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Editorials |

Can Bronchiolitis Obliterans Syndrome Be Diagnosed By Phone From the Comfort of Home?

Stephanie M. Levine, MD, FCCP (San Antonio, TX)
Author and Funding Information

Associate Professor of Medicine, University of Texas Health Science Center at San Antonio, and Medical Director of Lung Transplantation, South Texas Veterans Health Care System, Audie L. Murphy Memorial Veterans Hospital Division.

Correspondence to: Stephanie M. Levine, MD, FCCP, Department of Medicine, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78284-7885; e-mail: evines@uthscsa.edu.



Chest. 1999;116(1):5-6. doi:10.1378/chest.116.1.5
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Bronchiolitis obliterans (BO) remains the leading cause of long-term morbidity and mortality following lung transplantation and is thought to be chronic lung allograft rejection.1 It is estimated that up to 50% of lung transplant recipients surviving beyond the third posttransplant month will develop BO.2 BO is characterized clinically by limitation to airflow and pathologically by obliterative bronchiolitis, and is thought to be related to recurrent acute rejection and/or infection. Due to the poor sensitivity of transbronchial biopsy for the diagnosis of BO, the bronchiolitis obliterans syndrome (BOS) staging system was established by the International Society for Heart and Lung Transplantation.3 This staging system is based on airflow limitation (a percent change from a baseline posttransplant FEV1 as obtained on formal clinic spirometry) with or without the diagnostic histologic finding of BO. Inherent to the BOS diagnosis is the exclusion of other causes of graft dysfunction by bronchoscopy, such as acute rejection, infection, and anastomotic complications.


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