Restrictive chronic lung function decline after haematopoietic stem cell transplantation

Until recently, it was generally thought that bronchiolitis obliterans syndrome (BOS), which is a type of obstructive lung disease with a dismal outcome, was the sole form of chronic lung allograft dysfunction (CLAD) occurring after lung transplantation. However, recent publications reported that some patients experience a restrictive form of chronic lung complication that has been termed restrictive allograft syndrome (RAS) [1]. Approximately one-third of patients with CLAD after lung transplantation can be classified as having RAS [2, 3]. This distinct form of CLAD is considered to be an important entity and has features that are distinct from those of BOS. First and foremost, the mortality of RAS is even greater than that from BOS: a previous study reported that the survival of patients with RAS was significantly poorer than that of patients with BOS [3]. Secondly, imaging of BOS on computed tomography (CT) has revealed air trapping, tree-in-bud opacities and peribronchial infiltrates, whereas RAS presented mainly with alveolar or interstitial changes such as septal thickening or reticulation [4]. Additionally, RAS has been histologically characterised by diffuse alveolar damage and extensive fibrosis in the alveolar interstitium and interlobular septa [2].

Source: European Respiratory Journal - December 31, 2015 Category: Respiratory Medicine Authors: Yang, J.-Y., Oh, S. Y., Song, J. W., Shim, T. S., Lee, S. W., Lee, J. S., Kim, D.-Y., Lee, J.-H., Lee, J.-H., Lee, K.-H., Jo, K.-W. Tags: Lung structure and function Original Articles: Research letters Source Type: research