Stanford Experience With Obliterative Bronchiolitis After Lung and Heart-Lung Transplantation

main chronic complication after heart-lung (HLTx) and lung transplantation (LTx), limiting the long-term suc-cess of both transplant procedures. Methods. Since 1981, 135 HLTxs and 61 isolated LTxs were performed in 184 patients at Stanford University. Results. The overall prevalence of OB in patients surviving longer than 3 months postoperatively was 64% after HLTx and 68 % after LTx. The actuarial freedom from OB was 72%, 51%, 44%, and 29 % at 1, 2, 3, and 5 years, respectively, after HLTx and LTx. An analysis of potential risk factors revealed that the frequency and severity of acute rejection episodes (p < 0.001) and the appearance of lymphocytic bronchiolitis on biopsy (p < 0.05) were significantly associated with the development of OB. With regard to diagnosis of OB, pulmonar