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Donor Posterior Atrial Flap Rotation for Left Atrial Cuff Reconstruction in Lung Transplantation
Published on: October 11, 2024
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Acute rejection and post lung transplant surveillance
Mrinalini Venkata Subramani1, Sumir Pandit2, Shruti Kumar Gadre2
1Department of Pulmonary and Critical Care, Thomas Jefferson University, Philadelphia, PA USA.
Indian Journal of Thoracic and Cardiovascular Surgery
|March 28, 2022
Summary
Acute rejection is a common complication following lung transplantation, affecting nearly 30% of recipients. Early diagnosis and management of acute cellular rejection and antibody-mediated rejection are crucial for preventing chronic lung allograft dysfunction.
Area of Science:
- Transplant Immunology
- Pulmonology
- Allograft Pathology
Background:
- Acute rejection is a frequent complication after lung transplantation, despite advances in transplant immunology.
- Acute cellular rejection (ACR) affects up to 30% of lung transplant recipients within the first year.
- ACR, lymphocytic bronchiolitis, and antibody-mediated rejection (AMR) are significant risk factors for chronic lung allograft dysfunction (CLAD).
Purpose of the Study:
- To review and synthesize current evidence on the evaluation and treatment of acute rejection in lung transplant recipients.
- To highlight the diagnostic criteria and grading for ACR and lymphocytic bronchiolitis.
- To emphasize the multidisciplinary approach required for diagnosing AMR.
Main Methods:
- Literature review of current evidence on acute lung allograft rejection.
- Analysis of diagnostic criteria and risk factors for rejection.
- Synthesis of treatment strategies for acute rejection.
Main Results:
- Acute cellular rejection and lymphocytic bronchiolitis have established histopathologic diagnostic criteria.
- Antibody-mediated rejection diagnosis necessitates a multidisciplinary approach.
- Acute rejection is a known risk factor for the development of chronic rejection and allograft failure.
Conclusions:
- Further research is needed to refine risk factors, surveillance, and management strategies for acute allograft rejection.
- Effective management of acute rejection is critical to improve long-term lung transplant outcomes.
- Understanding and addressing acute rejection are key to preventing chronic lung allograft dysfunction.
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