Acute cellular rejection
Evidence level: abstract-only observational studies; association, not causation
Acute cellular rejection is reported in the abstracts read to be associated with CLAD, although one study found no association for a first untreated minimal episode.
As of . Primary source: Peghin et al. 2019 (DOI).
Summary
A Barcelona cohort of 98 recipients reports acute rejection as an independent risk factor for CLAD (hazard ratio 2.97, 95 percent confidence interval 1.51 to 5.83). A cohort abstract (Verleden 2013) reports that acute rejection was more frequent in patients who later developed BOS or RAS than in stable patients. The abstract of a Toronto cohort states that acute cellular rejection is a significant risk factor for CLAD and reports no significant difference in CLAD or death after a first untreated, spirometrically stable minimal (A1) episode compared with matched episodes without rejection. The studies are observational and show association; this record gives no advice on management.
Sources and links
Related
Links from this record
- supports: Community-acquired Respiratory Viruses Are a Risk Factor for Chronic Lung Allograft Dysfunction.
- supports and qualifies: The impact of first untreated subclinical minimal acute rejection on risk for chronic lung allograft dysfunction or death after lung transplantation.
- supports: Bronchiolitis obliterans syndrome and restrictive allograft syndrome: do risk factors differ?
- reported association: Bronchiolitis obliterans syndrome (BOS)
- reported association: Restrictive allograft syndrome (RAS)
Linked from (derived)
- studies: The CD8+ T cell content of transbronchial biopsies from patients with a first episode of clinically stable grade A1 cellular rejection is associated with future chronic lung allograft dysfunction
- reviews: Acute Rejection and Chronic Lung Allograft Dysfunction: Obstructive and Restrictive Allograft Dysfunction
- studies: Center variability in the prognostic value of a cumulative acute cellular rejection "A-score" for long-term lung transplant outcomes
- relates to: Donor and recipient human leukocyte antigen-G polymorphisms modulate the risk of adverse immunologic events following lung transplantation
- studies: Prognosis and Risks for Probable Chronic Lung Allograft Dysfunction: A Prospective Multicenter Study
- relates to: Intra-subject variability in oscillometry correlates with acute rejection and CLAD post-lung transplant
- profiles: GEO GSE274199: single-cell analysis of acute cellular rejection and fibrogenic shift in lung allografts
Known gaps in this record
- grade-specific hazard ratios beyond the abstracts
- full text of all sources
Information resource only. Not medical advice. Not a substitute for the care of the patient's transplant team.