ABSTRACT
I. Introduction Lung transplantation is the final therapeutic option for selected patients with multiple end-stage pulmonary disease entities, yet its long-term success is significantly limited by chronic allograft dysfunction/rejection histologically characterized by obliterative bronchiolitis (OB). Bronchiolitis obliterans syndrome (BOS), the clinical syndrome associated with chronic allograft dysfunction, has a cumulative incidence of 40% to 80% at five years post transplant and accounts for 25% to 30% of the mortality after the first year (1) Unfortunately, therapies for BOS or OB have had limited efficacy and survival curves show little improvement in late mortality for lung transplant recipients over the past six years compared to earlier eras (Fig. 1). As the pathogenesis of OB has been discussed in a prior chapter, this chapter will review diagnosis and treatment strategies for chronic allograft dysfunction.
