| Bronchial hyperresponsiveness and the bronchiolitis obliterans syndrome after lung transplantation. | |
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MedLine Citation:
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PMID: 15797754 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Because bronchial hyperresponsiveness has been linked to the bronchiolitis obliterans syndrome (BOS), we determined PD(20) methacholine (PD(20(M))), PD(15) hypertonic saline (PD(15(HS))) and their dose-response slopes (DRS(M) and DRS(HS)) 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 PD(15(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 DRS(HS) (r = -0.5, p < 0.05) - that is, the greater the response, the shorter the time to BOS. Interestingly, DRS(HS) 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. |
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Authors:
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David W Reid; E Haydn Walters; David P Johns; C Ward; Graham P Burns; Pam Liakakos; Trevor J Williams; Greg I Snell |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation Volume: 24 ISSN: 1053-2498 ISO Abbreviation: J. Heart Lung Transplant. Publication Date: 2005 Apr |
Date Detail:
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Created Date: 2005-03-30 Completed Date: 2005-06-28 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9102703 Medline TA: J Heart Lung Transplant Country: United States |
Other Details:
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Languages: eng Pagination: 489-92 Citation Subset: IM |
Affiliation:
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Lung Transplant Service, Department of Respiratory Medicine, The Alfred Hospital and Monash University, Melbourne, Australia. David.Reid@monash.edu.au |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Inhalation Adult Aged Biopsy Bronchial Hyperreactivity / diagnosis, etiology*, physiopathology Bronchial Provocation Tests Bronchiolitis Obliterans / diagnosis, etiology*, physiopathology Bronchoalveolar Lavage Fluid / cytology Bronchoconstrictor Agents / administration & dosage, diagnostic use Bronchoscopy Disease Progression Female Follow-Up Studies Forced Expiratory Volume Humans Lung Transplantation / adverse effects* Male Methacholine Chloride / administration & dosage, diagnostic use Middle Aged Postoperative Complications Prognosis Retrospective Studies Risk Factors Saline Solution, Hypertonic / administration & dosage, diagnostic use Total Lung Capacity |
| Chemical | |
Reg. No./Substance:
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0/Bronchoconstrictor Agents; 0/Saline Solution, Hypertonic; 62-51-1/Methacholine Chloride |
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