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Bronchial hyperresponsiveness and the bronchiolitis obliterans syndrome after lung transplantation


Reid, DW and Walters, EH and Johns, DP and Ward, C and Burns, GP and Liakakos, P and Williams, TJ and Sneil, GI, Bronchial hyperresponsiveness and the bronchiolitis obliterans syndrome after lung transplantation, Journal of Heart and Lung Transplantation, 24, (4) pp. 489-492. ISSN 1053-2498 (2005) [Refereed Article]

DOI: doi:10.1016/j.healun.2004.02.006


Because bronchial hyperresponsiveness has been linked to the bronchiolitis obliterans syndrome (BOS), we determined PD20 methacholine (PD 20(M)), PD15 hypertonic saline (PD15(HS)) and their dose-response slopes (DRSM and DRSHS) in 8 single and 18 double lung transplant recipients within 1 year of lung transplantation and examined the relationship to bronchoalveolar lavage cell profiles and subsequent development of BOS. Twenty-two patients (81%) had a positive methacholine and 6 (25%) a positive hypertonic saline challenge. A positive PD15(HS) was associated with an increased risk for BOS at 2 years (odds ratio 12.6, 95% confidence interval 1.3-123.5, p < 0.05), and time to BOS was significantly and negatively related to DRSHS (r = -0.5, p < 0.05) - that is, the greater the response, the shorter the time to BOS. Interestingly, DRSHS correlated positively with recipient:donor total lung capacity ratio (r = 0.5, p < 0.05), but there was no relationship between either challenge result and airway inflammation. Methacholine hyperresponsiveness is common after lung transplantation but is not prognostic, whereas response to hypertonic saline may reflect recipient:donor size matching and provide useful information regarding the potential for BOS development. Copyright © 2005 by the International Society for Heart and Lung Transplantation.

Item Details

Item Type:Refereed Article
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Respiratory diseases
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Reid, DW (Dr David Reid)
UTAS Author:Walters, EH (Professor Haydn Walters)
UTAS Author:Johns, DP (Associate Professor David Johns)
ID Code:36106
Year Published:2005
Web of Science® Times Cited:13
Deposited By:Medicine
Deposited On:2005-08-01
Last Modified:2006-05-11

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