Original ArticlesTransforming growth factor beta (TGF-β) and obliterative bronchiolitis following pulmonary transplantation
Section snippets
Patients and sample
Specimens from 93 consecutive lung transplantations performed on 91 patients in the Wythenshawe Lung Transplant Program between January 1990 and March 1996 were analyzed retrospectively. In addition 380 fixed unstained transbronchial biopsies from our histologic archives were stained for TGF-β. We also reviewed 780 transbronchial biopsies from all the recipients to classify and score rejection, infection, and fibrosis of our patients. Technical aspects of lung transplantation operative
Results
Procedures were heart and lung (n = 32), double lung (n = 18), and single lung transplantation (n = 41). Descriptive statistics of different variables are shown in Table III. The incidence of OB in this group was 28.5% (n = 26/91). All satisfied the functional decline accepted as a definition for BOS, of whom 20 had positive histology at the time of OB diagnosis and 6 were confirmed at postmortum. BOS grades are presented in Figure 1. Overall 30-day mortality was 10.9% (n = 10/91), and 90-day
Discussion
Since the first long-term success of human lung transplant in 1983 (Toronto Lung Transplant Group, 1986) remarkable progress has been achieved. The operative mortality rate is now in the range of 10%. One- and 2-year survival rates are 80% and 70%, respectively.21 However, problems remain, most notably chronic rejection, which is manifested in the pulmonary allograft as OB.
TGF-β is an important member of a family of cytokines involved in controlling the differentiation and proliferation of a
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