Colombat et al listed criteria for when to perform a transbronchial biopsy in a patient with a lung transplant. The authors are from Beaujon Hospital in Clichy Cedex, France.
Patient selection: lung transplant
Indications for transbronchial biopsy:
(1) dyspnea that is not otherwise explained (by pneumonia, heart failure, etc)
(2) decrease in FEV1 by >= 11%
(3) decrease in PaO2 by >= 11 mm Hg
(4) chest X-ray abnormal
(5) poor or suboptimal response to antibiotics (presumably with a pulmonary infiltrate)
where:
• The decrease in FEV1 as a decimal fraction is ((baseline) - (current)) / (baseline). Alternatively (baseline FEV1) > 1.11 * (current FEV1)
A patient with one or more of these findings should be considered for transbronchial biopsy and bronchio-alveolar lavage.
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