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Development of Obliterative Bronchiolitis in a Murine Model of Orthotopic Lung Transplantation
10:01

Development of Obliterative Bronchiolitis in a Murine Model of Orthotopic Lung Transplantation

Published on: July 10, 2012

Aspergillus colonization of the lung allograft is a risk factor for bronchiolitis obliterans syndrome

S S Weigt1, R M Elashoff, C Huang

  • 1Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. sweigt@mednet.ucla.edu

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
|May 23, 2009
PubMed

Insights

Aspergillus colonization in lung transplant recipients is linked to bronchiolitis obliterans syndrome (BOS) and decreased survival. Preventing Aspergillus may reduce BOS incidence post-transplant.

Area of Science:

  • Medicine
  • Transplantation Immunology
  • Infectious Diseases

Background:

  • Bronchiolitis obliterans syndrome (BOS) is a major cause of graft failure after lung transplantation.
  • Lung allograft airway colonization by Aspergillus species is frequently observed in lung transplant recipients.
  • The role of Aspergillus colonization in BOS development and post-transplant survival remains unclear.

Purpose of the Study:

  • To investigate the association between Aspergillus colonization and the development of BOS post-lung transplantation.
  • To determine if Aspergillus colonization impacts survival rates in lung transplant recipients.
  • To explore Aspergillus colonization as a potential risk factor for BOS, independent of acute rejection.

Main Methods:

  • Retrospective review of lung transplant recipients from January 2000 to June 2006.
  • Surveillance and clinically indicated bronchoscopies with bronchoalveolar lavage.
  • Definition of Aspergillus colonization: positive culture in absence of invasive aspergillosis.
  • Cox regression analyses to assess associations with BOS and mortality.

Main Results:

  • Aspergillus colonization was strongly associated with BOS development and BOS-related mortality.
  • Aspergillus colonization preceded BOS onset by a median of 261 days.
  • Multivariate analysis identified Aspergillus colonization as an independent risk factor for BOS, separate from acute rejection.

Conclusions:

  • Aspergillus colonization appears to play a causative role in the development of BOS post-lung transplantation.
  • Preventive strategies targeting Aspergillus colonization may potentially delay or reduce BOS incidence.
  • Further research is warranted to confirm these findings and develop targeted interventions.

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