Q: Acute rejection of acute lung transplant is? 

A) lymphocyte predominant inflammatory response
B) neutrophil predominant inflammatory response 
C) monocyte predominant inflammatory response
D) eosinophil predominant inflammatory response
E)  basophil predominant inflammatory response


Answer: A

Transbronchial lung biopsy is important to watch in new post lung transplant patients  as acute rejection may be clinically asymptomatic. Hallmark of acute rejection is a lymphocyte predominant inflammatory response. It should be looked for with care in biopsy report.



References: 

1.  Martinu T, Chen DF, Palmer SM. Acute rejection and humoral sensitization in lung transplant recipients. Proc Am Thorac Soc 2009; 6:54. 

2. Martinu T, Pavlisko EN, Chen DF, Palmer SM. Acute allograft rejection: cellular and humoral processes. Clin Chest Med 2011; 32:295. 

3. Haque MA, Mizobuchi T, Yasufuku K, et al. Evidence for immune responses to a self-antigen in lung transplantation: role of type V collagen-specific T cells in the pathogenesis of lung allograft rejection. J Immunol 2002; 169:1542.