RT Journal Article
SR Electronic
T1 Airway versus transbronchial biopsy and BAL in lung transplant recipients: different but complementary
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 2876
OP 2880
DO 10.1183/09031936.97.10122876
VO 10
IS 12
A1 C Ward
A1 GI Snell
A1 B Orsida
A1 L Zheng
A1 TJ Williams
A1 EH Walters
YR 1997
UL http://erj.ersjournals.com/content/10/12/2876.abstract
AB Lung transplantation is now an established therapeutic intervention for end-stage cardiopulmonary disease in humans. Chronic rejection, in the form of bronchiolitis obliterans syndrome (BOS), remains the commonest cause of morbidity and mortality in those surviving more than 3 months. The pathology of BOS involves airway changes. We have evaluated the potential for endobronchial biopsies (EBB) to complement existing sampling methods used in allograft monitoring and have compared the results of EBB findings with those of bronchoalveolar lavage (BAL) and transbronchial biopsy (TBB) in 18 clinically stable patients. We found that all the EBB had inflammatory cells present but that only five TBB specimens had evidence of inflammation, with airway material being present in 78% of the TBB. Paired BAL and EBB yielded different results, with no correlations between total macrophages, lymphocytes, CD4+ cells or CD8+ cells. We conclude that endobronchial biopsies are potentially useful as an additional sample for the monitoring of inflammation in lung allografts, since they yield different, and potentially complimentary, information to bronchoalveolar lavage and transbronchial biopsy.