Bronchoalveolar lavage in lung transplantation

One of the dilemmas in the management of lung allotransplant recipients is our inability to precisely determine the cause of graft dysfunction. Differentiating between lung allograft infection, rejection, atelectasis, or ischemic injury remains a difficult task. Tests directed at identifying systemic abnormalities such as peripheral blood analysis so far have been nonspecific and unlikely to accurately and promptly represent changes occurring within the lungs. Transbronchial biopsy and bronchoalveolar lavage have emerged as two methods with the most potential for aiding in the establishment of diagnosis. This review attempts to provide the readers with a current knowledge of the cellular events in lung allograft and the status of bronchoalveolar lavage in experimental and clinical lung transplantation.