Exploring Chronic Lung Transplant (LTx) Allograft Dysfunction (CLAD): The Potential Clinical Prognostic Relevance of Single Bite Transbronchial Biopsy (TBB) Microarray

Abstract

Purpose TBB histologic assessment of CLAD status, particularly late post-LTx, is typically clinically unhelpful. Microarray analyses using the Molecular Microscope Diagnostic System (MMDx) in kidney & heart recipients are proving useful in providing mechanistic targets that inform therapeutic interventions, and could show similar promise in LTx. Methods LTx recipients with clinical instability- typically a falling FEV1 and symptoms- had bronchoscopic lavage with microbiologic & cytologic analyses and TBB [4-6 bites analyzed via histology, I TBB bite by MMDx microarray (Alberta Transplant Applied Genomic Center, Edmonton)]. The MMDx uses weighted equations to reflect probabilities of 4 ideali..