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Updated: Oct 28, 2026
Development of Obliterative Bronchiolitis in a Murine Model of Orthotopic Lung Transplantation
Published on: July 10, 2012
Possible baseline lung allograft dysfunction within the first year defines a high-risk and potentially reversible
Michael Gerckens1,2, Aorchie Siddiqui1, Julian Schlatzer1
1Department of Medicine V, LMU University Hospital, LMU Munich, Comprehensive Pneumology Center (CPC), Member of the German Center of Lung Research (DZL), Munich, Germany.
Background:
Baseline lung allograft dysfunction (BLAD) has been associated with impaired long-term outcomes. However, BLAD within the first post-transplant year represents a potentially dynamic state. This is the first study evaluating a provisional Possible BLAD state, investigating risk factors and evolution to normal baseline lung function or confirmed BLAD.
Methods:
Possible BLAD was defined as failure to reach baseline forced expiratory volume in 1 s and forced vital capacity (FVC) ≥lower limit of normal within the first post-transplant year. Association of Possible BLAD and BLAD with allograft failure was investigated using multivariate time-dependent Cox regression analysis.
Results:
Among lung allograft recipients in the Munich Lung Transplant cohort, Possible BLAD occurred in a substantial share of lung allograft recipients. Possible BLAD was independently associated with a markedly increased risk of allograft failure (HR 4.76, 95% CI 2.64-8.61). Patients who recovered from Possible BLAD to normal baseline lung function had similar survival compared to lung allograft recipients directly reaching normal baseline lung function. A four-item clinical score at timepoint of first spirometry predicted recovery from possible BLAD (area under the curve (AUC) 0.83 for double lung allograft recipients, AUC 0.88 for single lung allograft recipients).
Conclusion:
Possible BLAD is associated with a markedly increased risk of mortality. A share of patients with Possible BLAD may recover to normal baseline lung function, while others progress to BLAD. Possible BLAD characterisation improves early risk stratification and might provide further insight into modifiable mechanisms underlying impaired allograft performance.
