Successful Lung Transplantation for Patients with Graft Versus Host Disease After Bone Marrow Transplantation: An Australian 2 Centre Case Series

Pulmonary graft versus host disease (GVHD), manifest as bronchiolitis obliterans, bronchiectasis and pulmonary fibrosis, is a serious complication of haematopoietic stem cell transplantation (HSCT) causing respiratory failure and death. There are limited therapeutic options for severe cases other than lung transplantation (LTx) but < 80 patients transplanted for GVHD have been reported worldwide. The optimum levels of immunosuppression required to prevent chronic lung allograft dysfunction (CLAD) yet maintain marrow function and avoid uncontrolled sepsis are unknown.