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Systematic Reporting of Eosinophils in Transbronchial Biopsies After Lung Transplantation Defines a Distinct Inflammatory Response.
Darley, David R; Sivasubramaniam, Vanathi; Qiu, Min R; Barrett, Wade A; Wong, Stephen J; Martinu, Tereza; Pal, Prodipto; Thwe, Le Myo; Tonga, Katrina O; MacDonald, Peter S; Plit, Marshall L.
Afiliación
  • Darley DR; Department of Thoracic Medicine and Lung Transplantation, St Vincent's Hospital Sydney, University of New South Wales, Sydney, NSW, Australia.
  • Sivasubramaniam V; St Vincent's Clinical Campus, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.
  • Qiu MR; St Vincent's Clinical Campus, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.
  • Barrett WA; Department of Anatomical Pathology, St Vincent's Hospital Darlinghurst, Sydney, NSW, Australia.
  • Wong SJ; St Vincent's Clinical Campus, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.
  • Martinu T; Department of Anatomical Pathology, St Vincent's Hospital Darlinghurst, Sydney, NSW, Australia.
  • Pal P; Department of Anatomical Pathology, St Vincent's Hospital Darlinghurst, Sydney, NSW, Australia.
  • Thwe LM; Department of Anatomical Pathology, St Vincent's Hospital Darlinghurst, Sydney, NSW, Australia.
  • Tonga KO; Toronto Lung Transplant Program, Toronto General Hospital, University Health Network, Toronto, ON, Canada.
  • MacDonald PS; Department of Medicine, University of Toronto, Toronto, ON, Canada.
  • Plit ML; Toronto Lung Transplant Program, Toronto General Hospital, University Health Network, Toronto, ON, Canada.
Transplantation ; 2024 Jul 01.
Article en En | MEDLINE | ID: mdl-38946037
ABSTRACT

BACKGROUND:

Descriptions of eosinophils in transbronchial biopsy (TBBx) pathology reports after lung transplantation (LTx) are associated with poor long-term outcomes. The absence of routine reporting and standardization precludes accurate assessment of this histologic predictor. A systematic reporting scheme for the presence of TBBx eosinophils after LTx was implemented. This report aims to assess this scheme by describing the presence, pattern, and gradation of TBBx eosinophils and clinical associations.

METHODS:

A prospective cross-sectional study of all TBBx reports was performed including all patients presenting for a surveillance or diagnostic TBBx between January 2020 and June 2023. Each TBBx was systematically reported in a blinded manner. Mixed-effects logistic regression was performed to measure the association between concurrent clinical and histologic features, and the presence of TBBx eosinophils.

RESULTS:

A total of 410 TBBx reports from 201 patients were systematically reported. In 43.8% recipients, any TBBx eosinophils were detected and in 17.1% recipients, higher-grade eosinophils (≥3 per high power field) were present. Adjusted analysis showed that retransplantation, A- and B-grade cellular rejection, positive bronchoalveolar lavage (BAL) bacterial microbiology, and elevated blood eosinophil count were independently associated with the presence of any TBBx eosinophils. Diagnostic "for-cause" procedures were independently associated with higher quantities of TBBx eosinophils.

CONCLUSIONS:

Systematic reporting demonstrates that TBBx eosinophils are a distinct inflammatory response associated with rejection, infection, and peripheral eosinophilia. Although these findings require multicenter external validation, standardized reporting for TBBx eosinophils may assist in identifying recipients at risk of poor outcomes and provides a platform for mechanistic research into their role after lung transplantation.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Transplantation Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Transplantation Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Estados Unidos