Chronic rejection in single-lung transplantation manifested by obliterative bronchiolitis

Chronic rejection of the lung in patients with heart-lung transplants has most often been associated with the development of obliterative bronchiolitis. Previously only one patient receiving a single-lung transplant suffered from the development of this problem. We describe a patient whose obliterative bronchiolitis developed 9 months after single-lung transplantation. Progressive deterioration occurred until his death from obliterative bronchiolitis at 21 months after transplantation. The functional and histologic changes are described and the possible mechanisms discussed.