View Case

Back

Questions
Discussion
References

648) According to current (2011) national transplant statistics published by the United Network for Organ Sharing (UNOS), heart, kidney, and liver primary allograft survival rates are roughly 70% at 5 years. Which one of the following is true regarding lung allograft survival?

Graft Survival (%)
1 Year	87.1	91.9	83.3	83.1	76.9
3 Year	78.5	82.4	73.6	62.2	52.2
5 Year	71.5	72.0	67.3	46.2	38.2

It is much better than other solid organs because the lung is an immune-privileged site. It is much worse than other solid organs due to the inflammation elicited by airborne antigens. It is about in line with other solid organs because rejection is histocompatibility driven and other organ-specific factors play only minor roles. All lung allografts are lost within 5 years due to bronchiolitis obliterans syndrome (BOS).

Show Diagnosis/Topic

• Lung and small bowel allograft survival is significantly worse than that for other solid organs.

• Lung allograft survival is affected by the complexity of the surgical procedure, area of exposure to the external environment, and size-matching requirements.

• Infections represent a major morbidity factor in transplantation. Some, such as bacterial pneumonia, are particular to lung transplantation, whereas others are the result of chronic immunosuppression and are common to many types of transplantation (i.e., cytomegalovirus [CMV] infections). Cystic fibrosis, one of the major pathologies addressed by lung transplantation, is notorious for its association with persistent airway infections.

• Bronchiolitis obliterans syndrome (BOS) is a lung-specific fibroproliferative reaction in the small airway lumens, leading to allograft dysfunction. BOS is caused by alloimmune, autoimmune, and nonimmunologic factors and has a major impact on lung allograft survival.

Back

Graft Survival (%)
Time	Heart	Kidney	Liver	Lung	Intestine
1 Year	87.1	91.9	83.3	83.1	76.9
3 Year	78.5	82.4	73.6	62.2	52.2
5 Year	71.5	72.0	67.3	46.2	38.2

Clinical Pathology: General Principles, Immunology & Histocompatibility

648) According to current (2011) national transplant statistics published by the United Network for Organ Sharing (UNOS), heart, kidney, and liver primary allograft survival rates are roughly 70% at 5 years. Which one of the following is true regarding lung allograft survival?

View Notes

Add a Note