Exploring the different phenotypes and their pathophysiology of Chronic rejection after lung transplantation.

Lung transplantation is a well accepted treatment option for patients with end-stage lung disease. The outcome of lung transplantation is hampered by chronic rejection, or its clinical correlate Bronchiolitis Obliterans Syndrome (BOS), which has a 50% prevalence at 5 years after transplantation. Recently an attempt was made to identify other phenotypes of chronic rejection such as NRAD, fBOS, RAS and follicular bronchiolitis. All phenotypes seem to have different survival outcomes after diagnosis, therefore better phenotyping and unraveling the mechanisms leading to a specific phenotype seem of utmost importance. In a first part of this research project we will try to retrospectively characterize different phenoytypes and the inherent risk factors in our lung transplant population of > 600 patients. In a second part we will further examine explants lings of patients with chronic rejection wh need a retransplant; This will be done by micro CT scanning and microbiome analysis, in a search of specific risk factors. Furthermore, broncho-alveolar lavage samples of patients with different phenotypes of chronic rejection will be explored for its possibility to induce proliferation of fibroblasts. We will also use in vivo microCT in our mouse lung transplant model to characterize early lesions of chronic rejection.

Keywords:Lung transplantation, Chronic rejection, BOS, RAS, Micro CT scanning, BAL

Disciplines:Laboratory medicine, Palliative care and end-of-life care, Regenerative medicine, Other basic sciences, Other health sciences, Nursing, Other paramedical sciences, Other translational sciences, Other medical and health sciences