Update on Chronic Lung Allograft Dysfunction

被引:37
作者
Gauthier J.M. [1 ]
Hachem R.R. [2 ]
Kreisel D. [1 ,3 ,4 ]
机构
[1] Department of Surgery, Washington University in St. Louis, Saint Louis, MO
[2] Department of Medicine, Washington University in St. Louis, Saint Louis, MO
[3] Department of Pathology & Immunology, Washington University in St. Louis, Saint Louis, MO
[4] Washington University School of Medicine, Campus Box 8234, 660 South Euclid Avenue, St. Louis, 63110, MO
关键词
Azithromycin responsive allograft dysfunction; Bronchiolitis obliterans; Bronchiolitis obliterans syndrome; Chronic lung allograft dysfunction; Neutrophilic reversible allograft dysfunction; Restrictive allograft syndrome;
D O I
10.1007/s40472-016-0112-y
中图分类号
学科分类号
摘要
Chronic lung allograft dysfunction (CLAD) encompasses a range of pathologies that cause a transplanted lung to not achieve or maintain normal function. CLAD manifests as airflow restriction and/or obstruction and is predominantly a result of chronic rejection. Three distinct phenotypes of chronic rejection are now recognized: bronchiolitis obliterans, neutrophilic reversible allograft dysfunction, and restrictive allograft syndrome. Recent investigations have revealed that each phenotype has a unique pathology and histopathological findings, suggesting that treatment regimens should be tailored to the underlying etiology. CLAD is poorly responsive to treatment once diagnosed, and therefore, the prevention of the factors that predispose a patient to develop CLAD is critically important. Small and large animal models have contributed significantly to our understanding of CLAD, and more studies are needed to develop treatment regimens that are effective in humans. © 2016, Springer International Publishing AG.
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页码:185 / 191
页数:6
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