CYTOLOGICAL DATA OF ALVEOLAR-LAVAGE IN LU NG TRANSPLANTED PATIENTS WITHOUT BRONCHIAL INFECTION

Total and differential cells counts from 173 bronchoalveolar lavages ( BAL) carried out in 19 lung transplanted recipients have been analysed . The patients were separated into seven groups: (a) those without det ectable complications (86 BAL); (b) those with acute rejection (AR) (2 6 BAL); (c) those with bronchiolitis obliterans (BO) (21 BAL); (d) tho se with intra-alveolar cytomegalovirus (CMV) but asymptomatic (11 BAL) ; (e) those with an associated intra-alveolar CMV and AR (7 BAL); (f) those with CMV pneumonia (11 BAL); (g) those with infectious pneumonia excluding CMV (11 BAL). The alveolar cytological data were compared t o those from control subjects who were smokers (7 BAL) or non-smokers (8 BAL). Excluding the BO group, the total cell count from the BAL of transplanted patients was significantly higher than in the non-smoking controls and was approaching that of the smoking controls. The lympho cytes count was significantly higher in transplanted patients without complication and in the AR group than in th controls, but there was no significant difference between the two groups. There was a significan tly greater eosinophilia at the time of AR than either before or after . Eosinophilia was also higher in grade 3 AR then in grade 1 or 2 AR. These data stress the absence of any correlation between the lymphocyt e count in the BAL and the existence of AR. Alternatively, the alveola r eosinophilia observed at the time of AR does not allow the possibili ty of an infection to be elimitated with certainty.