Distinction between Infection and Rejection in Lung Transplantation

• Published in: British Medical Journal Vol. 2; no. 5805; pp. 71 - 74
• Main Authors: Cullum, P. A., Bewick, M., Shilkin, Keith, Tee, D. E. H., Ayliffe, P., Hutchison, D. C. S., Laws, J. W., Mason, S. A., Reid, Lynne, Hugh-Jones, P., Macarthur, A. M.
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 08.04.1972; British Medical Association; BMJ Publishing Group LTD
• Subjects: Antibodies; Antigen-Antibody Reactions; Autopsy; Blood; Erythrocytes - immunology; Fluorescent Antibody Technique; Graft Rejection; Humans; Infection - diagnosis; Infections; Lung - pathology; Lung Transplantation; Lungs; Lymphocytes; Lymphocytes - immunology; Oxygen Consumption; Papers and Originals; Postoperative Complications - immunology; Pulmonary alveoli; Radiology; Respiration; Sepsis; Sputum; Transplantation; Transplantation Immunology; Transplantation, Homologous
• ISSN: 0007-1447; 1468-5833
• DOI: 10.1136/bmj.2.5805.71

In distinguishing between infection and rejection after human lung transplantation clinical and radiological features were unhelpful, and even confusing. However, incipient rejection could be predicted and distinguished from infection by monitoring alterations in lymphocyte activity by the rosette inhibition test. Earlier prediction seems possible by detecting circulating lung-binding antibody. The ability to detect changes in the immunological status of a patient, even before clinical deterioration, has fundamental implications for the management of patients after transplantation.