One of the major obstacles in postoperative management of lung transplant recipients is differentiating between rejection and infection episodes. In addition, there are no reliable methods routinely to monitor lung allografts to ascertain that they are well tolerated by the host. Conventional noninvasive methods such as chest roentgenographs, radio nuclide perfusion scans, and pulmonary function tests used in conjunction with clinical assessment have been shown to be nonspecific (1,2). Other invasive methods used to facilitate the differentiation of rejection from infection are transbronchial biopsy (TBB) and bronchoalveolar lavage (BAL)(3-6) The technique of BAL offers a unique opportunity for the safe and repetitive harvesting of large quantities of graft infiltrating immunocompetent cells from the transplanted lung. The supernatant fluid collected may also contain microorganisms, soluble cytokines, and other mediators that may reflect the changes occurring in the allograft due to infection or rejection.
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