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Eur J Cardiothorac Surg 2006;30:846-851
© 2006 Elsevier Science NL

Review

Bronchiolitis obliterans following lung transplantation

^a Department of Surgery, Division of Cardiothoracic Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, PR China
^b Department of Radiology, King Faisal Specialist Hospital and Research Centre, P.O. Box 40047, Jeddah 21499, Saudi Arabia

Received 7 April 2006; received in revised form 16 September 2006; accepted 20 September 2006.

^_* Corresponding author. Address: Division of Cardiothoracic Surgery, Department of Surgery, The Chinese University of Hong Kong General Office, 4/F Clinical Science Building, Prince of Wales Hospital, Shatin, Hong Kong SAR, PR China. Tel.: +852 2632 2629; fax: +852 2637 7974. (Email: algithmi{at}surgery.cuhk.edu.hk).

Bronchiolitis obliterans syndrome (BOS) is the main and late chronic complication after lung transplantation. It remains a major impediment to long-term outcome. Unfortunately, the survival rate of lung transplant recipients lags behind that of other organ transplant recipients, and BOS accounts for more than 30% of all mortality after the third year following lung transplantation. Most recent studies suggest that immune injury is the main pathogenic event in small airway obliteration and the development of BOS. Early detection of BOS is possible as well as essential because prompt initiation of treatment may halt the progress of the disease and the development of chronic graft failure. Current treatment of BOS is disappointing despite advances in surgical techniques and improvements in immunosuppressive therapies. Therefore, a clear understanding of the pathogenesis of BOS plays a major role in the search for new and effective therapeutic strategies for better long-term survival and quality of life after lung transplantation.

Key Words: Lung transplantation • Bronchiolitis obliterans • Pathogenesis

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