The lung is particularly vulnerable to function-limiting, structural damage after allogeneic transplantation. This is mediated by multiple mechanisms, including early innate and adaptive immune responses that are followed all too frequently by fibrotic remodeling. Within 5 years, this produces the largely untreatable bronchiolitis obliterans syndrome in the majority of lung transplant patients, leading to significant morbidity and mortality. Recent studies have focused on the contribution of lung-resident mesenchymal stem cells (MSCs) to both positive and negative regulation of these graft-damaging processes.
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