Lung Transplant Pathology : An Overview on Current Entities and Procedures - 28/01/20

Doi : 10.1016/j.path.2019.11.003

Christopher Werlein ^a,^⁎ , Allison Seidel ^a,^b, Gregor Warnecke, MD ^b,^c, Jens Gottlieb, MD ^b,^d, Florian Laenger, MD ^a,^b,^{^{1
These authors contributed equally and share last authorship.}}, Danny Jonigk, FRCPath ^a,^b,^{^{1
These authors contributed equally and share last authorship.}}
^a Institute for Pathology, OE 5110, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany
^b Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH)
^c Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, OE6210, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany
^d Department of Pneumology, OE6210, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany

^∗Corresponding author.

Abstract

Alloimmune reactions are, besides various infections, the major cause for impaired lung allograft function following transplant. Acute cellular rejection is not only a major trigger of acute allograft failure but also contributes to development of chronic lung allograft dysfunction. Analogous to other solid organ transplants, acute antibody-mediated rejection has become a recognized entity in lung transplant pathology. Adequate sensitivity and specificity in the diagnosis of alloimmune reactions in the lung can only be achieved by synoptic analysis of histopathologic, clinical, and radiological findings together with serologic and microbiologic findings.

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Keywords : Acute cellular rejection, Acute antibody-mediated rejection, Chronic lung allograft dysfunction, Lung transplant, Alveolar fibroelastosis

Plan

Contributors: C. Werlein prepared the images. A. Seidel and J. Gottlieb prepared the tables. C. Werlein, A. Seidel, J. Gottlieb, G. Warnecke, F. Laenger, and D. Jonigk wrote the article. Grant numbers and sources of support: Sonderforschungsbereich, SFB’ 738 (Projekt B9) of the German Research Foundation to D. Jonigk and F. Laenger. The grants of the European Research Council (ERC); European Consolidator Grant, XHale to D. Jonigk (ref. no.771883).