Graft dysfunction after lung transplantation signals later onset of serious complication

Reported by Susan Aldridge, PhD, medical journalist

Primary graft dysfunction after lung transplantation increases the risk of bronchiolotis obliterans at a later stage.
Around 25 per cent of lung transplantation patients experience primary graft dysfunction, which is an acute lung injury occurring within hours of receiving the new organ. It is very serious, proving fatal for up to 50 per cent of those affected. Now researchers at Washington University School of Medicine reveal that primary graft dysfunction can also have long term consequences.

They looked for a complication called bronchiolotis obliterans syndrome (BOS) which involves chronic scarring in the small airways of the lung, leading to obstructive lung disease. BOS is the leading cause of death of lung transplantation patients at one year. In this study, 161 of a group of 320 patients went on to develop BOS. Those who had not developed primary graft dysfunction were far less likely to develop BOS. The more severe the level of primary graft dysfunction, the greater the risk of BOS. Therefore, avoiding primary graft dysfunction after lung transplantation surgery is crucial. The researchers suggest careful optimization of the immunosuppressive regime and close monitoring of lung function in the early days after surgery.

Source
American Journal of Respiratory and Critical Care Medicine March 2007

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