Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Vogl, UM; Nagayama, K; Bojic, M; Hoda, MA; Klepetko, W; Jaksch, P; Dekan, S; Siersch, V; Mitterbauer, M; Schellongowski, P; Greinix, HT; Petkov, V; Schulenburg, A; Kalhs, P; Rabitsch, W.
Lung transplantation for bronchiolitis obliterans after allogeneic hematopoietic stem cell transplantation: a single-center experience.
Transplantation. 2013; 95(4): 623-628.
Doi: 10.1097/TP.0b013e318277e29e
Web of Science
PubMed
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- Co-Autor*innen der Med Uni Graz
- Greinix Hildegard
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- Abstract:
- Bronchiolitis obliterans (BO) is a detrimental late pulmonary complication after allogeneic hematopoietic stem cell transplantation (HCT) associated with chronic graft-versus-host disease (cGvHD). When systemic immunosuppressive treatment fails to improve, severe BO patients should be considered for lung transplantation (LuTX). We present seven patients undergoing LuTX for severe refractory BO after HCT. Seven patients with hematologic malignancies developed severe cGvHD with lung involvement presenting as BO after allogeneic HCT. Evaluation for LuTX was initiated after failure of a median of 4 immunosuppressive regimens. Between 1996 and 2012, seven patients with severe refractory BO were evaluated for LuTX. The median time from HCT to diagnosis of chronic lung GvHD was 8.2 months (range, 3.7-16.6). At a median time of 18.1 months (range, 6-120) after diagnosis of BO, six patients received a bilateral sequential LuTX, and one patient received a single LuTX. Six postoperative courses were uneventful; the patient with single LuTX died from septic multiorgan failure. Three LuTX recipients had a mild acute rejection after one to three months after LuTX, and one patient experienced fatal chronic rejection and hemolytic uremic syndrome. At present, three (43%) LuTX recipients remain alive at a median observation time of 26 months (range, 1 month-16 years) after LuTX. The median overall survival from LuTX was 24 months (95% CI, 0.5-78); the median overall survival time after allogeneic HCT is 98 months (95% CI, 46-198). This case series illustrates that LuTX is a possible therapeutic option for selected patients with severe treatment-refractory BO.
- Find related publications in this database (using NLM MeSH Indexing)
- Acute Disease -
- Adolescent -
- Adult -
- Adult -
- Bronchiolitis Obliterans - diagnosis Bronchiolitis Obliterans - drug therapy Bronchiolitis Obliterans - etiology Bronchiolitis Obliterans - mortality Bronchiolitis Obliterans - surgery
- Chronic Disease -
- Drug Resistance -
- Female -
- Graft Rejection - etiology Graft Rejection - mortality
- Graft vs Host Disease - diagnosis Graft vs Host Disease - drug therapy Graft vs Host Disease - etiology Graft vs Host Disease - mortality Graft vs Host Disease - surgery
- Hematopoietic Stem Cell Transplantation - adverse effects
- Hemolytic-Uremic Syndrome - etiology Hemolytic-Uremic Syndrome - mortality
- Humans -
- Immunosuppressive Agents - therapeutic use
- Lung Transplantation - adverse effects Lung Transplantation - mortality
- Male -
- Middle Aged -
- Multiple Organ Failure - etiology Multiple Organ Failure - mortality
- Survival Analysis -
- Time Factors -
- Treatment Outcome -
- Young Adult -
- Find related publications in this database (Keywords)
- Hematopoietic stem cell transplantation
- Lung transplantation
- Bronchiolitis obliterans