Chambers, D.Hodge, S.Hodge, G.Yerkovich, S.Kermeen, F.Reynolds, P.Holmes, M.Hopkins, P.2012-06-192012-06-192011Journal of Heart and Lung Transplantation, 2011; 30(5):544-5511053-24981557-3117http://hdl.handle.net/2440/71679<h4>Background</h4>Lymphocytic bronchiolitis (LB) is the strongest risk factor for subsequent allograft loss due to bronchiolitis obliterative syndrome (BOS); however, it is poorly assessed by transbronchial biopsy (TBBx) because of sampling error, interpretation error and the presence of non-alloimmune airway inflammation. We hypothesized that flow cytometric evaluation of bronchiolar brushings (transbronchial brush, TBBr) may be a better approach.<h4>Methods</h4>Transbronchial brushings (2 to 3 cm from the pleural surface under radiologic guidance) were obtained prior to TBBx in 32 patients and analyzed by flow cytometry. We assessed the proportion of nucleated cells that were CD3(+)CD103(+) (epithelial-specific T cells).<h4>Results</h4>No adverse events occurred; 0.5% (0.27 to 0.84) of the cells were epithelial-specific T cells and numbers increased with episodes of Grade A1 rejection (p < 0.01) and in patients with BOS (p = 0.02). Viral and invasive fungal infection were associated with marked infiltration with CD103(-) T cells (p < 0.01).<h4>Conclusion</h4>TBBr is simple to obtain, low risk, quantitative, and can discriminate between infective and alloimmune LB. It may be a valuable addition to current lung allograft assessment.enCopyright © 2011 Elsevier B.V.BronchiT-LymphocytesHumansBronchiolitisBronchiolitis ObliteransIntegrin alpha ChainsAntigens, CDDiagnostic Techniques, Respiratory SystemBronchoscopyLung TransplantationFlow CytometryRisk FactorsCross-Sectional StudiesGraft RejectionAdultMiddle AgedFemaleMaleJournal article002011787410.1016/j.healun.2010.10.0180002897488000092-s2.0-7995377310525162Hodge, S. [0000-0002-3602-9927] [0000-0002-9401-298X]Reynolds, P. [0000-0002-2273-1774]