학술논문
Total lymphoid irradiation in progressive bronchiolitis obliterans syndrome after lung transplantation: a single-center experience and review of literature.
Document Type
Academic Journal
Author
Lebeer M; Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium.; Kaes J; Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases, Metabolism & Ageing (CHROMETA), KU Leuven, Leuven, Belgium.; Lambrech M; Department of Radiation Oncology, University Hospitals Leuven, Leuven, Belgium.; Vanstapel A; Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium.; Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases, Metabolism & Ageing (CHROMETA), KU Leuven, Leuven, Belgium.; Beeckmans H; Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium.; Ambrocio GPL; Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium.; Vanaudenaerde BM; Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases, Metabolism & Ageing (CHROMETA), KU Leuven, Leuven, Belgium.; Verleden SE; Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases, Metabolism & Ageing (CHROMETA), KU Leuven, Leuven, Belgium.; Verbeken EK; Department of Histopathology, KU Leuven, Leuven, Belgium.; Neyrinck AP; Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases, Metabolism & Ageing (CHROMETA), KU Leuven, Leuven, Belgium.; Department of Anesthesiology, University Hospitals Leuven, Leuven, Belgium.; Ceulemans LJ; Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases, Metabolism & Ageing (CHROMETA), KU Leuven, Leuven, Belgium.; Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium.; Van Raemdonck DE; Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases, Metabolism & Ageing (CHROMETA), KU Leuven, Leuven, Belgium.; Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium.; Verleden GM; Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium.; Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases, Metabolism & Ageing (CHROMETA), KU Leuven, Leuven, Belgium.; Vos R; Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium.; Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases, Metabolism & Ageing (CHROMETA), KU Leuven, Leuven, Belgium.
Source
Publisher: Frontiers Media S. A Country of Publication: Switzerland NLM ID: 8908516 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-2277 (Electronic) Linking ISSN: 09340874 NLM ISO Abbreviation: Transpl Int Subsets: MEDLINE
Subject
Language
English
Abstract
Limited results about treatment with total lymphoid irradiation (TLI) in lung transplant (LTx) recipients suffering from progressive bronchiolitis obliterans syndrome (BOS) have been reported. We performed a retrospective analysis of all LTx recipients undergoing TLI for progressive BOS in our center, focusing on long-term outcomes regarding overall survival and lung allograft function. Treatment with TLI (2004-2017, n = 20, 1 BOS stage 1, 6 BOS stage 2, and 13 BOS stage 3) resulted in significant attenuation of the FEV 1 -decline in the majority of patients, mainly in those with a rapid decline (P = 0.0005). This allowed bridging to redo-transplantation in five patients. However, three patients progressed from BOS to RAS following prior TLI. Overall patient survival was 44% at 2 years post-TLI and 38% after 17 years. Generally, TLI was well tolerated, with limited side effects and no serious adverse events. TLI may attenuate the decline in FEV 1 of LTx recipients with rapid progressive BOS and could thus help to bridge selected patients to redo-transplantation.
(© 2019 Steunstichting ESOT.)
(© 2019 Steunstichting ESOT.)