- Prof. Annette Boehler, Principal Investigator
- Dr Sarosh Irani, Co-Investigator
- University Hospital, Zurich, Switzerland
- Confocal Microscopy after Lung Transplantation: Specific Findings during Rejection?
In lung transplant recipients chronic allograft rejection remains the most relevant obstacle for both maintaining high quality of life and long-term survival after an initially successful transplantation. Chronic lung allograft rejection is characterized by an inflammation of the small airways, finally leading to their increasing obliteration and destruction. The mechanisms of chronic allograft rejection are incompletely understood. So far, direct assessment of the small airways of the human lung has been limited to invasive procedures only. Therefore, until now a systematic investigation of this important part of the transplanted lung was difficult and scarcely performed in lung transplant recipients. Hence, early and potentially subtle changes of chronic rejection remain completely unrecognized. As a consequence of this lack of knowledge only limited therapeutic options exist for this pernicious condition.
Confocal microscopy is a recently developed technique that can be used to investigate the microscopic architecture of living structures while avoiding any tissue destruction. In the current study this technique is applied in lung transplant recipients to investigate the changes of microanatomical structures in graft rejection. With the aid of computerized image analysis, quantitative description of the observed alterations is attempted.
At best, this new technique bears the potential not only to make an early diagnosis of graft rejection, but also to allow diagnosis of graft tolerance. Advancement in allograft surveillance is a prerequisite for a more targeted immunosuppressive therapy, which is one of the most promising strategies for an improved long-term allograft functioning and long-term survival in lung transplant recipients.