BACKGROUND: Lung transplantation is an established treatment modality for a number of chronic @entity358 . Long-term survival after lung transplantation is limited by chronic allograft dysfunction, usually manifested by @entity4154 . We describe a case series with @entity82 , a novel presentation of chronic allograft dysfunction. METHODS: We reviewed lung transplants at the Toronto General Hospital and Duke University Hospital from 1990 to 2002 and identified @entity1 with @entity82 . RESULTS: Thirteen of 686 @entity1 (6 @entity1 ) developed @entity82 (Toronto, 9; Duke, 4); 12 of 13 had bilateral transplants. The median age at diagnosis was 42 years (range, 19-70). Primary diagnoses were @entity1577 , 6; @entity2415 , 4; @entity370 , 1; and @entity3794 , 2 @entity1 . Radiographic diagnosis was made at a median of 700 days post-transplant (range, 150-2,920). Pulmonary function tests demonstrated predominantly a progressively worsening restrictive pattern. Open lung biopsy specimens revealed @entity82 , with occasional features of obliterative @entity3617 , @entity3616 , and @entity1173 . Nine @entity1 died at a median follow-up of 2,310 days (range, 266-3,740), 8 due to @entity1576 . CONCLUSION: Upper lobe @entity82 is a novel presentation of chronic allograft dysfunction in lung transplant recipients and is differentiated from @entity4154 on the basis of physiologic and radiologic findings.

Upper lobe XXXX : a novel manifestation of chronic allograft dysfunction in lung transplantation.

@entity1 :: ('9606', 'Species') :: ['women', 'patients'] @entity3617 :: ('MESH:D001991', 'Disease') :: ['bronchitis'] @entity82 :: ('MESH:D005355', 'Disease') :: ['dense interstitial fibrosis', 'upper lobe fibrosis', 'fibrosis'] @entity3794 :: ('MESH:D011658', 'Disease') :: ['pulmonary fibrosis'] @entity3616 :: ('MESH:D018549', 'Disease') :: ['bronchiolitis obliterans obstructive pneumonia'] @entity2415 :: ('MESH:D004646', 'Disease') :: ['emphysema'] @entity358 :: ('MESH:D008171', 'Disease') :: ['lung diseases'] @entity1576 :: ('MESH:D012131', 'Disease') :: ['respiratory failure'] @entity4154 :: ('MESH:D001989', 'Disease') :: ['bronchiolitis obliterans syndrome'] @entity370 :: ('MESH:D012507', 'Disease') :: ['sarcoidosis'] @entity1577 :: ('MESH:D003550', 'Disease') :: ['cystic fibrosis'] @entity1173 :: ('MESH:D053120', 'Disease') :: ['aspiration']
@entity82 :: (MESH:D005355,Disease) :: ['fibrosis']
