Diagnosis and Management of Bronchiolitis Obliterans Syndrome
Publication Date: October 1, 2014
Last Updated: March 14, 2022
Recommendations
For lung transplant recipients who have non-minimal acute cellular rejection (Grade ≥2) or lymphocytic bronchitis on transbronchial lung biopsy specimens, we suggest augmented immunosuppression with a course of systemic steroids to prevent the development of BOS. (C, VL)
Values and preferences: this recommendation places a high value on preventing a life-threatening complication of lung transplantation and a lower value on avoiding short-term adverse effects.
Remarks: a typical course of systemic corticosteroids used to augment immunosuppression in adult recipients is intravenous methylprednisolone 1000 mg daily for 3 days (many centres use 10–15 mg·kg−1 per day for smaller patients).
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Title
Diagnosis and Management of Bronchiolitis Obliterans Syndrome
Authoring Organizations
American Thoracic Society
European Respiratory Society
International Society for Heart and Lung Transplantation