  
Bronchoalveolar lavage analysis predicts obliterative bronchiolitis posttransplant
Last Updated: 2001-01-30 19:00:29 EST (Reuters Health)
WESTPORT, CT (Reuters Health) - Analysis of bronchoalveolar lavage fluid (BALF) within 2 months of lung transplantation can help predict which patients are likely to develop obliterative bronchiolitis within a year, according to a report published in the December 2000 issue of the American Journal of Respiratory and Critical Care Medicine.
Dr. Janny Scholma and colleagues, from the University of Groningen, in the Netherlands, prospectively assessed the value of BALF analysis in predicting obliterative bronchiolitis in 60 lung transplant recipients. The investigators compared BALF analyses from 19 patients who developed obliterative bronchiolitis with analyses from 41 patients who did not develop obliterative bronchiolitis.
The median time between lung transplantation and the first BAL was just over 40 days in both groups, the authors state. After logistic regression analysis, higher total cell, neutrophil, and lymphocyte counts, the presence of eosinophils, and higher interleukin-6 and -8 levels were significantly associated with an increased risk of developing obliterative bronchiolitis.
The investigators suggest that early recognition of transplant patients at risk of obliterative bronchiolitis could allow intervention with anti-inflammatory drugs or agents such as mofetil or FK506 to inhibit cytokine-driven lymphocyte proliferation.
"Early adjustment of the therapeutic regimen of patients according to their BALF cell count and cytokines profile may contribute to better prevention of obliterative bronchiolitis," Dr. Scholma's group added, "but further studies are needed to attain a better defined risk stratification and to gain more insight into the underlying mechanisms contributing to the development of obliterative bronchiolitis."
Am J Respir Crit Care Med 2000;162:2221-2225.
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