tailieunhanh - Báo cáo y học: " A review of bronchiolitis obliterans syndrome and therapeutic strategies."

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: A review of bronchiolitis obliterans syndrome and therapeutic strategies. | Hayes Journal of Cardiothoracic Surgery 2011 6 92 http content 6 1 92 REVIEW JCTS JOURNAL OF CARDIOTHORACIC SURGERY Open Access A review of bronchiolitis obliterans syndrome and therapeutic strategies Don Hayes Jr Abstract Lung transplantation is an important treatment option for patients with advanced lung disease. Survival rates for lung transplant recipients have improved however the major obstacle limiting better survival is bronchiolitis obliterans syndrome BOS . In the last decade survival after lung retransplantation has improved for transplant recipients with BOS. This manuscript reviews BOS along with the current therapeutic strategies including recent outcomes for lung retransplantation. Introduction Lung transplantation is a treatment option for patients with advanced lung disease or irreversible pulmonary failure. Despite advancements in surgical techniques lung preservation immunosuppression and management of ischemia reperfusion injury and infections acute and chronic allograft rejection continues to be a major problem. The incidence and severity of acute rejection in lung transplantation exceeds all other solid organ transplants 1 2 . Chronic rejection more commonly called bronchiolitis obliterans syndrome BOS is the leading cause of death beyond the first year post lung transplantation 3 4 . The key clinical feature of BOS is the development of airway obstruction with a reduction of forced expiratory volume in 1 second FEV1 that does not respond to bronchodilators Table 1 5 6 . The hallmark histological findings of chronic rejection is obliterative bronchiolitis OB which is an inflammatory process affecting small noncartilagenous airways 7 8 . Figure 1 is representative of the typical findings of OB histopathologically. The development of BOS is rare within the first year after lung transplant but the cumulative incidence ranges from 43 to 80 within the first five years of transplantation 4 9-11 . Diagnosis The .