Cytokine Biomarkers as Indicators of Primary Graft Dysfunction, Acute Rejection, and Chronic Lung Allograft Dysfunction in Lung Transplant Recipients: A Review

Lung transplantation is well accepted form of treatment for end-stage lung disease in selected patients. The number of lung transplants performed worldwide has increased annually with chronic obstructive pulmonary disease being the leading cause. The morbidity and mortality in the early period are due to nonspecific primary graft dysfunction (PGD) and acute lung rejection (ALR). Chronic lung allograft dysfunction (CLAD) is the cause of long-term complications following lung transplantation and seen in almost half of the patient during the first 5 years. Activation of pro- and anti-inflammatory cytokines and chemokines has been described during various phases of lung transplantation recovery. We reviewed the literature for cytokine activity associated with PGD, ALR, and CLAD. This review aims to summarize the specific associations between bronchoalveolar lavage (BAL) and plasma cytokine levels and the association of PGD, ALR, and CLAD.