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Title: The impact of traffic air pollution on bronchiolitis obliterans syndrome and mortality after lung transplantation
Authors: Nawrot, Tim S. 
Vos, Robin 
Jacobs, Lotte
Verleden, Stijn E.
Wauters, Shana
Mertens, Veerle
Dooms, Christophe
Hoet, Peter H.
Van Raemdonck, Dirk E.
Faes, Christel 
Dupont, Lieven J.
Nemery, Benoit
Verleden, Geert M.
Vanaudenaerde, Bart M.
Issue Date: 2011
Source: Thorax, 66 (9), p. 748-754
Abstract: Background: Approximately half of all patients who underwent a lung transplantation suffer from bronchiolitis obliterans syndrome(BOS), the clinical correlate of chronic rejection, within 5 years after transplantation. This prevalence is much higher than for other solid organ transplantations, possibly due to the lung's direct contact with the environment. The authors assessed the association between proximity of the home to major roads and BOS and mortality in a cohort of patients after lung transplantation. Methods: The authors calculated hazard ratios for BOS and mortality in relation to proximity of the home to major roads, adjustng for relevant covariables, in 288 patients after lung transplantation at the Leuven University Hospital between 1997 and 2009 and with follow-up until August 2009. Inflammatory parameters in plasma and bronchoalveolar lavage were assessed in 207 patients. Results: During follow-up, 117 (41%) patients developed BOS and 61 (21%) died. Patients who lived within 171 m of a major road (lowest tertile) were 2.06 (95% CI 1.39 to 3.05) times more likely to develop BOS and 2.20 (1.25 to 3.86) times more likely to die than patients living farther away. The adjusted hazard ratios of BOS and mortality were 0.57 and 0.72 for each 10-fold increase in distance from major roads. Proximity to a major road was inversely associated with plasma C-reactive protein levels, neutrophil percentage and interleukin-6 concentration in bronchoalveolar lavage. Conclusion: Traffic-related air pollution appears to constitute a serious risk of BOS and mortality after lung transplantation.
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ISSN: 0040-6376
e-ISSN: 1468-3296
DOI: 10.1136/thx.2010.155192
ISI #: 000293962600005
Category: A1
Type: Journal Contribution
Validations: ecoom 2012
Appears in Collections:Research publications

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