Diagnosis and Management of Bronchiolitis Obliterans

The most common cause of late death after lung transplantation has been a progressive and unrelenting deterioration in pulmonary allograft function related to the development of obliterative airway disease. In the transplantation literature this entity has been referred to as bronchiolitis obliterans, obliterative bronchiolitis, chronic rejection and, most recently, bronchiolitis obliterans syndrome. Although the etiology of bronchiolitis obliterans remains unclear, it most likely represents a manifestation of chronic lung rejection. The current approaches to the diagnosis and management of bronchiolitis obliterans are reviewed below.