Spectrum of chronic lung allograft dysfunction pathology in human lung transplantation.
Evidence level: human explant histology study (20 CLAD patients, 13 controls); abstract-only
A Toronto histology study of explanted lungs from 20 patients retransplanted for CLAD, reporting a wide overlap between BOS and RAS pathology.
As of . Primary source: Publisher record via DOI.
Summary
According to the abstract, paraffin-embedded explant samples from 3 lobes of 20 consecutive patients undergoing a second lung transplant for CLAD were compared with 13 control samples from lobectomies or donor lungs, using blinded semi-quantitative grading of airway fibrosis, parenchymal and pleural fibrosis, and epithelial and vascular abnormalities. CLAD samples scored higher than controls on all airway- and lung-related parameters. The abstract reports a notable overlap in scores between BOS and RAS, with parenchymal and vascular fibrosis scores significantly higher in RAS (p = 0.003 for both). Immunofluorescence showed a trend toward fewer club cells in CLAD and a higher frequency of apoptotic club cells in BOS samples (p = 0.01). The authors conclude that CLAD is a spectrum of airway, parenchymal and pleural fibrosis with epithelial, vascular and inflammatory changes, and that their grading score may be useful for future histologic assessment. The authors include Tereza Martinu and Stephen Juvet.
Details
- doi
- 10.1016/j.healun.2024.04.002
- pmid
- 38663465
- authors
- Renaud-Picard B, Berra G, Hwang D, Huszti E, Miyamoto E, Berry GJ, Pal P, Juvet S, Keshavjee S, Martinu T
- journal
- The Journal of Heart and Lung Transplantation
- year
- 2024
- volume
- 43
- issue
- 10
- pages
- 1701-1715
Sources and links
- Publisher record via DOI (primary)
- PubMed 38663465
Related
Links from this record
- discusses: Bronchiolitis obliterans syndrome (BOS)
- discusses: Restrictive allograft syndrome (RAS)
- supports: Airway epithelial dysfunction
- coauthor: Tereza Martinu
- coauthor: Stephen Juvet
- affiliation named in PubMed record (Toronto Lung Transplant Program): Toronto Lung Transplant Program (University Health Network)
Linked from (derived)
- author: Shaf Keshavjee
Known gaps in this record
- full text not read (abstract only)
- funding statement and grant numbers
- full author affiliations (only the PubMed affiliation text was checked for named centres)
Information resource only. Not medical advice. Not a substitute for the care of the patient's transplant team.