Lung transplant rejection
| Type | Onset | Etiology | Pathophysiology |
|---|---|---|---|
| Hyperacute | Minutes to hours | Preformed host antibodies to donor ABO or HLA | Neutrophilic infiltration with fibrinoid necrosis and thrombosis |
| Acute | ≤ 6 months | Cell-mediated response to mismatched donor HLA | Perivascular (small lung vessels) & submucosal (bronchiole) lymphocytic infiltrates |
| Chronic | Months to years | Chronic, low-grade, mixed cell-mediated and antibody response to HLA antigens | Submucosal inflammation -> granulation, scarring & bronchiolitis obliterans. |
HLA - Human leukocyte antigen.