2003; 22: 169–76CrossRef
80.
Novick RJ, Stitt LW, Al-Kattan K, et al. Pulmonary retransplantation: predictors of graft function and survival in 230 patients: Pulmonary Retransplant Registry. Ann Thorac Surg 1998; 65: 227–34PubMedCrossRef
81.
Miller JD, Patterson GA. Retransplantation following isolated lung transplantation. Semin Thorac Cardiovasc Surg 1992; 4: 122–5PubMed
82.
Schäfers H-J, Hausen B, Wahlers T, et al. Retransplantation of the lung: a single center experience. Eur J Cardiothorac Surg 1995; 9: 291–6PubMedCrossRef
83.
Wekerle T, Klepetko W, Wisser W, et al. Lung retransplantation: institutional report on a series of twenty patients. J Heart Lung Transplant 1996; 15: 182–9PubMed
84.
Brugiére O, Thabut G, Castier Y, et al. Lung retransplantation for bronchiolitis obliterans syndrome: long-term followup in a series of 15 recipients. Chest 2003; 123: 1832–7PubMedCrossRef
Metadaten
Titel
Bronchiolitis Obliterans Syndrome
Risk Factors and Therapeutic Strategies
verfasst von
Andrew I. R. Scott
Dr Linda D. Sharples
Susan Stewart
Publikationsdatum
01.04.2005
Verlag
Springer International Publishing
Erschienen in
Drugs / Ausgabe 6/2005
Print ISSN: 0012-6667
Elektronische ISSN: 1179-1950
DOI
https://doi.org/10.2165/00003495-200565060-00004

Weitere Artikel der Ausgabe 6/2005

Drugs 6/2005 Zur Ausgabe

Review Article

Optimising the Use of β-Adrenoceptor Antagonists in Coronary Artery Disease

Adis Drug Profile

Mycophenolate Sodium Delayed Release

Adis Drug Evaluation

Tacrolimus Ointment

Adis Drug Evaluation

Valganciclovir

Adis Drug Profile

Mycophenolate Sodium Delayed Release

Therapy in Practice

Anaesthetic Agents for Advanced Regional Anaesthesia