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Department of
Pulmonary Diseases and Lung Transplantation, University Hospital
Groningen, P O Box 30001, 9700 RB Groningen, The Netherlands
Correspondence to: Dr J W K van den Berg.
Received 11 March 1998; Returned to authors 8 May 1998; Revised version received 7 December 1998; Accepted for publication 7 December 1998
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Introduction |
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Lung transplantation has become an accepted treatment modality for end stage lung disease.1 Traditionally, immunosuppressive maintenance therapy consists of cyclosporin, azathioprine, and prednisolone in kidney and liver transplantation as well as in lung transplantation. Despite the use of these drugs, acute rejection occurs frequently, especially in the first weeks and months after lung transplantation. Although these periods are now almost never life threatening, they are associated with substantial morbidity. Prevalences of acute rejection ranging from 60% to 100% have been reported, depending on whether acute rejection is based on clinical or histological diagnosis.2-4 The incidence of acute rejection is far higher after lung transplantation than after any other form of solid organ transplantation. This may be due to the fact that the donor lung contains a substantial amount of immunocompetent tissue and because the lungs are constantly exposed to environmental factors.5
Bronchiolitis obliterans syndrome (BOS) is the major cause of
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