PT -期刊文章盟Vanstapel阿诺AU -版本leden, Stijn E. AU - Weynand, Birgit AU - Verbeken, Eric AU - De Sadeleer, Laurens AU - Vanaudenaerde, Bart M. AU - Verleden, Geert M. AU - Vos, Robin AU - , TI - Late-onset “acute fibrinous and organising pneumonia” impairs long-term lung allograft function and survival AID - 10.1183/13993003.02292-2019 DP - 2020 Jan 01 TA - European Respiratory Journal PG - 1902292 4099 - //www.qdcxjkg.com/content/early/2020/04/20/13993003.02292-2019.short 4100 - //www.qdcxjkg.com/content/early/2020/04/20/13993003.02292-2019.full AB - Background Acute fibrinous and organising pneumonia (AFOP) after lung transplantation is associated with a rapid decline in pulmonary function. However, the relation with chronic lung allograft dysfunction (CLAD) remains unclear. We investigated the association between detection of AFOP in lung allograft biopsies with clinically important endpoints.Methods We reviewed lung allograft biopsies from 468 patients who underwent lung transplantation at the University Hospitals Leuven (2011–2017). AFOP was categorised as early new-onset (≤90 days post-transplant) or late new-onset (>90 days post-transplant); and associated with CLAD-free survival, graft survival, donor-specific antibodies, airway and blood eosinophilia.Results Early and late AFOP was detected in 24 (5%) and 30 (6%) patients, respectively. CLAD-free survival was significantly lower in patients with late AFOP (median survival 2.42y, p<0.0001) compared to patients with early or without AFOP and specifically associated with development of restrictive allograft syndrome (OR: 28.57; CI [11.34–67.88], p<0.0001). Similarly, graft survival was significantly lower in patients with late AFOP (median survival 4.39y, p<0.0001) compared to patients with early AFOP or without AFOP. Late AFOP was furthermore associated with detection of circulating donor-specific antibodies (OR: 4.75, CI [2.17–10.60], p=0.0004) compared to patients with early or without AFOP; and elevated airway and blood eosinophilia (p=0.043 and p=0.045, respectively) compared to early AFOP patients.Conclusions Late new-onset AFOP is associated with a worse prognosis and high risk of CLAD development, specifically restrictive allograft syndrome. Our findings indicate that late new-onset AFOP might play a role in the early pathogenesis of restrictive allograft syndrome.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Vanstapel has nothing to disclose.Conflict of interest: Dr. Verleden has nothing to disclose.Conflict of interest: Dr. Weynand has nothing to disclose.Conflict of interest: Dr. Verbeken has nothing to disclose.Conflict of interest: Dr. De Sadeleer has nothing to disclose.Conflict of interest: Dr. Vanaudenaerde has nothing to disclose.Conflict of interest: Dr. Verleden has nothing to disclose.Conflict of interest: Dr. Vos has nothing to disclose.