Acute fibrinous and organising pneumonia following lung transplantation is associated with severe allograft dysfunction and poor outcome: a case series

Table 1 Cohort clinical and demographic data

Case	Age (years)	Gender	Transplant indication and type	Time to onset (days post-transplantation)	Diagnostic modality	Pulmonary function^a		Treatment	Other complications	Post-transplantation survival (days)
						FEV₁	FVC
1	49	Female	CHD with severe PH; HLT	58	TBB	na	na	Antibacterials Corticosteroids	Grade A1B0 acute rejection; Citrobacter freundii isolated from blood, BAL and urine	118
2	26	Male	CF; BLT	299	SLB	54%	79%	Antibacterials Corticosteroids	Candida albicans and Stenotrophomonas maltophilia isolated from blood; MSSA and mucoid Pseudomonas aeruginosa isolated from BAL	344
3	41	Female	Fibrotic NSIP; SLT (left)	56	TBB autopsy	97%	88%	Antibacterials Corticosteroids	Persistent poor graft function from the time of transplant; Grade A2B0 acute rejection (previous TBB)	278
4	34	Female	Bleomycin-related PF; BLT	2,572	TBB	70%	72%	Corticosteroids Antibacterials	Multi-drug-resistant S. maltophilia isolated from BAL; breast carcinoma metastatic to lungs	2,793
5	71	Female	IPF; SLT (right)	1,354	TBB	63%	74%	Corticosteroids Antibacterials	Onset preceded by symptomatic GER episode	1,514
6	23	Male	CF; BLT	804	TBB	49%	49%	Corticosteroids Antibacterials	URI symptoms and dyspnoea noted for 4 weeks prior to diagnosis	1,476

BAL, bronchoalveolar lavage; BLT, bilateral lung transplant; CF, cystic fibrosis; CHD, congenital heart disease; FEV₁, forced expiratory volume in one second; FVC, forced vital capacity; HLT, heart-lung transplant; IPF, idiopathic pulmonary fibrosis; MSSA, methicillin-sensitive Staphylococcus aureus; na, not able to perform; NSIP, non-specific interstitial pneumonia; PF, pulmonary fibrosis; PH, pulmonary hypertension; SLB, surgical lung biopsy; SLT, single lung transplant; TBB, transbronchial lung biopsy; URI, upper respiratory infection; GER, gastro-oesophageal reflux
^apercentage of stable baseline values (average of 2 best results prior to acute fibrinous and organising pneumonia [AFOP] onset) at time of AFOP diagnosis

ISSN: 2200-6133