Antibody-mediated rejection in lung transplantation: Turning myth into reality

摘要

Acute antibody-mediated rejection (AMR) of the allo-graft is now recognized as a significant complication after cardiac and renal transplantation. In both the pediatric and adult cardiac transplant populations, AMR is responsible for acute allograft dysfunction and predisposes patients to accelerated development of transplant vasculopathy and graft loss.1"5 The diagnosis and management of cardiac AMR have evolved over the last 20 years and the pathologic criteria have recently been enumerated.5'6 Over the last decade, there has also been increased attention given to the concept of AMR in the pulmonary transplant population.7'8 The consequences of immunologic injury in the form of donor HLA-specific antibodies include the development of persistent/recurrent acute cellular rejection (ACR) of all grades, lymphocytic bronchiolitis (LB), chronic rejection manifested as bronchiolitis obliterans syndrome (BOS) and its histopathologic correlate of obliterative bronchiolitis (OB).9"13