ABSTRACT
Lung transplantation is increasingly practiced for patients with end-stage lung disease. The successful outcome of solid organ transplantation today is severely impeded by the production of alloantibodies, mainly directed against the protein products of the HLA complex of the organ donor. While the association between antibody mediated rejection and allograft damage has been well established in renal and heart transplantation, it has not yet been well characterized in lung transplantation. This review addresses the question of HLA matching in lung transplantation and current knowledge of the allogenicity of different HLA class I and II antigens. The role of the antibody mediated immune response is discussed as well as the importance of pre-transplant or de novo post-transplant circulating antibodies. Finally, potential mechanisms, which may act individually or in combination, of antibody mediated damage to solid organ transplants are considered.
ABSTRACT
El trasplante pulmonar es una opción terapéutica válida para mejorar la sobrevida de pacientes con enfermedades respiratorias en fase avanzada. La supervivencia tras el trasplante de pulmón ha mejorado en gran medida como resultado de los avances en la técnica quirúrgica, la cuidadosa preservación de órganos de donantes, las mejoras en la terapia inmunosupresora y el reconocimiento precoz de complicaciones con el uso de técnicas de imagen. Nuestro objetivo es proporcionar una guía radiológica del rechazo agudo y crónico del trasplante pulmonar. Se describirán los hallazgos por tomografía computada multidetector (TCMD).
Lung transplantation is a valid therapeutic option to prolong survival in patients with end-stage pulmonary disease. Survival after lung transplantation has greatly improved as a result of advances in surgical techniques, careful preservation of donor organs, progress in immunosuppressive therapy, and the use of imaging techniques for an early recognition of complications. Our goal is to provide a radiology guide of acute and chronic rejection of lung transplants. The fndings of multidetector computed tomography (MDCT) studies are described.
Subject(s)
Bronchiolitis , Tomography, X-Ray Computed , Lung Transplantation , Graft RejectionABSTRACT
El síndrome de Felty es la tríada de artritis, esplenomegalia y neutropenia. Adicionalmente, sepueden encontrar en este síndrome múltiples factores propios de la artritis reumatoide, entreellos la presencia de nódulos pulmonares. Presentamos el caso de un paciente con hallazgosclínicos y paraclínicos que evidencian la presencia del síndrome de Felty, presentando, además,nódulos pulmonares en los estudios radiológicos e histológicos que documentaron granulomascrónicos, bronquiolitis obliterante y neumonía organizante.