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Title: Bile Acids Aspiration Reduces Survival in Lung Transplant Recipients with BOS Despite Azithromycin
Authors: Mertens, V
Blondeau, Kathleen
Van Oudenhove, Lukas
Vanaudenaerde, Bart
Vos, R
Farre, Ricard
Pauwels, Ans
Verleden, Geert
Van Raemdonck, Dirk
Sifrim, Daniel
Dupont, Lieven # ×
Issue Date: Feb-2011
Publisher: Munksgaard International Publishers
Series Title: American Journal of Transplantation vol:11 issue:2 pages:329-335
Abstract: Azithromycin (AZM) improved bronchiolitis obliterans syndrome (BOS) and reduced aspiration in lung transplant (LTx) recipients. We hypothesize that AZM could improve graft and overall survival more efficiently in LTx patients with BOS who have bile acid (BA) aspiration by protecting against the aspiration-induced progression of BOS. The goal was to compare FEV1 (% baseline), BOS progression and overall survival in LTx recipients treated with AZM for BOS, both with versus without BA aspiration. Therefore, LTx recipients treated with AZM for BOS were recruited and broncho-alveolar lavage (BAL) samples were analyzed for the presence of BA and neutrophilia before the start of AZM treatment. Short-term effect of AZM on FEV1 and BAL neutrophilia was assessed, progression of BOS and survival were followed-up for 3 years and results were compared between patients with/without BA aspiration. 19/37 LTx patients had BA in BAL. BA aspiration predisposed to a significantly worse outcome, in terms of decline in FEV1, progression of BOS >= 1 and survival. AZM does not seem to protect against the long-term allograft dysfunction caused by gastroesophageal reflux (GER) and aspiration and an additional treatment targeting aspiration may be indicated in those LTx patients.
ISSN: 1600-6135
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Translational Research in GastroIntestinal Disorders
Thoracic Surgery
Pneumology
× corresponding author
# (joint) last author

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