Bronchoalveolar lavage fluid endotoxin elevation in human single lung transplant recipients during rejection

Endotoxin has been implicated as an aetiological factor in liver transplant rejection and acute graft-versus-host disease. To investigate the role of endotoxin in human single lung transplant rejection we measured the level of endotoxin in bronchoalveolar lavage (BAL) fluid from six subjects at base...

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Bibliographic Details
Published in:Transplant immunology 1995-03, Vol.3 (1), p.81-85
Main Authors: Lambert, Steven B, Frazier-Jessen, Michelle R, VanStedum, Susan, Hahn, Elisabeth L, Filkins, James P, Garrity, Edwards R, Kovacs, Elizabeth J
Format: Article
Language:English
Subjects:
Bronchoalveolar Lavage Fluid - cytology
Bronchoalveolar Lavage Fluid - immunology
Capillary Permeability - immunology
Endotoxins - metabolism
Graft Rejection - complications
Graft Rejection - metabolism
Graft Rejection - pathology
Humans
Lung Transplantation - adverse effects
Lymphocyte Count
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Summary:Endotoxin has been implicated as an aetiological factor in liver transplant rejection and acute graft-versus-host disease. To investigate the role of endotoxin in human single lung transplant rejection we measured the level of endotoxin in bronchoalveolar lavage (BAL) fluid from six subjects at baseline and during rejection, which was defined histologically from transbronchial biopsy. Differential cell counts of BAL fluid cells, the levels of protein and albumin in BAL fluid, and serum albumin levels were also examined. BAL fluid albumin to serum ratio was calculated to evaluate alveolar-capillary leakage. A significant elevation of BAL fluid endotoxin with rejection compared with baseline was observed. Standardized endotoxin levels to BAL fluid volume, protein, or albumin were all of similar significance. Examination of BAL fluid cell population revealed a significant elevation in the percentage of lymphocytes with rejection. No significance between BAL fluid protein levles, BAL fluid albumin levels, BAL fluid albumin to protein ratio, serum albumin levels, or BAL fluid albumin to serum albumin ratio was seen with rejection. We conclude that BAL fluid endotoxin levels increase during lung rejection, endotoxin levels can be accurately standardized to millilitres of BAL fluid, and abnormal alveolar-capillary leakage does not appear to account for the increased BAL fluid endotoxin.
ISSN:0966-3274
1878-5492
DOI:10.1016/0966-3274(95)80011-5