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Acute cellular rejection and humoral sensitization in lung transplant recipients.

Publication ,  Journal Article
Martinu, T; Howell, DN; Palmer, SM
Published in: Semin Respir Crit Care Med
April 2010

Despite the recent development of many new immunosuppressive agents for use in transplantation, acute cellular and humoral rejection represent extremely prevalent and serious complications after lung transplantation. Acute cellular rejection, defined as perivascular or bronchiolar mononuclear inflammation, affects over 50% of lung transplant recipients within the first year. Furthermore, the frequency and severity of acute rejections are the most important risk factors for the subsequent development of bronchiolitis obliterans syndrome (BOS), a condition of progressive airflow obstruction that severely limits survival after lung transplantation. Treatment options for cellular rejection include high-dose methylprednisolone, antithymocyte globulin, or alemtuzumab. Emerging evidence also suggests that humoral rejection occurs in lung transplantation, characterized by local complement activation or the presence of antibody to donor human leukocyte antigens and is associated with an increased risk for BOS. Treatment options for humoral rejection include intravenous immunoglobulin, plasmapheresis, or rituximab. Herein, we review the clinical presentation, diagnosis, mechanisms, and treatment of cellular and humoral rejection after lung transplantation.

Duke Scholars

Published In

Semin Respir Crit Care Med

DOI

EISSN

1098-9048

Publication Date

April 2010

Volume

31

Issue

2

Start / End Page

179 / 188

Location

United States

Related Subject Headings

  • Tissue Donors
  • Respiratory System
  • Lung Transplantation
  • Immunity, Humoral
  • Immunity, Cellular
  • Humans
  • Graft Rejection
  • Age Factors
  • 3201 Cardiovascular medicine and haematology
  • 1102 Cardiorespiratory Medicine and Haematology
 

Citation

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Martinu, T., Howell, D. N., & Palmer, S. M. (2010). Acute cellular rejection and humoral sensitization in lung transplant recipients. Semin Respir Crit Care Med, 31(2), 179–188. https://doi.org/10.1055/s-0030-1249113
Martinu, Tereza, David N. Howell, and Scott M. Palmer. “Acute cellular rejection and humoral sensitization in lung transplant recipients.Semin Respir Crit Care Med 31, no. 2 (April 2010): 179–88. https://doi.org/10.1055/s-0030-1249113.
Martinu T, Howell DN, Palmer SM. Acute cellular rejection and humoral sensitization in lung transplant recipients. Semin Respir Crit Care Med. 2010 Apr;31(2):179–88.
Martinu, Tereza, et al. “Acute cellular rejection and humoral sensitization in lung transplant recipients.Semin Respir Crit Care Med, vol. 31, no. 2, Apr. 2010, pp. 179–88. Pubmed, doi:10.1055/s-0030-1249113.
Martinu T, Howell DN, Palmer SM. Acute cellular rejection and humoral sensitization in lung transplant recipients. Semin Respir Crit Care Med. 2010 Apr;31(2):179–188.
Journal cover image

Published In

Semin Respir Crit Care Med

DOI

EISSN

1098-9048

Publication Date

April 2010

Volume

31

Issue

2

Start / End Page

179 / 188

Location

United States

Related Subject Headings

  • Tissue Donors
  • Respiratory System
  • Lung Transplantation
  • Immunity, Humoral
  • Immunity, Cellular
  • Humans
  • Graft Rejection
  • Age Factors
  • 3201 Cardiovascular medicine and haematology
  • 1102 Cardiorespiratory Medicine and Haematology