Abstract
Three cases of pulmonary alveolar proteinosis developing in lung allograft recipients are reported. In each case, repeated bouts of alveolar damage from harvest/reperfusion injury, rejection, and infection were observed before the development of intraalveolar accumulation of granular, periodic acid-Schiff-positive material in the allograft lungs. It is speculated that iatrogenic immunosuppression combined with defective clearance of alveolar material by alveolar macrophages created a milieu conducive to the accumulation of surfactant, lipoprotein, and fibrinous debris that was morphologically identical to alveolar proteinosis.
Publication types
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Case Reports
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Research Support, Non-U.S. Gov't
MeSH terms
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Adult
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Eisenmenger Complex / complications
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Eisenmenger Complex / surgery
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Female
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Heart Septal Defects, Atrial / complications
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Heart Septal Defects, Atrial / surgery
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Heart-Lung Transplantation / adverse effects
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Heart-Lung Transplantation / pathology
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Humans
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Hypertension, Pulmonary / complications
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Hypertension, Pulmonary / surgery
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Lung Diseases, Interstitial / complications
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Lung Diseases, Interstitial / surgery
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Lung Transplantation / adverse effects*
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Lung Transplantation / pathology
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Male
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Middle Aged
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Pulmonary Alveolar Proteinosis / etiology*
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Pulmonary Alveolar Proteinosis / pathology*
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Transplantation, Homologous